Triage is a critical assessment process performed by a registered nurse by which Emergency Rooms (ERs) sort patients who present for a medical evaluation. With ER visits increasing, pressure on staff to move patients through the department is often palpable. Whether a patient decides to walk in, or come in by ambulance, the first person to assess the patient is the triage nurse. They determine the appropriate level of care needed for the presenting complaint.

After a review of literature, it was found that fatigue is correlated with shift length in triage with the highest level of fatigue being at the 8th hour of the shift. However, literature also showed that nurses overall preferred a 12-hour shift length for work-life balance, thus a creative solution was warranted to decrease risk of mis-triaging and triage error. To accommodate both findings, the plan for this project is to rotate triage nurses every four hours utilizing mid-shift nurses that are already staffed in the Emergency Room (ER). This project requires no additional cost to the hospital system as the nurses are already hired and staffed. Although not implemented yet, the goals of this creative solution are to decrease triage error, decrease nurse triage fatigue and decrease negative outcomes for patients in the ER due to an error in assigned acuity level.

Date of publication

Spring 4-15-2023

Document Type

MSN Capstone Project



Persistent identifier



Masters in Nursing Administration