Search Advanced

AIMS Public Health

2024, Volume 11, Issue 4: 1049-1070. doi: 10.3934/publichealth.2024054
Previous Article Next Article
Research article

Effect of triage training on nurses with Emergency severity index and Australian triage scale: Α quasi-experimental study

  • 1.
    Department of Social Work, Democritus University of Thrace, University General Hospital of Alexandroupolis, Greece
  • 2.
    Department of Nursing, International Hellenic University, Thessaloniki, Greece
  • 3.
    Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
  • 4.
    Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
  • Received: 22 April 2024 Revised: 20 May 2024 Accepted: 07 June 2024 Published: 09 October 2024

  • Introduction 

    Triage training has positive effects on health professionals, the quality of indicators in emergency departments, and the patients. However, data on the effectiveness of triage training on nurses with two different triage scales is limited.

    Objective 

    This study sought to evaluate the effectiveness of a triage training program in Emergency Departments (EDs), as well as the effect on the accuracy, knowledge, and skills of nurses working in the National Health System of Greece.

    Methods 

    Α quasi-experimental study was carried out, with measurements taken pre-, post-, and three months after implementing the education program. Data were collected between March 2021 and July 2022. Eligible participants for this study included nurses employed in the hospital units of the 4th Health Region of the National Health System. A total of 117 nurses participated in the study. Skills, knowledge, and accuracy were assessed using the Emergency Severity Index and the Australian Triage Scale.

    Results 

    After completing the training program, there was a noticeable improvement in the nurses' performance. Their triage skills displayed an overall statistically significant increase (p < 0.001) and, more crucially, in the subscales of rapid patient assessment skills, patient categorization skills, and patient allocation skills. Additionally, statistically significant increases were observed for triage knowledge and for both screening scales that measured triage accuracy, namely the Emergency Severity Index (p < 0.001) and the Australian Triage Scale (p < 0.001). In addition, the number of over-triage and under-triage cases decreased.

    Conclusions 

    The education program had a positive impact on the nurses, resulting in a statistically significant increase in their triage skills and knowledge. Moreover, the use of both triage scales resulted in an increase in the triage accuracy. The increase in triage skills, knowledge, and accuracy decreased after three months.

    Citation: George Pontisidis, Thalia Bellali, Petros Galanis, Nikolaos Polyzos. Effect of triage training on nurses with Emergency severity index and Australian triage scale: Α quasi-experimental study[J]. AIMS Public Health, 2024, 11(4): 1049-1070. doi: 10.3934/publichealth.2024054

    Related Papers:

  • Introduction 

    Triage training has positive effects on health professionals, the quality of indicators in emergency departments, and the patients. However, data on the effectiveness of triage training on nurses with two different triage scales is limited.

    Objective 

    This study sought to evaluate the effectiveness of a triage training program in Emergency Departments (EDs), as well as the effect on the accuracy, knowledge, and skills of nurses working in the National Health System of Greece.

    Methods 

    Α quasi-experimental study was carried out, with measurements taken pre-, post-, and three months after implementing the education program. Data were collected between March 2021 and July 2022. Eligible participants for this study included nurses employed in the hospital units of the 4th Health Region of the National Health System. A total of 117 nurses participated in the study. Skills, knowledge, and accuracy were assessed using the Emergency Severity Index and the Australian Triage Scale.

    Results 

    After completing the training program, there was a noticeable improvement in the nurses' performance. Their triage skills displayed an overall statistically significant increase (p < 0.001) and, more crucially, in the subscales of rapid patient assessment skills, patient categorization skills, and patient allocation skills. Additionally, statistically significant increases were observed for triage knowledge and for both screening scales that measured triage accuracy, namely the Emergency Severity Index (p < 0.001) and the Australian Triage Scale (p < 0.001). In addition, the number of over-triage and under-triage cases decreased.

    Conclusions 

    The education program had a positive impact on the nurses, resulting in a statistically significant increase in their triage skills and knowledge. Moreover, the use of both triage scales resulted in an increase in the triage accuracy. The increase in triage skills, knowledge, and accuracy decreased after three months.



    加载中

    Acknowledgments


    We want to thank the participants nurses for their valuable time, without whom the research would not have been completed.

    Authors' contribution


    George Pontisidis: literature review, data collection and analysis; Petros Galanis: statistical analysis of data; Thalia Bellali: literature discussion; Nikolaos Polyzos: supervision, conclusion and editing.

    Conflict of interest


    Petros Galanis is an editorial board member for AIMS Public Health and were not involved in the editorial review or the decision to publish this article. All authors declare that there are no competing interests.

    [1] Corkery N, Avsar P, Moore Z, et al. (2021) What is the impact of team triage as an intervention on waiting times in an adult emergency department?–A systematic review. Int Emerg Nurs 58: 101043. https://doi.org/10.1016/j.ienj.2021.101043
    [2] Oredsson S, Jonsson H, Rognes J, et al. (2011) A systematic review of triage-related interventions to improve patient flow in emergency departments. Scand J Trauma Resusc Emerg Med 19: 43. https://doi.org/10.1186/1757-7241-19-43
    [3] Qureshi NA (2010) Triage systems: a review of the literature with reference to Saudi Arabia. East Mediterr Health J 16: 690-698. https://doi.org/10.26719/2010.16.6.690
    [4] Raita Y, Goto T, Faridi MK, et al. (2019) Emergency department triage prediction of clinical outcomes using machine learning models. Crit Care 23: 64. https://doi.org/10.1186/s13054-019-2351-7
    [5] Ghazali SA, Abdullah KL, Moy FM, et al. (2020) The impact of adult trauma triage training on decision-making skills and accuracy of triage decision at emergency departments in Malaysia: A randomized control trial. Int Emerg Nurs 51: 100889. https://doi.org/10.1016/j.ienj.2020.100889
    [6] Jang JH, Kim SS, Kim S (2020) Educational Simulation Program Based on Korean Triage and Acuity Scale. Int J Environ Res Public Health 17: 9018. https://doi.org/10.3390/ijerph17239018
    [7] Sartini M, Carbone A, Demartini A, et al. (2022) Overcrowding in Emergency Department: Causes, Consequences, and Solutions-A Narrative Review. Healthcare 10: 1625. https://doi.org/10.3390/healthcare10091625
    [8] Faheim S, Ahmed S, Aly E, et al. (2019) Effect of Triage Education on Nurses' Performance in Diverse Emergency Departments. Evid Based Nurs Res 1: 11. https://doi.org/10.47104/ebnrojs3.v1i2.45
    [9] Hinson JS, Martinez DA, Schmitz PSK, et al. (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. Int J Emerg Med 11: 3. https://doi.org/10.1186/s12245-017-0161-8
    [10] Moon SH, Cho IY (2022) The Effect of Competency-Based Triage Education Application on Emergency Nurses' Triage Competency and Performance. Healthcare 10: 596. https://doi.org/10.3390/healthcare10040596
    [11] Tam HL, Chung SF, Lou CK (2018) A review of triage accuracy and future direction. BMC Emerg Med 18: 58. https://doi.org/10.1186/s12873-018-0215-0
    [12] Campbell D, Fetters L, Getzinger J, et al. (2022) A Clinical Nurse Specialist–Driven Project to Improve Emergency Department Triage Accuracy. Clin Nurse Spec 36: 45-51. https://doi.org/10.1097/NUR.0000000000000641
    [13] Farrohknia N, Castrén M, Ehrenberg A, et al. (2011) Emergency Department Triage Scales and Their Components: A Systematic Review of the Scientific Evidence. Scand J Trauma Resusc Emerg Med 19: 42. https://doi.org/10.1186/1757-7241-19-42
    [14] Hardy A, Calleja P (2019) Triage education in rural remote settings: A scoping review. Int Emerg Nurs 43: 119-125. https://doi.org/10.1016/j.ienj.2018.09.001
    [15] Visser LS, CPEN F, Montejano AS (2019) Fast facts for the triage nurse: an orientation and care guide. New York, NY: Springer Publishing Company, LLC. https://doi.org/10.1891/9780826148513
    [16] Christ M, Grossmann F, Winter D, et al. (2010) Modern Triage in the Emergency Department. Dtsch Ärztebl Int 107: 892. https://doi.org/10.3238/arztebl.2010.0892
    [17] Hinson JS, Martinez DA, Cabral S, et al. (2019) Triage Performance in Emergency Medicine: A Systematic Review. Ann Emerg Med 74: 140-152. https://doi.org/10.1016/j.annemergmed.2018.09.022
    [18] Olsson M, Svensson A, Andersson H, et al. (2022) Educational intervention in triage with the Swedish triage scale RETTS©, with focus on specialist nurse students in ambulance and emergency care–A cross-sectional study. Int Emerg Nurs 63: 101194. https://doi.org/10.1016/j.ienj.2022.101194
    [19] Considine J, LeVasseur SA, Villanueva E (2004) The Australasian Triage Scale: Examining emergency department nurses' performance using computer and paper scenarios. Ann Emerg Med 44: 516-523. https://doi.org/10.1016/j.annemergmed.2004.04.007
    [20] Duko B, Geja E, Oltaye Z, et al. (2019) Triage knowledge and skills among nurses in emergency units of Specialized Hospital in Hawassa, Ethiopia: cross sectional study. BMC Res Notes 12: 21. https://doi.org/10.1186/s13104-019-4062-1
    [21] 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 J Nurs 3: 511-525.
    [22] Jordi K, Grossmann F, Gaddis GM, et al. (2015) Nurses' accuracy and self-perceived ability using the Emergency Severity Index triage tool: a cross-sectional study in four Swiss hospitals. Scand J Trauma Resusc Emerg Med 23: 62. https://doi.org/10.1186/s13049-015-0142-y
    [23] 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 Res Notes 11: 658. https://doi.org/10.1186/s13104-018-3769-8
    [24] Fathoni M, Sangchan H, Songwathana P (2010) Triage knowledge and skills among emergency nurses in East Java Province, Indonesia. Aust Emerg Nurs J 13: 153. https://doi.org/10.1016/j.aenj.2010.08.304
    [25] Varndell W, Hodge A, Fry M (2019) Triage in Australian emergency departments: Results of a New South Wales survey. Australas Emerg Care 22: 81-86. https://doi.org/10.1016/j.auec.2019.01.003
    [26] Pontisidis G, Platis C, Galanis P, et al. (2021) Emergency department triage: The knowledge and skills of Greek health professionals. Arch Hell Med 38: 497-507.
    [27] Gkampriell H, Voutsinou RN, Ekmektzoglou K, et al. (2023) Knowledge and Skills of the Medical and Nursing Staff of Emergency Department in Triage Comparative Study between Public and Private Hospitals in Athens. Health Sci J 17: 1-6.
    [28] Thawley A, Aggar C, Williams N (2020) The educational needs of triage nurses. Health Educ Pract J Res Prof Learn 3: 26-38. https://doi.org/10.33966/hepj.3.1.14121
    [29] Yazdannik A, Mohamadirizi S, Nasr-Esfahani M (2020) Comparison of the effect of electronic education and workshop on the satisfaction of nurses about Emergency Severity Index triage. J Educ Health Promot 9: 158. https://doi.org/10.4103/jehp.jehp_182_19
    [30] Jang K, Jo E, Song KJ (2021) Effect of problem-based learning on severity classification agreement by triage nurses. BMC Nurs 20: 256. https://doi.org/10.1186/s12912-021-00781-2
    [31] Molina-McBride A Improving triage and patient throughput process with emergency department rapid triage protocol and emergency severity index training (2022). Available from: https://share.calbaptist.edu/server/api/core/bitstreams/bef99d91-6c0e-480d-9ae2-7b97bdf46bc2/content
    [32] McElroy CD (2020) Improving Emergency Department Triage Accuracy and Effectiveness with Implementation of Emergency Severity Index Toolkit: A Doctor of Nursing Practice Project. Southeastern Louisiana University .
    [33] Recznik CT, Simko LC, Travers D, et al. (2019) Pediatric Triage Education for the General Emergency Nurse: A Randomized Crossover Trial Comparing Simulation with Paper-Case Studies. J Emerg Nurs 45: 394-402. https://doi.org/10.1016/j.jen.2019.01.009
    [34] Atack L, Rankin JA, Then KL (2005) Effectiveness of a 6-week Online Course in the Canadian Triage and Acuity Scale for Emergency Nurses. J Emerg Nurs 31: 436-441. https://doi.org/10.1016/j.jen.2005.07.005
    [35] Rahmati H, Azmoon M, Meibodi MK, et al. (2013) Effects of Triage Education on Knowledge, Practice and Qualitative Index of Emergency Room Staff: A Quasi-Interventional Study. Bull Emerg Trauma 1: 69-75.
    [36] Gilboy N, Tanabe T, Travers D, et al. (2012) Emergency severity index (ESI): A triage tool for emergency department care, version 4, implementation handbook 2012 edition. AHRQ publication : 12.
    [37] Triage workbook-Emergency, Triage Education Kit. Available from: https://www.health.gov.au/resources/publications/triage-workbook-emergency-triage-education-kit?language=en
    [38] MAPI Research InstituteLinguistic Validation Process (2002). Available from: http://www.mapi-re-searchinst.com/lvprocess.asp
    [39] Medical Outcomes Trust.Trust introduces new translation criteria. Med Outcom Trust Bull (1997) 5: 1-4.
    [40] Association WM (2013) World medical association declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA 310: 2191-2194. https://doi.org/10.1001/jama.2013.281053
    [41] Brosinski CM, Riddell AJ, Valdez S (2017) Improving Triage Accuracy: A Staff Development Approach. Clin Nurse Spec 31: 145-148. https://doi.org/10.1097/NUR.0000000000000291
    [42] Hoffman S, Voss JA, Hendrickx L, et al. (2022) Effect of Emergency Severity Index Annual Competency Assessment on Mistriage. J Nurs Care Qual 37: 356-361. https://doi.org/10.1097/NCQ.0000000000000638
    [43] Hoseini SD, Khankeh HR, Dalvandi A, et al. (2018) Comparing the effect of the two educational methods: competency-based, and lecture, on the knowledge and performance of nurses in the field of hospital triage. Health Emergencies Disasters Q 3: 77-84. https://doi.org/10.29252/nrip.hdq.3.2.77
    [44] Hosseini A, Mojtahedzadeh R, Aeen Mohammadi, et al. (2022) Effective triage training for nurses: comparison of face to face, pamphlet, and multimedia training. J E-Learn Knowl Soc 18: 101-106. https://doi.org/10.20368/1971-8829/1135442
    [45] Jahromi MK, Dost ER (2017) Assessing the Effect of Triage Education Emergency Severity Index (ESI) In Both Lecturing and Team Base Learning (TBL) On the Knowledge of Emergency Medical Staff Hospitals of Jahrom University of Medical Sciences. Int J Sci Stud 5: 267-270.
    [46] Javadi M, Gheshlaghi M, Bijani M (2023) A comparison between the impacts of lecturing and flipped classrooms in virtual learning on triage nurses' knowledge and professional capability: an experimental study. BMC Nurs 22: 205. https://doi.org/10.1186/s12912-023-01353-2
    [47] Mansour H, Ahmed N, Khafagy W, et al. (2015) Effect of implementing triage training competencies on newly graduated nurses working in emergency hospital. Mansoura Nurs J 2: 159-179. https://doi.org/10.21608/mnj.2015.149111
    [48] McNally S Triage education: From experience to practice standards (2006). Available from: https://researchdirect.westernsydney.edu.au/islandora/object/uws%3A24
    [49] Mohebbi K, Taheri_Ezbarami Z, Maroufizadeh S, et al. (2023) Effectiveness of Outcome-Based Pediatric Triage Education on knowledge and Decision Making of Nursing Students in Guilan: A Quasi-Experimental Study. Medbiotech J .
    [50] Rankin JA, Then KL, Atack L (2013) Can Emergency Nurses' Triage Skills Be Improved by Online Learning? Results of an Experiment. J Emerg Nurs 39: 20-26. https://doi.org/10.1016/j.jen.2011.07.004
    [51] Toffoli K (2016) Improving Emergency Department Triage Quality Improvement Project. Drexel University . https://doi.org/10.17918/etd-7230
    [52] Tran N (2019) Implementing ESI Education Project for Nurses in the Triage Process. Walden University . Available from: https://scholarworks.waldenu.edu/dissertations/7437.
    [53] Yazdannik A, Dsatjerdi E, Mohamadirizi S (2018) Utilizing mobile health method to emergency nurses' knowledge about Emergency Severity Index triage. J Educ Health Promot 7: 10. https://doi.org/10.4103/jehp.jehp_29_17
    [54] Zagalioti SC, Fyntanidou B, Exadaktylos A, et al. (2023) The first positive evidence that training improves triage decisions in Greece: evidence from emergency nurses at an Academic Tertiary Care Emergency Department. BMC Emerg Med 23: 60. https://doi.org/10.1186/s12873-023-00827-5
    [55] Bahlibi TT, Tesfamariam EH, Andemeskel YM, et al. (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 Emerg Med 22: 190. https://doi.org/10.1186/s12873-022-00755-w
    [56] Megginson LA (2008) RN-BSN education: 21st century barriers and incentives. J Nurs Manag 16: 47-55. https://doi.org/10.1111/j.1365-2934.2007.00784.x
    [57] Eley R, Fallon T, Soar J, et al. (2008) The status of training and education in information and computer technology of Australian nurses: a national survey. J Clin Nurs 17: 2758-2767. https://doi.org/10.1111/j.1365-2702.2008.02285.x
  • Reader Comments
  • © 2024 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索
AIMS Public Health
3.1 4.8

Metrics

Article views(530) PDF downloads(69) Cited by(0)

Preview PDF
Download XML
Export Citation
Article outline

Figures and Tables

Tables(4)

Other Articles By Authors

Related pages

Tools

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog