Journal of advanced nursing · 2025
Experiences of Emergency Triage Nurses and Evidence of Bias in the Assessment of People Experiencing Homelessness.
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Martineau Jackson Kim Y, Vogelsmeier Amy, Brandt Lea, Popejoy Lori, Sherwin LeeAnne B
Аннотация
AIM: To describe how the potential presence of cognitive biases in emergency nurses may influence the triage process in people experiencing homelessness compared to those who were not.
DESIGN: Qualitative descriptive design using observations and interviews.
METHODS: Twelve emergency department nurses participated in interviews after being observed for over 128 triage patient interactions. Qualitative content analysis was used for observation data and thematic analysis was used for interview data. Findings were compared to identify differences and similarities between the observed presence of bias and nurses' described experiences.
RESULTS: Observation findings included two themes: (1) Emergency medical services (EMS) presentation: Words matter and (2) Nurse response: Taking action. Interview findings identified four themes: (1) Objective interpretation, (2) Subjective interpretation, (3) Resulting disparities, and (4) Busy environment. Differences included nurses' observed actions of often disregarding people experiencing homelessness compared to perceptions of remaining impartial. Similarities included the presence of bias in observation and interviews and reflected how personal labels and assumptions can influence nurse response.
CONCLUSION: Findings provide evidence about how cognitive biases can influence the type of nurse response when triaging people experiencing homelessness and suggest an opportunity for future research to investigate strategies to mitigate bias during triage.
IMPLICATIONS: Emergency nurses may require additional bias awareness education specific to vulnerable populations.
IMPACT: Evidence from this research added knowledge about how bias in emergency nurses may influence nurse response when triaging people experiencing homelessness.
REPORTING METHOD: COREG.
PATIENT CONTRIBUTION: Patient contribution included presence and behaviour within the observed nurse/patient interactions, providing data for the descriptive statistics. Patients were not actively involved in data collection or analysis in a participatory sense.
DESIGN: Qualitative descriptive design using observations and interviews.
METHODS: Twelve emergency department nurses participated in interviews after being observed for over 128 triage patient interactions. Qualitative content analysis was used for observation data and thematic analysis was used for interview data. Findings were compared to identify differences and similarities between the observed presence of bias and nurses' described experiences.
RESULTS: Observation findings included two themes: (1) Emergency medical services (EMS) presentation: Words matter and (2) Nurse response: Taking action. Interview findings identified four themes: (1) Objective interpretation, (2) Subjective interpretation, (3) Resulting disparities, and (4) Busy environment. Differences included nurses' observed actions of often disregarding people experiencing homelessness compared to perceptions of remaining impartial. Similarities included the presence of bias in observation and interviews and reflected how personal labels and assumptions can influence nurse response.
CONCLUSION: Findings provide evidence about how cognitive biases can influence the type of nurse response when triaging people experiencing homelessness and suggest an opportunity for future research to investigate strategies to mitigate bias during triage.
IMPLICATIONS: Emergency nurses may require additional bias awareness education specific to vulnerable populations.
IMPACT: Evidence from this research added knowledge about how bias in emergency nurses may influence nurse response when triaging people experiencing homelessness.
REPORTING METHOD: COREG.
PATIENT CONTRIBUTION: Patient contribution included presence and behaviour within the observed nurse/patient interactions, providing data for the descriptive statistics. Patients were not actively involved in data collection or analysis in a participatory sense.