Triage Education Research Articles

Korean Triage and Acuity Scale education using role-playing and its effects on triage competency: A quasi-experimental design.

Triage is the process of prioritizing patients in the emergency department (ED). This has a pivotal role in ensuring patient safety and that the ED operates smoothly; therefore, triage training education is an important aspect of triage nurses' preparedness in different emergency situations. This study employed a quasi-experimental research design using a non-equivalent control group pre-post-test design to verify the effect of the Korean Triage and Acuity Scale (KTAS) education using role-playing on the knowledge of triage, triage performance ability, and triage competency in nursing students. Participants were 78 fourth-year nursing students from Shinseong University in South Korea; 39 were assigned to the experimental group, and 39 to the control group. The intervention was conducted for three weeks, from January 31 to February 16, 2024. The experimental group received KTAS education through role-playing, whereas the control group received triage education through lectures. Triage knowledge (t = 2.94, p = .004) and triage performance ability (t = 3.11, p = .003) were significantly improved in the experimental group. However, there was no significant difference in triage competency between groups (t = 1.32, p = .192). The post-test score of triage record in the experimental group showed a significant improvement over time (t = 0.56, p < .001). This study demonstrated that KTAS education using role-playing was more effective in improving triage knowledge and performance ability than traditional lecture methods for nursing students. Triage education programs should be developed considering the effectiveness of various teaching methods.

Validity and Reliability of The START Triage Knowledge and Attitude Instrument in Medical Personnel and Health Workers

Medical and health personnel have the potential to play an important role in triage START in the event of a disaster. However, it is important to have an instrument in evaluating the level of knowledge and attitudes of medical and health dragons regarding the START triage. This instrument is essential for the development of a comprehensive and efficient START triage education program for medical and health personnel. Therefore, this study aims to assess the accuracy and consistency of knowledge and attitude instruments in conducting START triage for medical and health personnel. A cross-sectional study involving 100 respondents. This instrument is created through a literature review. The instrument totaled 10 items of statements on knowledge and 10 items of statements on attitudes categorized into 6 groups: 1) disasters; 2) START triage; 3) START triage principle; 4) START triage indicator; 5) START triage implementation procedure. The results of this study showed 100 participants, the majority of whom were female with an average age of 36 years. All participants are medical and health personnel. The instruments used in the study were validated through content validity (Pearson Product Moment) and biserial correlation. Utilizing internal consistency reliability, the study found satisfactory inter-item reliability for all knowledge items (0.70 – 0.73) and attitude items (0.86 – 0.90). Conclusion: these findings suggest that knowledge and attitudes in performing the START triage are important for medical and health personnel

Nursing student's experiences of Role-Play Scenario-Based Disaster Triage (START) training: A qualitative research

BackgroundDisasters can overwhelm healthcare systems, making effective triage a crucial skill for nurses. Role-Play Scenario-Based Disaster Triage Training offers a promising approach to prepare nursing students for these situations. Understanding students' experiences with this training method can inform its development and effectiveness in fostering disaster preparedness. However, little is known about this training experience of nursing students. In particular, by examining the challenges faced by students, the emotional distress they experience and their achievements, it will provide guidance for the development of education programs in a more comprehensive and student-oriented manner. AimThe aim of this study is to elucidate the experiences of nursing students regarding Role-Play Scenario-Based Disaster Triage Training. Design and methodsA qualitative approach was employed to comprehend participating students' experiences. Face-to-face and online semi-structured interviews were conducted with 17 students using an interview guide, and the interactions were recorded for subsequent analysis. Thematic analysis was employed to develop themes. ResultsThe study results emphasize the challenges experienced by students during triage training, their gains and the support they need to cope with the challenges they experience. Data were organized around four main themes: “Challenges of the triage process” with subthemes such as “Thinking of the actual earthquake moment” and “Ethical dilemmas”; “Emotional turmoil” with subthemes including “Anxiety” and “Fear and Helplessness”; “Achievements” with subthemes such as “Increase in knowledge and skills” and “The importance of the nurse”; and “Suggestions” with subthemes including “Continuous education” and “Mandatory course”. ConclusionsThe findings of the study provide new insights into the experiences of nursing students during the disaster triage process. The results may contribute to the improvement of future training programs by identifying the challenges and needs faced by nursing students after disaster triage education.

Field Triage Tools in Mass Casualty Incidents: A Narrative Review

Mass casualty incidents (MCIs) pose significant challenges to healthcare systems, requiring rapid and effective triage strategies to optimize patient outcomes and resource utilization. This narrative review explores the evolution, effectiveness, ethical considerations, global perspectives, and future directions of field triage tools in MCIs. Beginning with the historical perspective, milestones in triage development, such as the Simple Triage and Rapid Treatment (START) protocol and its adaptations like Jump START and Sort, Assess, Lifesaving Interventions, Treat/Transport (SALT), are discussed. Current field triage systems are evaluated, including their application, limitations, and impact on patient outcomes. Training and education programs, challenges in triage education, and ethical/legal considerations in resource allocation and informed consent are examined. Global variations in triage systems, cultural factors, collaboration efforts, and standardization initiatives are explored to understand regional differences and promote interoperability. Future directions emphasize enhancing triage accuracy, integrating triage with healthcare systems, and research priorities. The review concludes with implications for practice and policy, calling for continued research, collaboration, and innovation to advance field triage capabilities and improve emergency response worldwide.

An Education and Training Program on Disaster Triage for Nurses and Nursing Students: Literature Review

Natural disasters continue to increase globally yearly. Over 1.6 billion people live in disaster-prone areas, conflict zones, and displacement areas. The impacts of disasters highlight the importance of disaster preparedness to minimize errors in disaster triage management. However, nurses' knowledge and skills in implementing initial triage procedures are still adequate. This scooping review aims to find an overview of implementing disaster triage education and training programs. This research is a scooping review using the Prisma flow chart in its implementation. This study showed significant results in all articles (n = 14) in increasing knowledge, attitudes, skills, awareness, preparedness, accuracy, and learning motivation in conducting disaster triage. The methods used are simulation methods (live, virtual reality, and screen-based) and training and education methods (lectures, discussions, videos, roleplay, and games) with material on disaster triage, START triage, and SALT triage concepts. This study concluded that disaster triage education for nurses and nursing students is very important to be provided by carrying out the latest methods so that the results are more effective.

Enhancing triage accuracy in emergency nurses: The impact of a game-based triage educational app

IntroductionDigital technology has enabled gamification methods to enhance triage education, reflecting an evolving healthcare landscape. ObjectiveTo evaluate the effectiveness of a Gamification Triage Education App (GTEA) as a learning tool for emergency nurses, with a focus on creating an engaging and educationally effective platform for triage training. MethodThe GTEA was developed using no-code based software and expanded upon previous iterations, with added features such as points, rankings, instant feedback, and quest-based stories. From December 2021 to March 2022, 27 emergency room nurses from three hospitals in Korea were instructed to use GTEA for 100 min over the course of a week. The effects were measured before and after the intervention. ResultsThe results demonstrated a significant increase in triage accuracy from 4.3 ± 2.00 to 5.33 ± 1.47 (t = −2.18, p = 0.039), along with a substantial reduction in overtriage (t = 3.11, p = 0.004). Additionally, increases in critical thinking disposition, triage competency, and triage knowledge were observed (t = −3.11, p = 0.004; t = −2.72, p = 0.011; t = −3.14, p = 0.004, respectively). ConclusionsThe findings provide robust evidence for the effectiveness of gamification in triage training within emergency nursing.

Transforming emergency triage: Apreliminary, scenario-based cross-sectional study comparing artificial intelligence models and clinical expertise for enhanced accuracy.

This study examines triage judgments in emergency settings and compares the outcomes of artificial intelligence models for healthcare professionals. It discusses the disparities in precision rates between subjective evaluations by health professionals with objective assessments of AI systems. For the analysis of the efficacy of emergency triage; 50 virtual patient scenarios had been created. Emergency medicine residents and other healthcare providers who had triage education were tasked with categorizing triage levels for virtual patient scenarios. Also artificial intelligence systems, tasked for resolving the same scenarios. All of them were asked to use three color-coded triage of the Republic of Turkey Ministry of Health. The answer keys were created by consensus of the researchers. In addition, Emergency medicine specialists were asked to evaluate the acuity level of each scenario in order to perform sub-analyses. The study consisted of 86 healthcare professionals, comprising 31 Emergency medicine residents (26.5%), 1 paramedic (0.9%), 5 emergency health technicians (4.3%), and 80 nurses (68.4%). Google Bard AI and OpenAI Chat GPT v.3.5 were used as artificial intelligence systems. The responses compared with the answer key to determine each groups efficacy. As planned the responses from healthcare professionals were analyzed individually for acuity level of scenarios. Emergency medicine residents and other groups of healthcare providers had significantly higher numbers of correct answers compared to Google Bard and Chat GPT (n=30.7 vs n=25.5). There was no significant difference between ChatGPT and Bard for low and high acuity scenarios (p=0.821)CONCLUSION: AI models can examine extensive data sets and make more accurate and quicker triage judgments with sophisticated algorithms. However, in this study, we found that the triage ability of artificial intelligence is not as sufficient as humans. Amore efficient triage system can be developed by integrating artificial intelligence with human input, rather than solely relying on technology (Tab. 4, Ref. 41). Text in PDF www.elis.sk Keywords: emergency triage, AI applications, health technology, artificial intelligence, emergency management.

Crossover design in triage education: the effectiveness of simulated interactive vs. routine training on student nurses’ performance in a disaster situation

IntroductionThis study investigates the effectiveness of incorporating simulated interactive guidelines in nursing students’ performance during disaster situations, compared to routine training.MethodThis study was a crossover design with pre-and post-tests for two groups. Each group consisted of 60 students selected using the census method. SIG and routine (Face-to-Face) training sessions were conducted as a crossover design. Triage knowledge questionnaires were used in the pretest to assess triage knowledge. An OSCE test was administered in the posttest to assess student performance, followed by a triage skills questionnaire. Both questionnaires were highly reliable, as indicated by Cronbach’s alpha coefficients (0.9 and 0.95, respectively). Statistical analysis was performed using SPSS version 26 software at a significance level 0.05.ResultThe chi-square test showed that the two groups were homogeneous regarding age. Regarding knowledge level, both groups were homogeneous before the intervention (P = 0.99). Nevertheless, the results of the OSCE test showed that the students in Group A had a higher level of skill than the students in Group B (93% versus 70%). Also, 18% of the students in group B had low skills.DiscussionThe study found that student outcomes improved in both groups receiving SIG, suggesting that interaction and simulation improve learning. However, gamification is an ideal precursor to learning and not a substitute for education. Therefore, gamification should not be used as a stand-alone teaching method.ConclusionsThe crossover study found that simulators and games should not be considered stand-alone teaching methods but can contribute to learning sustainability when used alongside instruction.

Development of a Competency-Based Triage Education Application and Usability Testing for Triage Training Based on the Korean Triage and Acuity Scale.

Improving the quality of emergency nursing care requires enhancing triage competency through education programs that integrate the content of the Korean Triage and Acuity Scale, a triage system specifically developed for the Korean context. Thus, this study developed a competency-based triage education application (CTEA), based on the Korean Triage and Acuity Scale, and evaluated its effectiveness through usability testing. The CTEA used various teaching methods and game mechanisms, including lectures, case studies, and video-based scenarios, to improve triage competency. In the usability testing phase, the CTEA was refined through expert heuristic evaluation and user interviews conducted with the think-aloud method. Six themes were derived from the interviews, highlighting the need for a well-structured program with realistic scenarios, easy accessibility, gamification, functional improvements, and future triage educational applications. These findings suggest that the CTEA is effective and satisfactory for users and can contribute to improving the triage competency of emergency nurses. [J Contin Educ Nurs. 2024;55(1):33-41.].

The Training Effects of Mass Casualty Triage in Radiological Events for 119 Emergency Medical Team

Introduction:Korea Institute Radiological Medical Sciences operates an emergency medical response system in case of a radiological accident or disaster. A radiation accident or disaster can affect large-scale patients and destroy medical infrastructure. However, there is currently a lack of specialized education for treating large-scale patients or high-dose exposure patients. This study aimed to evaluate the efficiency of radiological mass casualty triage education programs and present a new training method to improve the ability of 119 emergency medical teams in the event of a radiological accident or disaster.Method:The results of mass casualty triage for radiological events were analyzed using the audience response system and questionnaire for paramedics who participated in the radiation accident response training program. For 25 paramedics, a pre-post evaluation was conducted on two items: understanding the mass triage and understanding the radiological mass triage. The data were analyzed using the SPSS WIN 23.0 program.Results:Thirty simulated patient scenarios were developed with the addition of clinical symptoms of radiation exposure based on the four trauma classifications: immediate, urgent, delayed, and death. The triage results of 30 cases conducted by 119 emergency medical teams were evaluated, and the trainees were asked to respond to the level of improvement in their knowledge of triage through pre- and post-training questionnaires. As a result of the pre- and post-education questionnaire, the degree of understanding of the mass triage was 3.8 before education and 4.4 after education, showing a significant difference (p=.003/MAX=5). The pre- and post-education questionnaire results of radiological mass triage showed a difference between 2.3 before education and 4.1 after education (p=.000/MAX=5).Conclusion:For effective radiation medical response, 119 emergency medical teams are required to have a repetitive mass triage education program for radiological events. It is especially important to provide a radiological triage system for field application.

Evaluation of emergency care education and triage implementation: an observational study at a hospital in rural Liberia

IntroductionIn Liberia, emergency care is still in its early development. In 2019, two emergency care and triage education sessions were done at J. J. Dossen Hospital in Southeastern Liberia. The...

Effect of Pediatric Triage Education on Nurses' knowledge and Attitude at Emergency Department

Effect of Pediatric Triage Education on Nurses' knowledge and Attitude at Emergency Department

EDUKASI PELAKSANAAN TRIAGE TERHADAP TINGKAT PENGETAHUAN KELUARGA PASIEN DI IGD RS ADI HUSADA KAPASARI

Introduction &amp; Aim: The Emergency Department (ED) is one of the spearheads of hospital health services aimed at providing first aid for patients. Providing emergency services to reduce morbidity and mortality rates it requires the ability of nurses to sort out patients who need help first, this sorting is called Triage. This community service aims to provide education on the implementation of triage on the level of knowledge of the patient's family in the ED. Method of Activity: Implementation of community service at the ED of Adi Husada Kapasari Hospital, January 2023, the target is the patient's family. The method of providing education on the implementation of triage to the patient's family is with lectures and media leaflets. The first stage collects the patient's family and gives a questionnaire sheet. The second stage is the delivery of material and discussion of questions and answers about the implementation of triage, as well as giving questionnaires. Results: A total of 10 representatives of the patient's family members participated. Characteristics based on age showed that half (50%) were aged 36-45 years, based on gender the majority (60%) were female, and based on education the majority (80%) had high school/vocational high school education. Knowledge of the patient's family before being given triage education showed that most (60%) had less knowledge, whereas after being given triage education most (60%) had good knowledge about triage. Discussion: Providing education on the implementation of triage to the patient's family is very useful, and has proven to be able to provide information as well as understanding regarding health service procedures in the ED, families better understand the actions given to their family members while in the ED, and can change the behavior and perceptions of the patient's family towards the procedure given by ED health workers.

E046 Clinical triage and targeting education to improve quality of referrals

Abstract Background/Aims Referral quality has been an ongoing challenge over the years. We have delivered education sessions to primary care, trialled a referral proforma and co-produced referral pathways with our clinical commissioning group. The changing workforce of primary care is important to acknowledge with more referrals now coming from nurse practitioners, pharmacists, paramedics, physician associates and first contact practitioners (FCP). This project evaluates the impact of clinical triage to help identify if we can better target education to improve the quality of referrals and the patient pathway. Methods Consultant-led triage of every rheumatology referral was introduced in July 2021. Referrals are reviewed on the electronic referral system and accepted, returned or redirected to another service. To ensure consistency standard responses have been developed. All triage outcomes are recorded in a spreadsheet alongside the referring GP practice and professional role of the referring clinician. Referral rates per 1000 patients were calculated, adjusting for population served and high and low referring practices identified. Results In January to June 2022 we received 1194 referrals; 1054 were from primary care. Table 1 shows the breakdown of referrals and triage outcome by referring clinician. Conclusion Review of triage data has helped to understand how we can target education to improve the quality of referrals. We have identified that nurse practitioners and FCPs would benefit from education focusing on what should be referred to rheumatology and what information is important to include in a referral. Many referrals were returned with a request that the patient be examined and helping clinicians understand the value of examining patients is another important theme we identified. Next steps are to organise a workshop for nurse practitioners and FCPs and to visit the high referring practices who also have higher numbers of returned referrals. Disclosure E. MacPhie: None. S.M. Fish: None. A. Madan: None. C. Rao: None. S. Horton: None.

Effectiveness of Triage Education in Children Nursing Using Two Methods of Outcome-Based Education and Education Using Lectures on the Level of Knowledge and Clinical Decision-making of Nursing Students

Introduction: Triage is a process that prevents Children from being hospitalized unnecessarily by quickly diagnosing and identifying the client's condition. Due to physiological and anatomical differences in children, nursing students must complete at least one course on pediatric triage. This study aims to evaluate the effect of teaching children triage in two ways by using lecture and outcome-based method. Methods: In this quasi-experimental study with a two-group pretest-posttest design, 57 nursing students were selected by random allocation sampling method and were randomly divided into two groups. Triage scenarios were taught and presented in two ways by using lecture and outcome-based method. One month later, the post-test was taken. Data were collected using a questionnaire assessing the knowledge and Decision Making of ESI and were analysed using SPSS. Results: The results indicated that the average scores of clinical decision-making in two groups of lecture and outcome-based education before the study were 2.94 and 3.02 and after the study were 4.37 and 4.83 respectively. The average knowledge scores before the study in two groups of lecture and outcome-based education were 6.66 and 6.30 and after the study were 7.40 and 6.83, respectively. There is no statistically significant difference between the average clinical decision-making scores and knowledge scores of students in two groups of lecture and outcome-based education. Conclusion: Based on findings, there is no statistically significant difference between the adjusted average scores of knowledges and clinical decision-making of students in two groups of lecture and outcome-based education. Therefore, in charge of nursing undergraduate course planning, using active methods such as outcome-based education to teach children's triage topics is recommended.

Teledentistry use during the COVID-19 pandemic: perceptions and practices of Ontario dentists

BackgroundTeledentistry has demonstrated to expedite oral health consultations, diagnosis, and treatment planning while mitigating COVID-19 transmission risk in dental offices. However, the use of teledentistry by clinicians remains suboptimal. Therefore, this study aimed to determine the perceptions and practices of teledentistry among dentists during the COVID-19 pandemic in Ontario, Canada, and identify associated factors.MethodsA cross-sectional study using an online 39 item survey was conducted among Ontario dentists in December 2021. The questionnaire inquired about socio-demographic attributes, as well as perceptions of teledentistry use during the pandemic, and its future application. Descriptive statistics including frequency distribution of categorical variables and univariate analysis of continuous variables were conducted. Chi-square test was used determine the associations between professionals’ attributes such as age, gender, years of practice, and location of practice, and respondents use of teledentistry. SPSS Version 28.0 was used for statistical analysis.ResultsOverall, 456 dentists completed the survey. The majority were general dentists (91%), worked in private practices (94%), were between 55 and 64 years old (33%), and had over 16 years of professional experience (72%). Approximately 49.3% reported using teledentistry; 13% started before the pandemic, and 36% during the pandemic. The most common reason for non-utilization was a lack of interest (54%). Respondents identified patient triage, consultation, and patient education as the three most important uses of teledentistry. Female dentists (p < 0.05), dentist working in private practice (p < 0.05), and those who worked in a single dental office (p < 0.05) adopted teledentistry more during the pandemic. Respondents who accessed more resources were more likely to report greater utilization of teledentistry, while those who reported being unconformable with teledentistry (p < 0.05) reported less utilization. Additionally, participants who reported feeling comfortable discussing teledentistry with others (p < 0.05), were more inclined to use it in the future.ConclusionsParticipants expressed mixed perceptions toward teledentistry with more than half indicating it is reliable for patient triaging and patient follow-ups. Despite the increased utilization during the COVID-19 pandemic, participants' lack of interest in teledentistry emerged as a barrier to its use. More education and knowledge dissemination about teledentistry's areas of application and technical aspects of use can increase interest in this tool, which may lead to a greater uptake by dental professionals.

Training program impact on nurses' knowledge and practice regarding obstetric triage

Introduction: Patients frequently make their first contact with the birth unit through the nurse in the obstetric triage unit. Also, in order to prevent denial and delay in providing the necessary care, the triage unit nurse plays a crucial role in recognizing patients who present with urgent or emergent conditions. Thus, an important part of the triage unit for nurses' orientation is the Obstetric Triage Education course, which is the first course to cover obstetric triage unit nursing care. Aim: evaluate nurses' knowledge and practice regarding obstetric triage. Research Design: The current research used a quasi-experimental pre/post-test design. Setting: Conducted at delivery, Labor, Filter Clinic, and Highly Dependent Unit on Maternity and Child Minia University Hospital. Sample: A convenient sample of all nurses (63 nurses). Tools: Two tools; the first tool consisted of two parts a self-administered Questionnaire, the assessment of nurses' knowledge in relation to obstetric triage, and the second tool observational checklist to assess nurses' practice. Results: findings of this study demonstrated that no nurses had adequate knowledge as well as a satisfactory practice about triage. Also, 100% of them had inadequate knowledge as well as an unsatisfactory level of total practice about triage. Conclusion: there were positive correlations between total knowledge as well as total practice scores among the studied sample at 0.000 levels of statistical significance. Recommendation: Regular educational programs help nurses maintain and refresh their knowledge and practice regarding obstetric triage.

Reasons for Avoiding their Local Clinics among Non-emergency Patients at Accident and Emergency Department, Pretoria, South Africa

Background: An accident and emergency department (AED) is designated for patients who need to be seen urgently. However, at Jubilee Hospital, a large number of patients regularly presented directly to the AED with minor ailments. This resulted in long queues in the already overcrowded waiting room. Methods: A cross-sectional study design with a sample of 289 participants. Results: Those aged 21-40 years accounted for 44.6% of the participants. Patients mainly arrived on Fridays (72%), and medical-related complaints (128; 44.3%) were the most prevalent. In addition, patients primarily relied on public transportation to get there (180; 62.1%). In most cases, patients had previously visited clinics more than twice (141; 58.8%). Majority of patients were aware of the community health centres’ services. Only 33.6% of the clinics that were bypassed provided services 24 hours a day. Almost 80% of bypassed clinics were within 10 km of the District Hospital. Patients’ main reasons were long queues (89.6%) and medication shortages (67.6%). In 51.2% of cases, patients were aware of the referral system, but 14.5% did not think it made sense, and 11% did not understand it well. Conclusion: Proper strict application of the triage system and education of patients will decrease emergency department overcrowding. This will improve patient safety, clinical outcomes and the efficiency of the health system. In addition, changing local clinics’ operating hours will assist in reducing the high number of patients seen at Jubilee Hospital.

Perspective of Emergency Pediatric Nurses Triaging Pediatric Patients in the Emergency Department: A Phenomenographic Study

IntroductionTriage, a process to determine illness severity, is implemented by emergency nurses to prioritize treatment and provide care for a maximum number of patients using limited resources. The competency of emergency nurses and a highly reliable triage are crucial for the provision of emergency care. Pediatric patients are different from adult patients in certain aspects, such as growth-phase characteristics, communication ability, and the onset of disease; these aspects often pose challenges during their primary triage. This study explored how emergency nurses triage pediatric patients using the Korean Triage and Acuity Scale. MethodsEleven emergency nurses (N = 11) working in the pediatric emergency department of a university hospital in Seoul, South Korea, were recruited using purposive sampling methods. Phenomenography was used to investigate the strategies by which these nurses use the Korean Triage and Acuity Scale to triage pediatric patients. ResultsThe findings comprised 2 descriptive categories: 6 approaches on how to triage patients (categories of how) and 3 strategies (categories of what) used by pediatric emergency nurses to triage pediatric patients with the Korean Triage and Acuity Scale. DiscussionThe experience and proficiency of emergency nurses are essential factors for the effective triage of pediatric patients. Our findings qualitatively elucidate different ways of understanding pediatric triage and indicate the need for pediatric triage education programs.

NCMP-25. THE EFFECTS OF POLYPHARMACY IN PATIENTS WITH PRIMARY BRAIN TUMORS

Abstract Polypharmacy has been described as the use of five or more medications. With the effects of polypharmacy, patients may report difficulty with adherence to therapy, adverse drug-drug interactions, adverse drug-disease interactions, and cost. The development of cancer treatments for brain cancer is accomplished through clinical trials and the unfortunate truth is that most glioblastoma patients will have died in the time it can take to test a new treatment with more than half dying within the first 15 months of diagnosis. Upon completion, participants will be able to describe the effects of polypharmacy in patients with primary brain tumors in the outpatient setting. Additionally, participants will be able to identify the knowledge, skills, and attitudes necessary in the provision of nursing care to the patient with primary brain tumors. A working group comprised of two registered nurses in specialty neuro-oncology was formed. A knowledge, skills, ability framework was used to develop a survey to assess nurses' knowledge, skills, and attitudes regarding the effects of polypharmacy in patients with primary brain tumors. Two nurses were surveyed. Mean scores were calculated and ranked. The nurses reported important knowledge includes understanding of medication adverse and side effects, epidemiology and disease states including tumor histology. Important skills include neurological exam, triage, critical thinking, and patient education. The goal is to investigate the possibility of prioritizing care to include both a balance between treating the disease, use of concomitant medications and their associated adverse events. And in doing so encourage the individual to report an adverse event. In so doing this the patient is provided a wholistic treatment plan tailoring care to the individual. There was a stronger desire to better understand and manage these events.