Influence of culturally and linguistically diverse status on emergency triage documentation among patients with confirmed sepsis: A qualitative content analysis.

INTRODUCTION: Sepsis is a medical emergency, characterised by a dysregulated immune system response to infection. It requires a prompt and accurate clinical history to recognise and treat early. This process may be more complex when patients are from Culturally and Linguistically Diverse (CaLD) backgrounds. Linguistic and cultural barriers may impede the ability of a triage nurses in Emergency Departments (ED) to obtain adequate clinical information delaying the recognition of sepsis and initiation of the Sepsis Pathway. Therefore, this study explores how a CaLD background may influence sepsis recognition at triage through qualitative analysis of triage notes of patients with a confirmed diagnoses of sepsis in ED.

METHODS: Data were collected from 1000 participants with confirmed sepsis in Greater Western Sydney, NSW Australia between January 2022 and May 2024. Data were analysed using a hybrid approach to qualitative content analysis, drawing on both inductive and deductive reasoning.

RESULTS: Three key themes were constructed: 1. Language and cultural barriers to clinical communication; 2. Arrival context shapes the depth of triage narratives; 3. Altered physiological and cognitive function influence symptom expression and compound language barriers.

CONCLUSIONS: These three themes highlighted potential factors to timely recognition of sepsis in CaLD populations. Understanding and recognising these factors may further support timely assessment, accurate triage and early recognition of sepsis in CaLD populations.