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Overcrowding and long waiting times remain perennial issues in many emergency departments globally, resulting in unsafe and inefficient care. To facilitate the treatment of patients that arrive in the Emergency Department a triage process is often implemented. Triage enables the Emergency Department staff to prioritize patient care so that patients requiring more immediate care are seen first. This study described the competence and critical thinking ability of triage nurses in a selected hospital in Lipa City, Batangas, Philippines. The quantitative descriptive correlational research design was used in this study. Data was gathered through a self-administered questionnaire that adopted Yoon Critical Thinking Disposition and Triage Decision Making Inventory by Cone (2000). Results showed that decision-making competency is significantly different among different age groups (F=40.93, p<0.0001). Respondents’ critical thinking ability based on objectivity, healthy scepticism, systematicity and intellectual fairness, intellectual curiosity, self-confidence and prudence was at moderate level, with composite means of 3.23, 3.43, 3.22, 3.37, 3.33, 3.28, and 3.27, respectively.  Based on the results of the study, participants had a moderate level of critical thinking ability while doing triage. Also, over-all decision-making ability significantly increased with age and years of experience. Furthermore, objectivity, self-confidence, prudence and over-all critical thinking ability are significantly associated with age. Moreover, the triage nurses’ decision-making skills can be greatly influenced by their critical thinking ability.

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Comia, R. L., Floranda, L. M. M., & Durante, C. A. G. (2023). Decision-Making Competence and Critical Thinking Ability among Triage Nurses in a Selected Hospital in Batangas, Philippines. International Journal of Multidisciplinary: Applied Business and Education Research, 4(8), 2863-2871.


Al Hasani, A., & AL-Rawajfah, O. (2019). Effectiveness of implementing emergency severity index triage system in a selected primary health care center in Oman: a quasi-experimental study. Journal of Emergency Nursing.
Aloyce, R. Leshabari, S., & Brysiewicz, P. (2014). Assessment of knowledge and skills of triage among nurses working in emergency centres in Dar es Salaam Tanzania. African Journal of Emergency Medicine, 14-18.
Ausserhofer, D., Zaboli, A., Pfeifer, N., Solazzo, P., Magnarelli, G., Marsoner, T., . . . Turcato, G. (2021). Errors in nurse-led triage: an observational study. International Journal of Nursing Studies.
Chen Qiuju, Fang, Huang Ping, et al. (2015). The design and application of emergency triage information system. Chinese Journal of Nursing. 963-966
Cone, K. J., & Murray, R. (2002). Characteristics, insights decision making, and preparation of ED triage nurses. Journal of Emergency Nursing, 28: 401-6. Creswell, J. Educational Research. 2nd Edition. Pearson Prentice Hall. New Jersey. p. 237
Deng Meirong, (2006). Development of critical thinking ability of clinical nurses, Journal of Jinggangshan Medical College, 2016, Volume 13, Issue 6.
Domagala, S. E., & Vets, J. (2015). Emergency nursing triage: keeping it safe. Journal of Emergency Nursing, 313-316.
Duan Yanping, Hu Li, Ding Yinhua, (2018), Research on the Formation and Application Effect of Critical Thinking in Emergency Nursing, World Latest Medicine Information (Electronic Version), 2018, Volume 18, Issue 82.
Durand, A.-C., Gentile, S., Devictor, B., Palazzolo, S., Vignally, P., Gerbaux, P., & Sambuc, R. (2011). ED patients: how nonurgent are they? Systematic review of the emergency medicine literature. American Journal of Emergency Medicine, 333-345.
Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling. American Journal of Theoretical and Applied Statistics, 5(1): 1-4.
Fan Ying, Yuan Xiuqun. (2015). Application and effect evaluation of emergency pre-examination and triage system. Chinese Nursing Management, 2015, Issue 01.
Fong, R., Glen, W., Jamil, A., Tam, W., & Kowitlawakul, Y. (2018). Comparison of the emergency severity index versus the patient acuity category scale in an emergency setting. International Emergency Nursing, 13-18.
French, S., Gordon-Strachan, G., Kerr, K., Bisasor-McKenzie, J., Innis, L., & Tanabe, P. (2021). Assessment of interrater reliability of emergency severity index after implementation in emergency departments in Jamaica using a learning collaborative approach. Journal of Emergency Nursing, 58-65.
Ghazali, S. A., Abdullah, K. L., Foong, M. M., Ahmad, R., & Hussin, E. D. (2020). The impact of adult trauma triage training on decision-making skills and accuracy of triage decision at emergency departments in Malaysia: a randomized control trial. International Emergency Nursing, 51.
Göransson, k. E., Ehrenberg, A., Marklund, B., & Ehnfors, M. (2006). Emergency department triage: is there a link between nurses’ personal characteristics and accuracy in triage decisions? Accident and Emergency Nursing, 51.
Guo, Z., Jin, J., Chen, S., Yang, M., Wang, Y., & Sa, W. (2020). Reliability and validity of the four-level Chinese emergency triage scale in mainland China: a multicenter assessment. International Journal of Nursing Studies.
Hammad, K., Peng, L., Anikeeva, O., Arbon P., Du, H., & Li, Y. (2017). Emergency nurses’ knowledge and experience with the triage process in Hunan Province, China. International Emergency Nursing, 25-29.
Johnson, K. D., Punches, B. E., & Smith, C. R., (2021). Perceptions of the essential components of triage: a qualitative analysis. Journal of Emergency Nursing, 192-197.
Liu Wei, Huang Qingbo, Ding Suyun (2016). Construction of Quality Evaluation Standards for Pre-examination and Triage System in Emergency Department. Journal of Nursing, 2016, Volume 31, Issue 13.
Martínez-Segura, E., Lleixà-Fortuño, M., Salcadó-Uscah, T., Solà-Miravete, E., Adell-Lleixà, M., Chanovas-Borrás, M. R., . . . Mora-López, G. (2017). Competence of triage nurses in hospital emergency departments. Emergencias, 29:173-177.
Mistry, B., De Ramirez, S. S., Kelen, G., Schmitz, P. S., Balhara, K. S., Levin, S., . . . Hinson, J. S. (2018). Accuracy and reliability of emergency department triage using the emergency severity index: an international multicenter assessment. Annals of Emergency Medicine, 581-587.
Ng, C. J., Hsu, K. H., Kuan, J. T., Chiu, T. F., Chen, W. K., Lin, H., Chen, J. C. (2010). Comparison between Canadian triage and acuity scale and Taiwan triage system in emergency departments. Journal of the Formosan Medical Association, 828-837.
Parenti, N., Reggiani, M. L., Iannone, P., Percudani, D., & Dowding, D. (2014). A systematic review on the validity and reliability of an emergency department triage scale, the Manchester Triage System. International Journal of Nursing Studies, 1062-1069.
Patel, V. L., Gutnik, L. A., Karlin D. R., & Pusic, M. (2008). Calibrating urgency: triage decision-making in a pediatric emergency department. Advances in Health Sciences Education, 503-520.
Rahmati, H., Azmoon, M., Meibodi, M. K., & Zare, N. (2013). Effects of triage education on knowledge, practice, and qualitative index of emergency room staff: a quasi-interventional study. Bulletin of Emergency and Trauma, 69-75.
Reay, G., Smith-MacDonald, L., Then, K. L., Hall, M., & Rankin, J. A. (2020). Triage emergency nurse decision-making: Incidental findings from a focus group study. International Emergency Nursing.
Reblora, J., Lopez, V., & Goh, Y.-S. (2020). Experiences of nurses working in a triage area: an integrative review. Australian Critical Care, 567-575.
Rehman, S. A., & Ali, P. A. (2016). A review of factors affecting patient satisfaction with nurse-led triage in emergency departments. International Emergency Nursing, 38-44.
Ren Huicai, Wang Zhixian, Wang Li. (2018). The status quo of the triage emergency department and the research progress of its improvement measures. Nursing Practice and Research, 2018, Volume 15, Issue 11.
Smith, A. (2013). Using a theory to understand triage decision-making. International Emergency Nursing, 113-117.
Smith, A., & Cone, K. J. (2010). Triage decision-making skills, a necessity for all nurses. Journal for Nurses in Staff Development, E14-E19.
Stone, E. L., & Foley, A. L. (2019). Clinical decision support systems in the emergency department: opportunities to improve triage accuracy. Journal of Emergency Medicine, 220-222.
Tian Bing. (2019). The urgency of cultivating nurses’ critical thinking in nursing education in my country. Course Education Research, Issue 11, 2019.
Wang Mingping. (2019). Investigation and Research on the Diagnosis Ability of Emergency Nurses. Electronic Journal of Clinical Medicine Literature, Issues 46, 2019
Wolf, L. A., Delao, A. M., Perhats, C., Moon, M. D., & Zavotsky, K. E. (2017). Triaging the department, not the patien: United States emergency nurses’ experience of the triage process. Journal of Emergency Nursing.
Xi Shuhua, Li Rui. (2016). Establishment and current situation of domestic emergency pre-examination and triage standards. Shanghai Nursing, 2016, Issues 02.
Zhao Yuanyuan, Wang Yuqing, Wang Junyan, Chen Jing, Higher Education. (2017). Study on the status quo and related factors of pre-inspection and triage decision-making ability of emergency triage nurses in tertiary first-class hospitals, Journal of Nursing Administration, 2017, Issues 11.