Abstract:
Literature Review of the Role of Nurses in the Implementation of Triage Measures in
Emergency Installations
Anggun Dewi Apipah1, Tita Rohita2, Gita Cahyani 3
Faculty of Health Sciences, Galuh University
ABSTRACT
Background: Triage is a very important initial stage in emergency patient care to
determine treatment priorities based on the severity of the emergency. Nurses play a
spearhead in the implementation of triage, especially in making quick decisions under
pressure. However, practice in the field still shows inconsistencies regarding the
implementation of protocols, clinical skills, and accuracy in prioritization. Objective: To
identify and analyze the role of nurses in the implementation of triage measures in the
Emergency Facility (IGD) through a literature review. Methods: This study used a
literature review method conducted systematically on 10 national and international
journals selected from the PubMed, ScienceDirect, and Google Scholar databases, with a
publication year range of 2015–2025. Journal selection is carried out based on PICOS
criteria with quantitative, qualitative, and mixed methods study designs. Results: The
majority of journals (70%) used a cross-sectional design, and all showed that nurses'
competencies, such as triage knowledge, work experience, and formal training, had a
significant impact on the effectiveness of triage. The results of the analysis showed that the
accuracy of priorities and response time of nurses were the main indicators of triage
success. However, no journal explicitly examined patient safety as a primary outcome.
Conclusion: This literature review confirms that nurses have a vital role in the
implementation of triage in the emergency room. Adequate competence determines the
accuracy of triage decision-making and has a direct impact on service efficiency.
Strengthening training and periodic evaluation needs to be carried out to ensure the quality
of triage implementation by nurses.
Keywords: Nurse role, triage, Emergency Installation, triage implementation
