Are Telephone Triage Nurses Using Guidelines?

RECENT RESEARCH has found that Computerized Decision Support Systems (CDSS) do not perform effectively (or possibly safely)as decision support tools. Technical deficiencies included: not supportive of decision making, inconsistent documentation leading to mistriage, unintended self-care recommendations, information missing or outdated, questions subject to variable interpretation, clinical information captured incorrectly, lack of lay language, overly long algorithms prolonging the triage process and hindering communication. (Ernesater, Holmstrom, Moriarty).

In addition to introducing error, CDSS may interfere with decision-making.  One unintended consequence of the lack of user-friendliness is non-compliance. Not only are CDSS not being used as intended (especially by experienced clinicians, but dispositions were pre-empted, modified or customized by users (Greatbatch, Holmstrom).

• Do you and your colleagues use your electronic guidelines as intended?
• What is your experience of using CDSS?
• What would improve CDSS?

Written by Sheila Wheeler (14 Posts)

SHEILA WHEELER, RN, MS, is acknowledged as an international expert in the field of telephone triage. She has practiced nursing for over 30 years, primarily in critical care, emergency department and clinic settings. An accomplished writer, educator, researcher and consultant, Ms. Wheeler is currently President of TeleTriage Systems in San Anselmo, California.