Analysis of Factors Related to The Accuracy of Triage Assessment at The Emergency Room
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Abstract
Triage assessment in the emergency department plays an important role in providing appropriate and effective services for emergency patients. However, the factors that affect the accuracy of triage assessments still need to be further understood, especially in the context of the COVID-19 pandemic. This study aims to analyze the relationship between nurse response time, nurse knowledge level, and respondent characteristics with the accuracy of triage assessment in the emergency room. This study used an analytical observational approach with a cross-sectional study approach. The sample consisted of 24 emergency room nurses who were selected using a nonprobability sampling technique, namely consecutive sampling. Data were collected through questionnaires and observation sheets and analyzed using the chi-square test. The analysis showed that nurse response time had a significant relationship with the accuracy of triage scoring (p<0.001). In addition, the level of knowledge of nurses was also significantly relatedto the accuracy of triage assessment (p = 0.017). However, no significant association was found between respondent characteristics such as age, gender, and education and the accuracy of triage assessments. The results of this study concluded that nurse response time and nurse knowledge level contributed to the accuracy of triage assessment in the emergency room. Nonetheless, respondent characteristics such as age, gender, and education did not affect the accuracy of triage scoring. This research provides adeeper understanding of the factors that influence the accuracy of triage assessments, which can help improve the quality of emergency services and more accurate decision-making in emergency departments
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References
AlSerkal, Y., AlBlooshi, K., AlBlooshi, S., Khan, Y., Naqvi, S. A., Fincham, C., & AlMehiri, N. (2020). Triage Accuracy and Its Association with Patient Factors Using Emergency Severity Index: Findings from United Arab Emirates. Open Access Emergency Medicine : OAEM, 12, 427–434. https://doi.org/10.2147/OAEM.S263805 DOI: https://doi.org/10.2147/OAEM.S263805
Annisa, T., Wahdaniah, Risnah, & Ridwan, S. (2020). Validity Triage and Response Time Nurses in hospitals emergency room Sheikh Yusuf Gowa. Journal Of Nursing Practice, 3(2), 153–164. https://doi.org/10.30994/jnp.v3i2.82 DOI: https://doi.org/10.30994/jnp.v3i2.82
Ashcraft, S., Wilson, S. E., Nyström, K. V., Dusenbury, W., Wira, C. R., Burrus, T. M., & null, null. (2021). Care of the Patient With Acute Ischemic Stroke (Prehospital and Acute Phase of Care): Update to the 2009 Comprehensive Nursing Care Scientific Statement: A Scientific Statement From the American Heart Association. Stroke, 52(5), e164–e178. https://doi.org/10.1161/STR.0000000000000356 DOI: https://doi.org/10.1161/STR.0000000000000356
Bahlibi, T. T., Tesfamariam, E. H., Andemeskel, Y. M., & Weldegiorgis, G. G. (2022). Effect of triage training on the knowledge application and practice improvement among the practicing nurses of the emergency departments of the National Referral Hospitals, 2018; a pre-post study in Asmara, Eritrea. BMC Emergency Medicine, 22(1), 190. https://doi.org/10.1186/s12873-022-00755-w DOI: https://doi.org/10.1186/s12873-022-00755-w
Bijani, M., & Khaleghi, A. A. (2019). Challenges and Barriers Affecting the Quality of Triage in Emergency Departments: A Qualitative Study. Galen Medical Journal, 8, e1619. https://doi.org/10.31661/gmj.v8i0.1619 DOI: https://doi.org/10.31661/gmj.v8i0.1619
Cannavacciuolo, L., Ponsiglione, C., & D’Ambrosio, A. (2021). How to improve the Triage: A dashboard to assess the quality of nurses’ decision-making. International Journal of Engineering Business Management, 13, 18479790211065560. https://doi.org/10.1177/18479790211065558 DOI: https://doi.org/10.1177/18479790211065558
Cetin, S. B., Eray, O., Cebeci, F., Coskun, M., & Gozkaya, M. (2020). Factors affecting the accuracy of nurse triage in tertiary care emergency departments. Turkish Journal of Emergency Medicine, 20(4), 163–167. https://doi.org/10.4103/2452-2473.297462 DOI: https://doi.org/10.4103/2452-2473.297462
Cole, R., Kearney, L., Amarrador, A., Downer, T., Halsall, R., Davison, M., & Thomas, C. (2023). Using Web-based Training and Low-fidelity Simulation to Provide Education and Support to Emergency Nurses Undertaking Non-Urgent Paediatric Inter-Hospital Transfers. Clinical Simulation in Nursing, 83, 101435. https://doi.org/10.1016/j.ecns.2023.101435 DOI: https://doi.org/10.1016/j.ecns.2023.101435
Davidescu, A. A., Apostu, S.-A., Paul, A., & Casuneanu, I. (2020). Work Flexibility, Job Satisfaction, and Job Performance among Romanian Employees—Implications for Sustainable Human Resource Management. Sustainability, 12(15), Article 15. https://doi.org/10.3390/su12156086 DOI: https://doi.org/10.3390/su12156086
Delmas, P., Fiorentino, A., Antonini, M., Vuilleumier, S., Stotzer, G., Kollbrunner, A., Jaccard, D., Hulaas, J., Rutschmann, O., Simon, J., Hugli, O., Gilart de Keranflec’h, C., & Pasquier, J. (2020). Effects of environmental distractors on nurse emergency triage accuracy: A pilot study protocol. Pilot and Feasibility Studies, 6(1), 171. https://doi.org/10.1186/s40814-020-00717-8 DOI: https://doi.org/10.1186/s40814-020-00717-8
Duko, B., Geja, E., Oltaye, Z., Belayneh, F., Kedir, A., & Gebire, M. (2019). Triage knowledge and skills among nurses in emergency units of Specialized Hospital in Hawassa, Ethiopia: Cross sectional study. BMC Research Notes, 12, 21. https://doi.org/10.1186/s13104-019-4062-1 DOI: https://doi.org/10.1186/s13104-019-4062-1
Fekonja, Z., Kmetec, S., Fekonja, U., Mlinar Reljić, N., Pajnkihar, M., & Strnad, M. (2023). Factors contributing to patient safety during triage process in the emergency department: A systematic review. Journal of Clinical Nursing, 32(17–18), 5461–5477. https://doi.org/10.1111/jocn.16622 DOI: https://doi.org/10.1111/jocn.16622
Hardianto, Wiyadi, & Widiastuti, H. P. (2023). Relationship between Nurse Response Time and Accuracy of Triage in the Emergency Room. Formosa Journal of Applied Sciences, 2(5), Article 5. https://doi.org/10.55927/fjas.v2i5.3991 DOI: https://doi.org/10.55927/fjas.v2i5.3991
Huh, S.-S., & Kang, H.-Y. (2019). Effects of an educational program on disaster nursing competency. Public Health Nursing, 36(1), 28–35. https://doi.org/10.1111/phn.12557 DOI: https://doi.org/10.1111/phn.12557
Jeschke, M. G., van Baar, M. E., Choudhry, M. A., Chung, K. K., Gibran, N. S., & Logsetty, S. (2020). Burn injury. Nature Reviews. Disease Primers, 6(1), 11. https://doi.org/10.1038/s41572-020-0145-5 DOI: https://doi.org/10.1038/s41572-020-0145-5
Lea, A. I., Febriyanti, E., & Odja, N. (2022). Emergency Nurses’ Knowledge and Practices Regarding Triage. KnE Life Sciences, 872–881. https://doi.org/10.18502/kls.v7i2.10388 DOI: https://doi.org/10.18502/kls.v7i2.10388
Levis-Elmelech, T., Schwartz, D., & Bitan, Y. (2022). The effect of emergency department nurse experience on triage decision making. Human Factors in Healthcare, 2, 100015. https://doi.org/10.1016/j.hfh.2022.100015 DOI: https://doi.org/10.1016/j.hfh.2022.100015
Li, Z., Cheng, J., Zhou, T., Wang, S., Huang, S., & Wang, H. (2020). Evaluating a Nurse Training Program in the Emergency Surgery Department Based on the Kirkpatrick’s Model and Clinical Demand During the COVID-19 Pandemic. Telemedicine Journal and E-Health: The Official Journal of the American Telemedicine Association, 26(8), 985–991. https://doi.org/10.1089/tmj.2020.0089 DOI: https://doi.org/10.1089/tmj.2020.0089
Lindberg, B. H., Rebnord, I. K., & Høye, S. (2021). Phone triage nurses’ assessment of respiratory tract infections – the tightrope walk between gatekeeping and service providing. A qualitative study. Scandinavian Journal of Primary Health Care, 39(2), 139–147. https://doi.org/10.1080/02813432.2021.1908715 DOI: https://doi.org/10.1080/02813432.2021.1908715
Molina-Mula, J., & Gallo-Estrada, J. (2020). Impact of Nurse-Patient Relationship on Quality of Care and Patient Autonomy in Decision-Making. International Journal of Environmental Research and Public Health, 17(3), 835. https://doi.org/10.3390/ijerph17030835 DOI: https://doi.org/10.3390/ijerph17030835
Mulyadi, M., Dedi, B., Hou, W.-L., Huang, I.-C., & Lee, B.-O. (2022). Nurses’ experiences of emergency department triage during the COVID-19 pandemic in Indonesia. Journal of Nursing Scholarship: An Official Publication of Sigma Theta Tau International Honor Society of Nursing, 54(1), 15–23. https://doi.org/10.1111/jnu.12709 DOI: https://doi.org/10.1111/jnu.12709
Orangi, S., Orangi, T., Kabubei, K. M., & Honda, A. (2023). Original research: Understanding factors influencing the use of clinical guidelines in low-income and middle-income settings: a scoping review. BMJ Open, 13(6). https://doi.org/10.1136/bmjopen-2022-070399 DOI: https://doi.org/10.1136/bmjopen-2022-070399
Özhanlı, Y., & Akyolcu, N. (2020). Satisfaction of Patients with Triage and Nursing Practice in Emergency Departments. Florence Nightingale Journal of Nursing, 28(1), 49–60. https://doi.org/10.5152/FNJN.2020.18041 DOI: https://doi.org/10.5152/FNJN.2020.18041
Panagioti, M., Khan, K., Keers, R. N., Abuzour, A., Phipps, D., Kontopantelis, E., Bower, P., Campbell, S., Haneef, R., Avery, A. J., & Ashcroft, D. M. (2019). Prevalence, severity, and nature of preventable patient harm across medical care settings: Systematic review and meta-analysis. BMJ, 366, l4185. https://doi.org/10.1136/bmj.l4185 DOI: https://doi.org/10.1136/bmj.l4185
Phukubye, T. A., Ntho, T. A., Muthelo, L., Mbombi, M. O., Bopape, M. A., & Mothiba, T. M. (2023). Is the Triage System Welcomed in the Tertiary Hospital of the Limpopo Province? A Qualitative Study on Patient’s Perceptions. Nursing Reports, 13(1), Article 1. https://doi.org/10.3390/nursrep13010033 DOI: https://doi.org/10.3390/nursrep13010033
Pigoga, J. L., Joiner, A. P., Chowa, P., Luong, J., Mhlanga, M., Reynolds, T. A., & Wallis, L. A. (2020). Evaluating capacity at three government referral hospital emergency units in the kingdom of Eswatini using the WHO Hospital Emergency Unit Assessment Tool. BMC Emergency Medicine, 20(1), 33. https://doi.org/10.1186/s12873-020-00327-w DOI: https://doi.org/10.1186/s12873-020-00327-w
Piwowar-Sulej, K. (2021). Human resources development as an element of sustainable HRM – with the focus on production engineers. Journal of Cleaner Production, 278, 124008. https://doi.org/10.1016/j.jclepro.2020.124008 DOI: https://doi.org/10.1016/j.jclepro.2020.124008
Quah, L. J. J., Tan, B. K. K., Fua, T.-P., Wee, C. P. J., Lim, C. S., Nadarajan, G., Zakaria, N. D., Chan, S.-E. J., Wan, P. W., Teo, L. T., Chua, Y. Y., Wong, E., & Venkataraman, A. (2020). Reorganising the emergency department to manage the COVID-19 outbreak. International Journal of Emergency Medicine, 13(1), 32. https://doi.org/10.1186/s12245-020-00294-w DOI: https://doi.org/10.1186/s12245-020-00294-w
Reay, G., Smith-MacDonald, L., Then, K. L., Hall, M., & Rankin, J. A. (2020). Triage emergency nurse decision-making: Incidental findings from a focus group study. International Emergency Nursing, 48, 100791. https://doi.org/10.1016/j.ienj.2019.100791 DOI: https://doi.org/10.1016/j.ienj.2019.100791
Rezk, S. E. I., Gaber, M. A., & Mohamed, H. M. (2023). Information And Communication Technology: Nurses’ Empowerment At Alahrar Teaching Hospital. Journal of Pharmaceutical Negative Results, 3592–3606. https://doi.org/10.47750/pnr.2023.14.02.423
Rodziewicz, T. L., Houseman, B., & Hipskind, J. E. (2022). Medical Error Reduction and Prevention. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK499956/
Rusli, N. T., Mansyur, M., Kekalih, A., Sulistomo, A., & Werdhani, R. A. (2020). Assessment of compliance to standard precautions among nurses using the Health Belief Model. Universa Medicina, 39(3), Article 3. https://doi.org/10.18051/UnivMed.2020.v39.199-206 DOI: https://doi.org/10.18051/UnivMed.2020.v39.199-206
Saban, M., Dagan, E., & Drach-Zahavy, A. (2019). The Relationship Between Mindfulness, Triage Accuracy, and Patient Satisfaction in the Emergency Department: A Moderation-Mediation Model. Journal of Emergency Nursing, 45(6), 644–660. https://doi.org/10.1016/j.jen.2019.08.003 DOI: https://doi.org/10.1016/j.jen.2019.08.003
Savioli, G., Ceresa, I. F., Bressan, M. A., Piccini, G. B., Varesi, A., Novelli, V., Muzzi, A., Cutti, S., Ricevuti, G., Esposito, C., Voza, A., Desai, A., Longhitano, Y., Saviano, A., Piccioni, A., Piccolella, F., Bellou, A., Zanza, C., & Oddone, E. (2023). Five Level Triage vs. Four Level Triage in a Quaternary Emergency Department: National Analysis on Waiting Time, Validity, and Crowding—The CREONTE (Crowding and RE-Organization National TriagE) Study Group. Medicina, 59(4), Article 4. https://doi.org/10.3390/medicina59040781 DOI: https://doi.org/10.3390/medicina59040781
Seyed-Nezhad, M., Ahmadi, B., & Akbari-Sari, A. (2021). Factors affecting the successful implementation of the referral system: A scoping review. Journal of Family Medicine and Primary Care, 10(12), 4364–4375. https://doi.org/10.4103/jfmpc.jfmpc_514_21 DOI: https://doi.org/10.4103/jfmpc.jfmpc_514_21
Soemah, E. N. (2023). Accuracy of Triage in Service in The Emergency Department (Literature Review). Journal of Scientific Research, Education, and Technology (JSRET), 2(2), Article 2. https://doi.org/10.58526/jsret.v2i2.145 DOI: https://doi.org/10.58526/jsret.v2i2.145
Soola, A. H., Mehri, S., & Azizpour, I. (2022). Evaluation of the factors affecting triage decision-making among emergency department nurses and emergency medical technicians in Iran: A study based on Benner’s theory. BMC Emergency Medicine, 22. https://doi.org/10.1186/s12873-022-00729-y DOI: https://doi.org/10.1186/s12873-022-00729-y
Sutriningsih, A., Wahyuni, C. U., & Haksama, S. (2020). Factors affecting emergency nurses’ perceptions of the triage systems. Journal of Public Health Research, 9(2), 1808. https://doi.org/10.4081/jphr.2020.1808 DOI: https://doi.org/10.4081/jphr.2020.1808
Torraco, R. J., & Lundgren, H. (2020). What HRD Is Doing—What HRD Should be Doing: The Case for Transforming HRD. Human Resource Development Review, 19(1), 39–65. https://doi.org/10.1177/1534484319877058 DOI: https://doi.org/10.1177/1534484319877058
Unver, V., Basak, T., Tastan, S., Kok, G., Guvenc, G., Demirtas, A., Ayhan, H., Köse, G., Iyigun, E., & Tosune, N. (2018). Analysis of the effects of high-fidelity simulation on nursing students’ perceptions of their preparedness for disasters. International Emergency Nursing, 38, 3–9. https://doi.org/10.1016/j.ienj.2018.03.002 DOI: https://doi.org/10.1016/j.ienj.2018.03.002
Wang, M., Chen, X., Yang, Y., Wang, H., Yan, Y., Huang, X., Bi, Y., Cao, W., & Deng, G. (2023). Effect evaluation of case-based learning with situated cognition theory on competence training for student nurses in pediatric surgery. Heliyon, 9(2), e13427. https://doi.org/10.1016/j.heliyon.2023.e13427 DOI: https://doi.org/10.1016/j.heliyon.2023.e13427
Yancey, C. C., & O’Rourke, M. C. (2023). Emergency Department Triage. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK557583/
Yoo, H. J., & Lee, H. (2022). Critical role of information and communication technology in nursing during the COVID‐19 pandemic: A qualitative study. Journal of Nursing Management, 30(8), 3677–3685. https://doi.org/10.1111/jonm.13880 DOI: https://doi.org/10.1111/jonm.13880
Zakeri, H., Saleh, L. A., Niroumand, S., & Ziadi-Lotfabadi, M. (2022). Comparison the Emergency Severity Index and Manchester Triage System in Trauma Patients. Bulletin of Emergency & Trauma, 10(2), 65. https://doi.org/10.30476/BEAT.2022.92297.1302