Emergency nurses’ triage narrative data, their uses and structure: a scoping review protocol

• Published in: BMJ open Vol. 12; no. 4; p. e055132
• Main Authors: Picard, Christopher Thomas, Kleib, Manal, O'Rourke, Hannah M, Norris, Colleen M, Douma, Matthew J
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 13.04.2022; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Protocol
• Subjects: accident & emergency medicine; Artificial intelligence; Codes; Datasets; Documentation; Emergency medical care; epidemiology; Health Informatics; Hospitals; Humans; Influenza; Kappa coefficient; Narratives; Nurses; Nursing; Patients; Peer Review; Research Design; Review Literature as Topic; Surveillance; Systematic review; Systematic Reviews as Topic; Triage; accident & emergency medicine; epidemiology; health informatics
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2021-055132

IntroductionThe first clinical interaction most patients have in the emergency department occurs during triage. An unstructured narrative is generated during triage and is the first source of in-hospital documentation. These narratives capture the patient’s reported reason for the visit and the initial assessment and offer significantly more nuanced descriptions of the patient’s complaints than fixed field data. Previous research demonstrated these data are useful for predicting important clinical outcomes. Previous reviews examined these narratives in combination or isolation with other free-text sources, but used restricted searches and are becoming outdated. Furthermore, there are no reviews focused solely on nurses’ (the primary collectors of these data) narratives.Methods and analysisUsing the Arksey and O’Malley scoping review framework and PRISMA-ScR reporting guidelines, we will perform structured searches of CINAHL, Ovid MEDLINE, ProQuest Central, Ovid Embase and Cochrane Library (via Wiley). Additionally, we will forward citation searches of all included studies. No geographical or study design exclusion criteria will be used. Studies examining disaster triage, published before 1990, and non-English language literature will be excluded. Data will be managed using online management tools; extracted data will be independently confirmed by a separate reviewer using prepiloted extraction forms. Cohen’s kappa will be used to examine inter-rater agreement on pilot and final screening. Quantitative data will be expressed using measures of range and central tendency, counts, proportions and percentages, as appropriate. Qualitative data will be narrative summaries of the authors’ primary findings.Patient and public involvementNo patients involved.Ethics and disseminationNo ethics approval is required. Findings will be submitted to peer-reviewed conferences and journals. Results will be disseminated using individual and institutional social media platforms.