Critical Medical and Surgical Nursing Journal
Vol. 15 No. 2 (2026): JUNE 2026

Concept Analysis of Nursing Triage Accuracy Using the Emergency Severity Index: A Walker and Avant Approach

Ni Luh Putu Inca Buntari Agustini (Master Master Program in Nursing, Faculty of Health, Institute of Technology and Health Baliin Nursing, Faculty of Health, Institute of Technology and Health Bali,)
Santika Wiadnyana (Master Master Program in Nursing, Faculty of Health, Institute of Technology and Health Baliin Nursing, Faculty of Health, Institute of Technology and Health Bali,)
I Gusti Lanang Suta Jayendra (Master Master Program in Nursing, Faculty of Health, Institute of Technology and Health Baliin Nursing, Faculty of Health, Institute of Technology and Health Bali,)
I Putu Purnamayasa (Master Master Program in Nursing, Faculty of Health, Institute of Technology and Health Baliin Nursing, Faculty of Health, Institute of Technology and Health Bali,)
Ni Made Sari Utami (Master Master Program in Nursing, Faculty of Health, Institute of Technology and Health Baliin Nursing, Faculty of Health, Institute of Technology and Health Bali,)
Putri Dewi Utari (Master Master Program in Nursing, Faculty of Health, Institute of Technology and Health Baliin Nursing, Faculty of Health, Institute of Technology and Health Bali,)
Ni Wayan Sukerti (Master Master Program in Nursing, Faculty of Health, Institute of Technology and Health Baliin Nursing, Faculty of Health, Institute of Technology and Health Bali,)
Ni Luh Dwi Indrayani (Master Master Program in Nursing, Faculty of Health, Institute of Technology and Health Baliin Nursing, Faculty of Health, Institute of Technology and Health Bali,)
I Gede Putu Darma Suyasa (Master Master Program in Nursing, Faculty of Health, Institute of Technology and Health Baliin Nursing, Faculty of Health, Institute of Technology and Health Bali,)



Article Info

Publish Date
30 Jun 2026

Abstract

Introduction: Emergency nursing triage requires accurate and consistent decision-making to ensure patient safety and appropriate care prioritization. The Emergency Severity Index (ESI) is widely used as a five-level triage framework; however, conceptual ambiguity remains regarding nursing triage accuracy in its application. This study aimed to analyze the concept of nursing triage accuracy using ESI through Walker and Avant’s concept analysis method. Method: This study used Walker and Avant’s concept analysis approach. Literature from PubMed and ScienceDirect published between 2020 and 2025 was reviewed to identify concept uses, defining attributes, antecedents, consequences, empirical referents, and illustrative cases. Results: Nursing triage accuracy using ESI was identified as a multidimensional concept. Its defining attributes include clinical judgment, consistency in decision-making, accurate patient prioritization, reliability of clinical decisions, and patient safety-oriented decision-making. Key antecedents include nurses’ competence, emergency nursing experience, ESI training, standard operating procedures, adequate facilities, and healthcare system support. Consequences include improved patient safety, reduced undertriage and overtriage, shorter waiting times, efficient resource allocation, and improved emergency nursing care quality. Conclusions: Nursing triage accuracy using ESI is defined as the nurse’s ability to make accurate, consistent, reliable, and patient safety-oriented triage decisions by assessing patient acuity, recognizing clinical urgency, and prioritizing care appropriately within the ESI framework.

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Journal Info

Abbrev

CMSNJ

Publisher

Subject

Health Professions Nursing

Description

Critical Medical and Surgical Nursing Journal (CMSNJ) (p-ISSN: 2355-1992), (e-ISSN: 2656-470X) was established at the end of 2012 under Universitas Airlangga. The CMSNJ was prepared in response to the development of nursing/health science and technology to contribute to the development of ...