Effectiveness of Nurse-Initiated Sono Triage on Nurses’ Competence and Triage Rates in a Tertiary Care Emergency Department in New Delhi, India

Background: Point of Care Ultrasound is used in patient care, trauma, education, training, war, and disaster settings. Triage is a dynamic process, and in a busy high-volume department with limited information from patients, the emergency physician (EP) must triage the patient within a short period and with a high stress level; these factors increase the chance of error by the emergency physician. The nurses are also expected to do the triaging. It is imperative to do task shifting for the nurses; they can be empowered to conduct Sono triage to reduce the rate of under-triaging for better health outcomes with early identification and prompt management. Objectives: The pilot study assessed the effectiveness of Nurse-Initiated Sono triage (NISt) in enhancing nurses' knowledge and skills while improving patient triage accuracy in the emergency department (ED). Methods: A quasi-experimental pretest-post-test design was implemented at Tertiary care centre, New Delhi, India. A total of 15 nurses and 150 patients participated in the study. Data were analyzed using descriptive and inferential statistics. Results: Pre-intervention assessments showed limited knowledge and no prior training in extended focused assessment with sonography in trauma (e-FAST). Post-intervention findings demonstrated a significant increase in nurses' knowledge (mean score improvement from 17.3 to 20.9, p = 0.006) and skill acquisition. Also, 3% of patients initially triaged to the yellow zone were re-triaged to the red zone. Most nurses (mean acceptability score = 4.5) supported implementing NISt as a nurse-led initiative. Conclusion: The results suggest that nurse-initiated Sono triage can improve early identification of critically ill patients, facilitating timely interventions.