Factors Affecting the Duration of Nurses’ Decision Making in Triage in Japan

Purpose: In the present study, we aimed to identify the factors that affect nurses’ decision making in triage. Method: We used a predictive design in this survey, with triage records created by researchers and completed by triage nurses at five emergency hospitals. The survey was held for five days within January of 2012. We performed multiple linear regression analysis with triage duration as the dependent variable and all other factors as independent variables. Result: We recovered 1331 triage charts, all of which belonged to walk-in cases. The distribution of patients by triage category was as follows: Level 2 (Emergent), 2.8% of patients; Level 3 (Urgent), 16.8%; Level 4 (Less-Urgent), 42.1%; and Level 5 (Non-Urgent), 38.3%. The number of patients in the waiting room during triage averaged 14.2 ± 8.4 people. The data showed that triage duration decreased when nurses used structured triage (β = −0.27, p < 0.001) and increased when they used traditional triage (β = 0.53, p < 0.001). Triage duration also decreased with every increase in the number of patients in the waiting room (β = −0.04, p < 0.05). The regression model yielded an R2 value of 0.56 (F = 206.1, p < 0.001). Conclusion: Factors that affect decision making in triage include the presence of structured triage and the number of patients in the waiting room. These results highlight the importance of a structured triage system such as the JTAS in Japan where there is a limited history of formal triage.