Systematic ReviewResearchQuality Improvement

Education, technology, and audit-with-feedback each improved ED nurse triage quality

International Emergency Nursing (PubMed)Aug 1, 2025

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A systematic review found that education, technology, and audit-with-feedback each improved the quality of emergency department nurse triage.

What NurseJet pulled from the source

The review grouped triage-improvement strategies into education (64% of studies), technology (30%), and audit and feedback (6%), and reports all three were linked to short-term gains in triage accuracy, knowledge, and skills. The most common barriers were heavy workload and overcrowding; the strongest facilitators were nurse experience, interprofessional collaboration, and a unit culture of continuous improvement.

Why this matters for nurses

Triage is the first safety checkpoint of an ED visit, and the accuracy of that first decision shapes how quickly a deteriorating patient is seen. This may matter for nurses because it suggests triage accuracy is a trainable, auditable skill, and that pairing ongoing education with audit-and-feedback and frontline input is more likely to help than any single fix.

Bedside takeaway

Worth knowing that triage accuracy behaves like a trainable, auditable skill: education, technology, and audit-with-feedback each improved it, while workload and overcrowding degraded it.

Key takeaways

Strategies fell into three buckets: education (64% of studies), technology (30%), and audit and feedback (6%).
All three were associated with short-term improvements in triage accuracy and skills.
Workload and overcrowding were the biggest barriers; nurse experience and teamwork were the biggest facilitators.
The authors emphasize continuous training, nurse input into triage tools, and validated audit tools.

Practice implications

Treat triage accuracy as a skill to refresh, not a one-time orientation task. Use validated triage tools and engage with audit-and-feedback when offered, and recognize that overcrowding and workload degrade triage quality, which is worth escalating as a safety issue.

Limitations & cautions

Most included studies measured only short-term outcomes, so the durability of triage improvements is uncertain. A systematic review summarizes diverse studies and does not prescribe a single triage protocol; follow your facility's validated triage system.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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International Emergency Nursing (PubMed)

International Emergency Nursing (PubMed). Strategies to improve the quality of nurse triage in emergency departments: A systematic review.

Open original source

https://pubmed.ncbi.nlm.nih.gov/40532318/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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Pediatric emergency care (PubMed)Sep 7, 2026Research Article

A double-blind randomized trial found no reduction in vomiting or faster oral tolerance with intravenous pantoprazole versus placebo in children with acute gastroenteritis and persistent vomiting after ondansetron.

Peds EmergencyAI summaryReview source

Research ArticleResearchMedication SafetyAI summary · original source linked below

The trial randomized 100 children. Vomiting episodes and oral tolerance at 6 and 12 hours did not differ significantly, while median hospital stay was 2 days with pantoprazole and 1 day with placebo.

Key takeaways

The median participant age was 14 months, and 67% of participants were male.
Oral tolerance at 12 hours was 86% in both groups.
The longer stay associated with pantoprazole requires cautious interpretation because this was a single-center trial.

Why this matters on shift

The trial does not support empiric intravenous proton-pump inhibition for persistent vomiting in pediatric acute gastroenteritis after ondansetron.

Bedside takeaway

Clarify the indication for empiric acid suppression and keep hydration and oral-tolerance assessment central to care.

Nursing implications

Prioritize the ordered hydration and oral-tolerance plan, document ongoing emesis, and clarify the indication before administering empiric acid suppression.

Limitations & cautions

Abstract-only summary. This was a single-center study of 100 children in Tehran, and the abstract does not describe adverse events or explain why hospitalization was longer in the pantoprazole group.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Pediatric emergency care (PubMed). Effect of Intravenous Pantoprazole on Clinical Outcomes in Pediatric Acute Gastroenteritis: A Placebo-Controlled RCT.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

Journal of neurosurgical anesthesiology (PubMed)Sep 4, 2026Research Article

A five-center randomized trial found similar rescue-opioid use and moderate-to-severe PACU pain with dexmedetomidine-based opioid-sparing analgesia and fentanyl-based analgesia during elective craniotomy for brain tumors.

Emergency ICUAI summaryReview source

Research ArticleResearchMedication SafetyAI summary · original source linked below

The trial randomized 500 adults. Moderate-to-severe PACU pain occurred in 145 of 242 assessed participants in the fentanyl group and 138 of 233 in the dexmedetomidine group, with no significant difference.

Key takeaways

Intraoperative rescue fentanyl use did not differ significantly between groups.
Hypotension was more common with dexmedetomidine, while postoperative shivering was less common.
Other in-hospital outcomes were similar between the two regimens.

Why this matters on shift

An opioid-sparing label did not translate into better early pain control in this trial, and the differing hypotension and shivering profiles remain relevant during perioperative handoff and recovery monitoring.

Bedside takeaway

Monitor pain, hemodynamics, sedation, and shivering in relation to the analgesic regimen and local protocol.

Nursing implications

During PACU and postoperative handoff, monitor pain, hemodynamics, sedation, and shivering according to the administered regimen and local protocol.

Limitations & cautions

Abstract-only summary. The trial involved elective tumor craniotomy at five Indian centers, both groups also received locoregional analgesia, and the abstract does not provide longer-term outcome results in detail.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Journal of neurosurgical anesthesiology (PubMed). Opioid-Sparing Versus Opioid-Based Analgesia for Craniotomy: A Multicenter Randomized Controlled Trial.

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AI-summarized from the linked source. Review the original article before applying to practice.

BMC geriatrics (PubMed)Sep 5, 2026Research Article

A multicountry emergency-department analysis found that older patients' presenting complaints did not by themselves reflect underlying severity or disposition risk.

Emergency GeriatricsAI summaryReview source

Research ArticleResearchNew Grad FriendlyAI summary · original source linked below

The analysis included 2,794 adults aged 65 or older with one non-traumatic chief complaint across 36 emergency departments in nine European countries. Shortness of breath was associated with threefold admission odds and 2.2-fold in-hospital mortality odds.

Key takeaways

Shortness of breath, abdominal pain, chest pain, weakness or fatigue, and extremity symptoms accounted for 59% of presentations.
Age 85 or older, geriatric risk factors, polypharmacy, and shortness of breath were associated with admission.
The authors called for structured evaluation, staff training, and geriatric-specific care pathways.

Why this matters on shift

A seemingly routine complaint can coexist with frailty, polypharmacy, cognitive impairment, or other risks that change emergency assessment and disposition planning.

Bedside takeaway

Pair the presenting complaint with structured geriatric, medication, cognitive, functional, and physiologic assessment.

Nursing implications

Pair the chief complaint with structured geriatric, medication, cognitive, functional, and physiologic assessment using local emergency protocols.

Limitations & cautions

Abstract-only summary. This was a secondary observational analysis of seven-day samples collected during the 2020 COVID-19 pandemic; associations do not prove causation and may not generalize to all emergency settings.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

BMC geriatrics (PubMed). Non-traumatic chief complaints in older patients in European emergency departments and associated outcomes during the Covid-19 pandemic - a secondary analysis of the cross sectional EGERS study.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

IV pantoprazole did not improve vomiting or oral tolerance in pediatric gastroenteritis

Dexmedetomidine did not improve early pain outcomes versus fentanyl for craniotomy

Chief complaint alone did not capture risk in older emergency patients