Factors Influencing the Accuracy of Triage in Non-Trauma Patients by Emergency Nurses

Authors

  • Salisa Binsama
  • Kanittha Naka
  • Natenapha Khupantavee

Keywords:

Triage, Non-trauma patients, Factor influencing triage

Abstract

The predictive study aimed to explore the accuracy of triage in non-trauma patients and its influencing factors. The participants consisted of 88 emergency nurses from all levels of hospital care, from four provinces in Southern Thailand. Data were collected by questionnaires (personal information and triage knowledge questionnaires) and patient’s triage data collection forms. The questionnaires were checked for content validity by three experts, yielding the content validity of .83 and .94. Patients’ triage data were collected from each patient’s profile after completing the treatment at the ED and were analyzed using descriptive statistics and multiple regression.
The results showed that emergency nurses were able to triage non-trauma patients correctly in 72.70% and incorrectly in 27.30%. Almost half of those with triage inaccuracy were under-triage. In addition, triage knowledge and work experience at the ED could significantly predict the accuracy of triage in non-trauma patients with a coefficient of variance of 46% (p<.01). The findings of this study could be used as a guidance to improve the quality of patient triage in the ED.

References

Bloom, B.S. (1968). Learning for Mastery. Instruction and Curriculum. Regional Education Laboratory for the Carolinas and Virginia, Topical Papers and Reprints, Number 1. Evaluation comment, 1(2), n2.Retrieved April 27, 2020 fromhttps://files.eric.ed.gov/fulltext/ ED053419.pdf

Bureau of Epidemiology Ministry of Public Health. (2018). Classified by 75 causes of illness from health facilities Of the Ministry of Public Health Whole Kingdom 2007-2014.Retrieved July 6, 2019 from http://service.nso.go.th/nso/web/statseries/statseries09.html

Buriwong, R. (Editor). (2018). MOPH ED. Triage. Nonthaburi: Bureau of Medical Technology, Department of Medical Services, Ministry of Public Health. (in Thai)

Chen, S.S., Chen, J.C., Ng, C.J., Chen, P.L., Lee, P.H., & Chang, W.Y. (2010). Factors that influence the accuracy of triage nurses' judgment in emergency departments. Emergency Medicine Journal, 27(6), 451-455.

Dewey, J. (1938). Experience and Education (Touchstone Edition 1997 ed.): New York: Simon & Schuster, New York.

Ekins, K., & Morphet, J. (2015).The accuracy and consistency of rural, remote and outpost triage nurse decision making in on e Western Australia Country Health Service Region. Australasian Emergency Nursing Journal, 18(4), 227-233.

Fathoni, M., Sangchan, H., & Songwathana, P. (2013). Relationships between triage knowledge, training, working experiences and triage skills among emergency nurses in East Java, Indonesia. Nurse Media Journal of Nursing, 3(1), 511-525.

Gilboy, N., Tanabe, P., Travers, D., & Rosenau, A. M. (2012). Emergency Severity Index (ESI): a triage tool for emergency department care, version 4. Implementation handbook, 12-0014.

Goldstein, L., Morrow, L., Sallie, T., Gathoo, K., Alli, K., Mothopeng, T., … Samodien, F. (2017). The accuracy of nurse performance of the triage process in a tertiary hospital emergency department in Gauteng Province, South Africa. South African Medical Journal, 107(3), 243-247.

Hinson, J.S., Martinez, D.A., Schmitz, P.S., Toerper, M., Radu, D., Scheulen, J., … Levin, S. (2018). Accuracy of emergency department triage using the Emergency Severity Index and independent predictors of under-triage and over-triage in Brazil: a retrospective cohort analysis. International Journal of Emergency Medicine, 11(1), 3.

Jordi, K., Grossmann, F., Gaddis, G. M., Cignacco, E., Denhaerynck, K., Schwendimann, R., … Nickel, C.H. (2015). Nurses’ accuracy and self-perceived ability using the Emergency Severity Index triage tool: a cross-sectional study in four Swiss hospitals. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 23(1), 62.

Khamkhong, M., & Naosuwan, K. (2017). Guidelines for improving the quality and safety of care for accident-emergency patients. (electronics). Academic Journal, Eastern Asia University Science and Technology, 11(3), 30-42.

Kerie, S., Tilahun, A., & Mandesh, A. (2018). Triage skill and associated factors among emergency nurses in Addis Ababa, Ethiopia 2017: a cross-sectional study. BMC Research Notes, 11(1), 658.

Khlaisuban C. (Editor). (2018). Guidelines for emergency room service arrangements that are appropriate for the level of medical institutions' potential. Nonthaburi: Bureau of Medical Technology, Department of Medical Services, Ministry of Public Health. (in Thai)

Larthum, K., & Pearkao C. (2017). A study of quality of emergency patient triage at Srinagarind Hospital. MMP, 27, 1035-1046.

Martinez-Segura, E., Lleixa-Fortuno, M., Salvado-Usach, T., Sola-Miravete, E., Adell-Lleixa, M., Chanovas-Borras, M.R., … Mora-Lopez, G. (2017). Competence of triage nurses in hospital emergency departments. Emergencias, 29(3), 173-177.

Mistry, B., De Ramirez, S.S., Kelen, G., Schmitz, P.S., Balhara, K.S., Levin, S., … Hinson, J.S. (2018). Accuracy and reliability of emergency department triage using the emergency severity index: an international multicenter assessment. Annals of Emergency Medicine, 71(5), 581-587.

Moon, S.H., & Park, Y.H. (2018). Development of a triage competency scale for emergency nurses. Journal of Korean Academy of Nursing, 48(3), 362-374.

National Institute of Emergency Medicine. (2013). A guide to guidelines for compliance and procedures for emergency patient triage and prioritization of care at emergency rooms in accordance with the criteria established by the ERC. Bangkok: National Emergency Medicine Institute. (in Thai)

National Institute of Emergency Medicine. (2018). Performance of the emergency medical service system. Retrieved September 22, 2019 fromhttps://ws.niems.go.th/ITEMS_DWH/

Pimdee, E., Prompinit, S., Mitsungnuen, T., & Pugoen, P. (2015). Inter-rater reliability of triage patients among outpatient department, accident and emegency department nurses and emergency physicians in Srinagarind Hospital. Srinagarind Medicine Journal, 30(6), 587-591.

Polit, D.F., & Beck, C.T. (2012). Nursing research: Generating and assessing evidence for nursing practice (9thed.). Philadelphia; PA: Lippincott.

Saeed, A.B., Al-Fayyadh, F.M., Alshomar, K.M., Zekry, Z.W., Alamiri, N.N., Abaalkhail, A.M., … Alaska, Y.A. (2017). Validating the implementation of the triage system in an emergency department in a University Hospital. Journal of Health Specialties, 5(2), 73.

Soontorn, T., Sitthimongkol, Y., Thosingha, O., & Viwatwongkasem, C. (2018). Factors Influencing the Accuracy of Triage by Registered Nurses in Trauma Patients. Pacific Rim International Journal of Nursing Research, 22(2), 120-130.

Suamchaiyaphum, K., Chanruangvanich, W., Thosingha, O., & Momsomboon, A. (2019). Factors influencing the accuracy of emergency severity index-based emergency patient triage. TJNC, 34(4), 34-47.

Sukswang, S. (2018). Triage nurse: beyond main process through practice. JOHSS, 5(2), 1-14

Tam, H.L., Chung, S.F., & Lou, C.K. (2018). A review of triage accuracy and future direction. BMC Emergency Medicine, 18(1), 58.

Wachiradilok, P., Sirisamutr, T., Chaiyasit, S., &Sethasathien, A. (2016). A nationwide survey of Thailand emergency departments triage systems. Thai Journal of Nursing Council, 31(2), 96-108.

Additional Files

Published

2021-09-15

How to Cite

Binsama, S., Naka, K., & Khupantavee, N. (2021). Factors Influencing the Accuracy of Triage in Non-Trauma Patients by Emergency Nurses. Princess of Naradhiwas University Journal, 13(3), 24–39. Retrieved from https://li01.tci-thaijo.org/index.php/pnujr/article/view/245631

Issue

Section

บทความวิจัย