Although there has been a significant amount of research on nurse workloads in hospital environments, there has been a lack of comprehensive investigation of the workload of triage nurses. This study assesses the workload fluctuations of triage nurses in various emergency departments in the same region and examines how workload varies based on emergency department visit volumes and seasonal fluctuations. The study is a retrospective, multicentre, observational study from January 1, 2019, to December 31, 2023, in seven Italian emergency departments, gathering information on all patients who went through the triage process. We documented the number of nurses present throughout each shift and adjusted the data to account for the number of patients attended to by each triage nurse per shift. The EDs were classified into high-inflow, medium-inflow and low-inflow categories according to the annual number of patients they served. The study included 1,223,331 emergency department triage assessments. During daytime shifts, triage nurses in high-inflow emergency departments assessed a median of 74 patients, while those in medium-inflow and low-inflow emergency departments assessed 63 and 32 patients, respectively. During nighttime shifts, triage nurses in high-inflow emergency departments assessed 26 patients, compared to 14 in medium-inflow and 5 in low-inflow emergency departments. Significant seasonal fluctuations in the workload of triage nurses were observed. This study reveals substantial disparities in the number of patients triage nurses assess, which vary according to emergency department patient inflow volumes and seasonal factors. The findings emphasise the need for more standardised and equitable workload distribution among triage nurses. Future research should aim to establish a systematic nurse staffing model for triage to ensure manageable workloads and maintain patient safety. The Strengthening the Reporting of Observational Studies in Epidemiology was used. No patient or public contribution.
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