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clinical nurse specialist, emergency department nurses, Emergency Severity Index (ESI), mobile technology, simulation-based learning experience (SBLE)



  1. Campbell, Denise DNP, RN, ACNS-BC, CEN, CHSE
  2. Fetters, Lisa DNP, RN, AG-ACNP, CCNS
  3. Getzinger, Jac MSN, RN, TCRN
  4. Perko, Alayna BSN, RN, CEN
  5. Slater, Scott MSN, RN, FNP-C


Purpose/Aims: The purpose of this quality improvement project was to examine the use of video-simulated scenarios and mobile technology to improve accuracy of emergency department (ED) nurses' triage using the Emergency Severity Index (ESI).


Design: A quality improvement project with a pre/post educational intervention design consisting of a convenience sample (n = 33) of ED registered nurses (RNs) at a large tertiary hospital in the Midwest was used.


Methods: A retrospective chart review (n = 495) was completed to obtain ESI accuracy for each triage RN. For 12 consecutive weeks, the ED RNs received different video simulations via mobile technology to determine the ESI level. After receiving their scores, the project team provided the RNs the correct ESI score with rationale via mobile technology. Post intervention, a retrospective chart review was conducted to evaluate RNs' ESI accuracy.


Results: Results of this ED triage educational intervention to improve the accuracy of ED nurses' ESI scores were not significant; however, this novel approach may be considered in addition to other teaching strategies to improve outcomes.


Conclusions: Triage nurses' ESI scoring accuracy can be inconsistent. Therefore, to ensure patients are receiving prompt and appropriate care for their acuity level, it is important to continuously provide education on ESI scoring.