Aderenza alle linee di indirizzo nel triage infermieristico: studio osservazionale retrospettivo monocentrico

Nurse-led triage is a key process for patient safety and for the efficient management of Emergency Departments. Adherence to regional triage guidelines is essential to ensure appropriate prioritisation, particularly in clinical presentations characterised by high decision-making complexity. To assess adherence to regional triage priority codes among patients presenting with chest pain (CP) and abdominal pain (AP), and to analyse the frequency of overtriage and its association with selected clinical and organisational variables. About this study, we have used a retrospective, monocentric observational study was conducted at the Emergency Department of the Sant’Andrea University Hospital. A total of 401 patient visits for CP and AP over a onemonth period were analysed. Triage appropriateness was assessed by comparing the nurse-assigned priority code with the expected code according to regional algorithms. Associations between triage appropriateness, nurse experience, pain intensity (Numerical Rating Scale, NRS), and time of arrival were analysed using chi-square tests. In patients with chest pain, adherence to triage guidelines was observed in 75.4% of cases, with overtriage occurring in 24.5% and no cases of undertriage. In abdominal pain presentations, adherence was 67.1%, with overtriage in 32.9% of cases. A statistically significant association emerged between nurse experience and overtriage (p-value <0,05). Pain intensity was significantly associated with higher triage codes in abdominal pain (p-value <0,05), but not in chest pain. No significant associations were found with time of arrival. Overall adherence to regional triage guidelines was satisfactory, with relevant differences between chest and abdominal pain presentations. These findings provide a quantitative description of guideline application in real-world clinical practice, within the limits of a retrospective, single-centre study.