Evidence map›Paper›PMID 39648140›Full record

Observational studyJournal of clinical nursing2026

Comparing Safety and Accuracy of Standardised Versus Subjective Triage Code Assignment by Nurses: A Multicenter Observational Simulated Study.

Arian Zaboli, Francesco Brigo, Gloria Brigiari, Magdalena Massar, Gabriele Magnarelli, Norbert Pfeifer, Tiziano Garbin, Patrick Clauser, Serena Sibilio, Gianni Turcato

Abstract readMulticenter StudyObservational StudyComparative Study
In one paragraph

Observational study in Journal of clinical nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Arian ZaboliInnovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy.ORCID https://orcid.org/0000-0002-4204-8884
Francesco BrigoInnovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy.
Gloria BrigiariUnit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
Magdalena MassarInnovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy.
Gabriele MagnarelliDepartment of Emergency Medicine, Hospital of Merano-Meran (SABES-ASDAA), Merano-Meran, Italy.
Norbert PfeiferDepartment of Emergency Medicine, Hospital of Merano-Meran (SABES-ASDAA), Merano-Meran, Italy.
Tiziano GarbinLehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, Salzburg, Austria.
Patrick ClauserLehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, Salzburg, Austria.
Serena SibilioUniversitat Basel Department Public Health, Institute of Nursing Science, Basel, Switzerland.
Gianni TurcatoDepartment of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Santorso, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStandardised triage systems have been in place for decades with minor modifications, while nurses' skills and knowledge have significantly advanced.

aimTo determine whether nurses' clinical expertise outperforms triage systems in simulated clinical cases.

designA multicenter simulated observational study.

methodsThe study was conducted from January 1, 2024 to March 31, 2024, in four Italian emergency departments, enrolling triage-performing nurses. Thirty clinical cases, based on real patients representing daily emergency department influx, were reconstructed. The primary outcome was the agreement between the triage code assigned by the Manchester Triage System and the code assigned based on clinical expertise. The secondary outcome compared the predictive ability of the codes assigned by nurses regarding clinical outcomes, such as death within 72 h, the need for hospitalisation, and the need for life-saving intervention. The study was reported in accordance with the STROBE statement.

resultsSeventy-seven triage nurses completed the 30 vignettes. The agreement between the MTS-assigned code and the clinical expertise triage reported a Cohen's kappa of 0.576 (95% CI: 0.564-0.598). For death within 72 h, the clinical expertise code reported better results than the Manchester Triage System. For life-saving interventions, the Manchester Triage System reported a lower performance than clinical expertise. The variability in triage code assignment was higher for clinical expertise compared to the Manchester Triage System.

conclusionsTriage codes assigned by nurses based on clinical expertise perform better in terms of clinical outcomes, suggesting a need to update triage systems to incorporate nurses' knowledge and skills. However, standardised triage systems should be maintained to reduce variability and ensure consistent patient classification. REPORTING

methodThe study was conducted and reported according to the STROBE statement. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Indexed as

Clinical CompetenceEmergency NursingPatient SafetyTriageEmergency Service, HospitalFemaleHumansItalyclinical competenceemergency medicineemergency nursingnursingrisk assessmentsimulation trainingstandardisedsubjectivetriage

Identifiers

PMID39648140
PMCPMC13569225

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.