DECISION FATIGUE AMONG EMERGENCY NURSES AND ITS IMPACT ON TRIAGE ACCURACY AND CLINICAL PRIORITIZATION

Abstract

Decision fatigue is a phenomenon that affects individuals who must make numerous decisions over long periods of time. In emergency care, the volume, frequency, and rapid pace of decision making, coupled with environmental stressors, can collectively lead to a decrease in decision quality over time. This literature review assesses the impact of decision fatigue on triage accuracy and clinical prioritization in emergency departments. Emergency nurses are among the first healthcare professionals to interact with patients and collect preliminary assessment data. Triage nurses are expected to assign triage categories and indicate clinical priority as part of the initial assessment. Mitigating decision fatigue during this crucial period could improve triage performance, assuring appropriate care, timely interventions, and optimal patient flow.

Emergency nursing involves a demanding, fast-paced environment that generates high workload and significant mental effort. The cumulative mental effort required to continuously monitor multiple patients, identify and prioritize patient needs, and make relevant decisions influences triage performance by creating operating pressure on emergency nurses. Accordingly, triage workflow in the emergency patient journey is studied by empirically observing the scenario, identifying predominant workflow, and pinpointing triage assessment types. A conceptual framework of decision fatigue is therefore established to identify tractable components that nurses contend within their routine environment.