The role of the nurse in reverse triage: A review of the literature

Abstract

Aim: Disasters often result in an unanticipated ‘surge’ of patients to hospitals requiring care. Hospitals are expected and required to have emergency operation management plans to expand surge capabilities to care for incoming disaster victims while continuing to care for current patients. Reverse triage for early discharge or transfer uses assessment of the clinical status of current inpatients and decision-making regarding discharge, transfer, and further definitive care to open hospital resources for a sudden surge of patients. This type of decision-making lies well within the scope of nursing practice; however, many nurses may be unaware of this patient management strategy or their role using it as a strategy to enhance hospital surge capacity.

Methods: A systematic literature review was conducted using a modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach. Inclusion and exclusion criteria were identified to query three databases (CINAHL, OVID, and PubMed) for literature addressing the role of the nurse in reverse triage of hospitalized inpatients in readiness for a disaster event patient surge.

Results: Twenty-six records were identified for full review. Of the 26 records, seven provided some reference but little information regarding the role of the nurse in reverse triage.

Conclusion: This review provided limited information regarding the role of the nurse in reverse triage. Nurses’ roles will be extended during disaster events that require a hospital to utilize surge capabilities and are integral to the process of operationalizing reverse triage. There is a lack of evidence to aide understanding of the role of the nurse in reverse triage.