BACKGROUND: Patients who frequently attend emergency departments (EDs) due to alcohol and substance use often have complex healthcare needs, which can place significant demands on services, particularly in rural areas. Nursing triage notes capture critical information about these presentations.

AIM: To use nursing triage records to provide context which can aid greater understanding of patients who repeatedly attend the ED with alcohol- or substance-related health issues within a wider dataset.

METHODS: A retrospective review of triage notes from three rural hospitals in Ireland from October 2020 to February 2023 included 31 patients who had attended more than ten times each, accounting for 623 attendances in total. Data were analysed for substance use, mental and physical health concerns, mode of arrival and referral, including any police involvement.

RESULTS: Alcohol was implicated in 94.7% (n=590) of attendances. Mental health crises occurred in 13.3% (n=83), physical injuries in 38.7% (n=241), and issues surrounding withdrawal or detoxification in 10.6%(n=66). Ambulances transported 49.9% (n=311) of patients, and the police (An Garda Síochána in Ireland) were involved in 8.2% (n=51) of cases.

CONCLUSION: Nursing triage notes provide essential insight into the complex health needs of frequent attenders seeking emergency care. They can assist nurses in the early identification of patients who would benefit from integrated care pathways and coordinated interventions. This would reduce repeated presentations to the ED and improve patient-centred care and patient outcomes in rural settings.