Effect of a Manchester Triage System-Based Digital Decision Support System on Nurse Triage Accuracy and Triage Concordance

This study will evaluate the effect of a Manchester Triage System (MTS)-based digital decision support system (MTS-DSS) on emergency nurses' triage accuracy and triage concordance. The study will use a single-group pretest-posttest quasi-experimental design and will be conducted in the adult emergency department of Dr. Burhan Nalbantoğlu State Hospital, Nicosia, Northern Cyprus.

Emergency nurses participating in the study will first perform routine triage according to their usual clinical practice during the pretest phase. Patient-related triage information, including presenting complaint and relevant clinical findings, will be recorded by the researcher. The nurses will subsequently receive structured training on the Manchester Triage System and the use of the digital decision support system.

Following the training period, nurses will perform triage during the posttest phase. The nurse will initially make a triage decision based on clinical assessment and will then enter the relevant patient information into the MTS-DSS. The system will provide a triage category based on the MTS algorithms. The nurse may retain or change the initial triage decision after viewing the system output.

The primary evaluations will compare triage accuracy before and after the intervention and assess the concordance between nurses' triage decisions and the MTS-DSS output. Nurse-related characteristics and relevant patient characteristics will also be recorded to describe the study population and examine factors associated with triage decisions.

The digital decision support system is web-based and will be accessed through password-protected accounts. The system will not be integrated with the hospital information system. Patient information will be recorded using study-specific codes rather than directly identifying information. Participation of nurses will be voluntary.