Evidence map›Paper›PMID 41933431›Full record

Observational studyJournal of clinical nursing2026

Evaluation of Nurse-Led Triage in the Emergency Department: A Retrospective Observational Study.

Dolores Selva-Medrano, Jose Alberto Laredo-Aguilera, Víctor Serrano-Fernández, Juan Manuel Carmona-Torres, Ángel López-González, Inmaculada Pérez-Rodríguez, Carmen María Guerrero-Agenjo, Juan David Fernández-Sánchez, Gloria Mota-Cátedra, Joseba Rabanales-Sotos

Abstract readObservational 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. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Dolores Selva-MedranoGerencia de Atención Integrada de Albacete, Servicio de Salud de Castilla-La Mancha (SESCAM), Albacete, Spain.
Jose Alberto Laredo-AguileraFacultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha (UCLM), Toledo, Spain.ORCID https://orcid.org/0000-0002-3661-3584
Víctor Serrano-FernándezGrupo de Investigación Multidisciplinar en Cuidados (IMCU), Universidad de Castilla-La Mancha (UCLM), Toledo, Spain.ORCID https://orcid.org/0000-0002-5982-259X
Juan Manuel Carmona-TorresFacultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha (UCLM), Toledo, Spain.ORCID https://orcid.org/0000-0002-7781-872X
Ángel López-GonzálezGrupo de Actividades Preventivas en el ámbito Universitario de Ciencias de la Salud (GAP-CS), Universidad de Castilla-La Mancha (UCLM), Albacete, Spain.
Inmaculada Pérez-RodríguezGerencia de Atención Integrada de Albacete, Servicio de Salud de Castilla-La Mancha (SESCAM), Albacete, Spain.
Carmen María Guerrero-AgenjoGrupo de Actividades Preventivas en el ámbito Universitario de Ciencias de la Salud (GAP-CS), Universidad de Castilla-La Mancha (UCLM), Albacete, Spain.
Juan David Fernández-SánchezGerencia de Atención Integrada de Albacete, Servicio de Salud de Castilla-La Mancha (SESCAM), Albacete, Spain.
Gloria Mota-CátedraHospital Universitario de Toledo, Toledo, Spain.
Joseba Rabanales-SotosGrupo de Actividades Preventivas en el ámbito Universitario de Ciencias de la Salud (GAP-CS), Universidad de Castilla-La Mancha (UCLM), Albacete, Spain.ORCID https://orcid.org/0000-0002-6649-4395

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo assess the quality of the Spanish Triage System performed by nurses according to the triage code assigned to each patient and to examine factors associated with the need for re-evaluation after completion of triage.

designRetrospective longitudinal observational study.

methodsA retrospective analysis was conducted of patients triaged in the emergency department between 2018 and 2023. Patients triaged by other healthcare professionals and those who did not receive a triage priority level were excluded.

results493,211 episodes were analysed. Most were low/intermediate acuity (Level IV 65.4%, Level III 23.9%; Level I 0.1%). Mean time-to-first physician record entry increased as acuity decreased (38 min Level I vs. 81 min Level V), yet recorded time-target compliance was lowest in Levels I-II (23.8% and 14.7%). Re-evaluation occurred more often in high-acuity levels and was independently associated with older age, male sex, lower oxygen saturation and longer emergency department length of stay; compared with Level I, Levels II-III and lower adjusted odds of re-evaluation.

conclusionNurse-led triage demonstrated coherent clinical and operational stratification; however, the lowest recorded time-target compliance in the sickest patients suggests a gap between immediate care and electronic documentation. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Streamline documentation workflows for high-acuity cases and use re-evaluation risk profiles to prioritize monitoring and escalation. IMPACT: Evidence on nurse-led Spanish Triage System performance and time-documentation quality is limited. Acuity and flow metrics showed expected gradients, but target-time compliance was lowest in Levels I-II; predictors of re-evaluation were also identified. Findings support emergency department nursing, quality improvement and potential benefits for patients attending emergency departments. REPORTING

methodSTROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct or reporting.

Indexed as

Emergency NursingEmergency Service, HospitalTriageAdultAgedEmergency Room VisitsFemaleHumansLongitudinal StudiesMaleMiddle AgedRetrospective StudiesSpain

Identifiers

PMID41933431
PMCPMC13353632

What OpenQuestion holds

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Registered trials

None linked

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.