Nurses’ experiences with the Implementation of a Manchester Triage System in an Emergency Department

Background

Emergency Departments (ED) are very often confronted with a high number of non-acute patients. This circumstance has negative effects on the quality of care because of limited human resources and infrastructure in dealing with overcrowding. In Spring 2017 an Austrian hospital has implemented the Manchester Triage System to improve the management of patient flows. From the date of implementation the nurses were responsible for the preliminary assessment of the patients. The aim of this study was to investigate the nurses’ experiences and attitudes concerning the implemented Manchester Triage System as well as its impact on their work and quality of patient care.

Methods

A qualitative approach was chosen. In order to get a deep insight interviews with ten nurses were conducted by using an interview guide with open questions. The answers of the interviewed people were recorded, transcribed and analyzed by the qualitative method GABEK (GAnzheitliche BEwältigung von Komplexität).

Results

The triage process has changed the working hours, processes, collaboration, task responsibilities and stress levels. The triage process itself is defined by the nurses as diversified activity with a high degree of responsibility. Experienced, well-trained nurses guarantee an appropriate preliminary assessment of the patient. Teamwork and backing by nurses and physicians are of importance in the case of unclear patient assessments. Finally, more time is available for acute patients in order to provide them an appropriate care.

Conclusions

The Manchester Triage System has changed the nurses’ working conditions and influences positively the management of patient flow and quality of care.

Key messages

The activities of the nurses have changed into diversified tasks with a high degree of responsibility. The implementation of the Manchester Triage System has a positive impact on the patient flow and quality of care.