Purpose: Within our ambulatory primary care clinics, planning for the ever-changing needs of our patients and communities is a priority of leadership and clinical education. Ambulatory care telephone triage is one of the organization's most rapidly growing and changing specialties. Our goal was to improve and expand telephone triage nurse knowledge through the implementation of a standardized triage core class for new and experienced triage nurses. This program would be the replacement for a multitude of individual processes that existed among the over 50 ambulatory primary care practices.

Description: A literature review of evidence related to telephone triage nurses was conducted using the search terms “primary care triage,” “triage education,” and “telephone triage.” Based on these findings, a proposal was developed for a standardized triage nurse-training program. In November 2021, the triage core class was launched. Working with our ambulatory care and triage leadership, priority attendees were identified and an ongoing attendance schedule was established. This program promoted standardized, evidence-based education for all primary care telephone triage nurses and allowed them to enhance their skills, knowledge, and understanding of the significance that their role had on patient safety and satisfaction.

The triage core class was initially rolled out as a 2.5-day in-person, biweekly class. Due to a number of COVID surges and creative hiring strategies, the class was converted to a 2-day virtual, biweekly class.
Evaluation and outcome: Each attendee completed a pre-class “knowledge check” that surveyed their self-reported ability to demonstrate various tasks and skills critical to their ambulatory care telephone triage role. At the conclusion of class, attendees were notified that they would receive a post-class “knowledge check” with the same questions in the weeks following. This would provide their self-assessment after having an opportunity to apply and utilize the information learned in class. 81% of attendees responded to the post-class “knowledge check”. Responses to each of the 14 knowledge questions demonstrated an increase in the number of triage nurses who felt that they were able to demonstrate each item without assistance (between 10 to 39% increase). Additionally, triage core class attendees rated themselves using Benner’s novice to expert scale, with 53% of all new and experienced triage nurses rating themselves as competent to expert.
This program provided an opportunity to close identified educational gaps, standardize the information shared with our triage nurses, identify future educational needs and opportunities, and facilitate the delivery of high-quality patient care in a telehealth setting. It also created an opportunity for resourceful education for staff spread amongst a wide geographical area, including those that work remotely.

Rebecca Jo Teirney MSN, RN, NPD-BC, CCRN

Appearances