The following is a summary of “Cognitive biases regarding utilization of emergency severity index among emergency nurses,” published in the November 2023 issue of Emergency Medicine by Essa, et al.

For a study, researchers sought to determine the prevalence of cognitive biases among emergency nurses using the Emergency Severity Index (ESI) and to analyze the variations in these biases based on demographic factors. Emergency nurses rely on the Emergency Severity Index (ESI) to prioritize patient care effectively. However, cognitive biases compromise the accuracy of nurses’ clinical decisions during triage, potentially compromising patient care quality and safety.

Using a cross-sectional analytical design, the study engaged 208 emergency nurses across four tertiary care hospitals. Necessary ethical approvals were secured, and informed consent was obtained before collecting data. A structured scenario-based questionnaire evaluated cognitive biases across five ESI levels. Data analysis was conducted using version 25.0 of the SPSS software, encompassing descriptive and inferential statistical methods.

With a robust response rate of 86.6%, the participant demographic revealed that 56.2% were male, and 62.90% held nursing diplomas. Cognitive biases manifested across all ESI levels: 51%, 45%, 90%, 89%, and 91% for levels one through five, respectively. The observed biases included premature closure (22%), tolerance to risk (12%), satisfying bias (25%), framing effect (22%), and blind obedience (34%) across these ESI levels. Specific demographic variables such as being male, having 2 to 5 years of experience, possessing a general nursing qualification, and lacking ESI certification were associated with a higher propensity for cognitive biases during triage decisions.

The study underscored the presence of significant cognitive biases among emergency nurses during patient prioritization using the ESI. Implementing cognitive de-biasing strategies is imperative to refine triage decisions, ultimately bolstering patient care quality and safety outcomes.

Source: sciencedirect.com/science/article/abs/pii/S0735675723004394