Electronic alerts for triage protocol compliance among XXXX triage nurses: a randomized controlled trial.

@entity1 @entity341 @entity130 @entity490
BACKGROUND: Alerts embedded in electronic health records (EHRs) are designed to improve processes at the point of care. OBJECTIVE: The aim of this study was to determine if an EHR alert-at @entity341 ( @entity341 ) triage-increases the @entity341 triage nurse's utilization of triage protocols. METHODS: @entity341 triage nurses were randomized to receive either a passive EHR alert or no intervention for @entity1 with the following complaints: minor @entity130 with extremity injuries or female @entity1 with @entity490 . The EHR alert notified the nurse that the @entity1 was eligible for diagnostic testing: radiographs for @entity1 with injured extremities or urinalysis for female @entity1 with @entity490 . RESULTS: Twenty-eight nurses triaged 20,410 @entity1 in the 6 months before the intervention and 19,157 in the 6 months after the intervention. Before the intervention, the urinalysis protocol was implemented in 101/624 (16.2%) @entity1 triaged by the intervention group and 116/711 (16.3%) triaged by the control group. After the intervention, the urinalysis protocol was implemented in 146/530 (27.6%) @entity1 triaged by the intervention group and 174/679 (25.6%) triaged by the control group. Before the intervention, the radiograph protocol was implemented in 58/774 (7.5%) @entity1 triaged by the intervention group and 45/684 (6.6%) triaged by the control group. After the intervention, the radiograph protocol was implemented in 78/614 (12.7%) @entity1 triaged by the intervention group and 79/609 (13.0%) triaged by the control group. CONCLUSION: The use of a passive EHR alert to promote @entity341 triage protocols showed little benefit. Before the widespread implementation of EHR alerts for @entity1 care, rigorous studies are required to determine the best alert methods and the impacts of such interventions.
