UEA researchers warn pressure on A&E is impacting how well staff can care for patients
The study featured 51 triage nurses from hospitals across the UK through posts on social media and online forums
Researchers in Norfolk are telling us increasing pressure on A&E departments is impacting how well staff can triage patients.
The University of East Anglia's carried out the first ever survey of A&E nurses, which found issues with a lack of training, low staffing and high stress.
"Has a negative impact on their stress and their abilities to triage effectively"
Lead author Hugh Gorick, a PhD researcher at UEA’s School of Health Sciences who also works as an assistant practitioner in an NHS hospital’s Acute Medical Unit, said:
“More than 24 million patients present to emergency departments in the UK every year, resulting in a high-pressure situation with limited resources.
“When the patients arrive, they will be triaged to assess how sick they are, to know how quickly they will need to receive treatment.
“These assessments need to be rapid and accurate to prevent delays and harm from occurring.
“Triage nurses told us that if they experience low staffing and busy environments this has a negative impact on their stress and their abilities to triage effectively.
“The survey also showed there is a huge variation in the frequency and quality of training for this vital role.”
"Highlights the need to ensure triage areas are properly staffed"
Dr Marie McGee, of UEA’s School of Health Sciences, said:
“This research highlights the need to ensure triage areas are properly staffed with enough space to see patients.
“We would recommend legislation for safe nurse staffing and the development of a national standard for triage nurses with defined knowledge and skills that need to be achieved and set periods for refresher courses.
“Managers also need to ensure the psychological welfare of nurses in emergency departments, with access to proper support systems.”
What did the study involve?
It recruited 51 participants from hospitals across the UK through posts on social media and online forums for nurses.
The nurses who were assessing and prioritising patients turning up at A&E departments came from different backgrounds and ranged from very experienced to newly qualified.
When they were tested on how they make decisions in these urgent situations, they generally scored well.
But the study found that training for triage nurses varied greatly, and 53% felt they wanted more training to be available.
Meanwhile 43% felt the quality and content of the training could also be improved.
It also highlighted a lack of space to conduct assessments in emergency departments as impacting efficiency, as well as a lack of staff.
The researchers previously carried out a systematic review which found that nurses around the world favour using clinical reasoning and intuition over triage algorithms to work out how sick a patient is before triaging for treatment.
However, this latest survey showed that nurses in the UK rely more on their training and comprehensive assessments, rather than just their gut feeling when making these decisions.
The researchers acknowledged that the number of triage nurses in the UK is not known, and as such it is difficult to assess the reach of this study.