Decision-making in A&E by expert nurses.

The A&E service at Manchester Royal Eye Hospital uses triage as a method of prioritising patients to ensure that those whose needs are urgent receive immediate attention. The service has been extended to include formalised telephone triage. This study investigates the way in which telephone triage decisions are made by nurse practitioners in A&E. Although the sample is small, interviews with nurse practitioners reinforce previous theories about expert knowledge and decision-making. The practitioners use a process of hypothesis testing and a systematic and complex framework for decision-making.