Knowledge, Skills, and Practices of Triage among Emergency Nurses in Jordan

The effect of disaster management training program on emergency nurses' knowledge, skills, and personal preparedness in Palestine

PURPOSE

Healthcare professionals including nurses have a crucial role in reducing the impact of severe crises, also emergency nurses are the majority of healthcare professionals who directly work with catastrophe victims. Thus, they should be prepared well to cope with such situations and they need to have appropriate knowledge, skills, and competencies to manage their tasks during disasters. Thus, this study aimed to assess the effect of a training program for disaster management on knowledge, skills, and personal preparedness among emergency nurses in Palestine.

METHODS

A one-group pretest-post-test design was used. The data were collected from 64 emergency nurses from governmental and non-governmental hospitals in Palestine by distributing the Disaster Preparedness Evaluation Tool before and after the educational program. Nursing Triage Observation Checklist (NTOC) was used to assess the nurses' skills in the emergency departments.

RESULTS

The findings demonstrated that emergency nurses' knowledge, skills, and personal readiness for disaster preparedness before the training program were moderate. There were significant increases in nurses' knowledge after a training program (pre [M = 3.83, SD = 0.82]; post [M = 5.15, SD = 0.29]), skills (pre [M = 3.70, SD = 0.87]; post [M = 5.04, SD = 0.27]), and personal preparedness (pre [M = 3.85, SD = 0.83]; post [M = 5.12, SD = 0.27]). After the training program, nurses demonstrated strong knowledge, skills, and personal preparedness. There were significant differences in nurses' knowledge, skills, and personal preparedness before and after the disaster training program (t = -13.326; p < 0.001; t = -12.539; p < 0.001, t = -12.256; p < 0.001, respectively). The observation of nurses' skills pre-intervention indicated that 51 (79.6 %) nurses of the participants had good skills in triage and observation of nurses' skills one-month post-intervention program indicated that all nurses (100 %) showed good skills in triage.

CONCLUSIONS

The results proved the effectiveness of a disaster training program in improving emergency nurses' knowledge, skills, and personal preparedness for disaster management. Therefore, policymakers and healthcare professionals must ensure that disaster preparedness training for emergency nurses is continuously updated to incorporate new developments in the field. This will equip nurses to respond effectively, mitigate risks, and deliver high-quality care during disasters.

Optimizing triage education for emergency room nurses: A scoping review

AIMS

Accurate triage decisions by emergency room nurses are pivotal for patient prognosis and efficient utilization of resources. This study aimed to identify teaching methods, contents, intervention characteristics, and initial consideration of educational design for the development of triage education, targeting triage nurses.

DESIGN

A scoping review.

DATA SOURCES

PubMed, CINAHL, Web of Science, Embase, and RISS were searched for studies in either English or Korean, regardless of publication year.

REVIEW METHODS

The review was conducted according to the Joanna Briggs Institute guidelines. Studies published before November 15, 2023 were selected, based on the following index terms in each database: nurses, triage, education, and emergency services, hospital.

RESULTS

Of the 20 studies included in this review, five focused on severity classification of patients with cardiovascular diseases, one addressed infectious diseases, two examined pediatric patients, one explored patients with trauma, and the remaining eleven were not limited to specific diseases. Eleven studies (55 %) employed face-to-face (offline) education, whereas six (30 %) used non-face-to-face (online) education. The teaching methods were classified as teacher-centered learning and student-centered learning. The educational strategies included in-person lectures, online classes, demonstrations, simulations, mobile technology or web-based programs, group discussions, role-plays, and flipped learning. Outcome variables, such as triage accuracy, knowledge, performance ability, self-efficacy, satisfaction, wait time, and competency were measured as intervention effects.

CONCLUSIONS

This review demonstrates the key characteristics and contents of triage education interventions, along with key considerations in the initial design stages. Triage education covers a wide range of contents and diverse teaching methods pertinent to severity classification in triage practice. Effective educational programs hinge on the meticulous planning of objectives, optimal selection of the target population, needs assessment, and suitable teaching methods and materials. Future triage education for emergency room nurses should be tailored to specific participants while anticipating and planning all potential circumstances of implementation.

Construction of learning objectives and content for emergency triage nurses in tertiary general hospitals: A Delphi study

AIM

To construct learning objectives and educational content for emergency triage nurses based on core competencies.

BACKGROUND

The core competencies of emergency triage nurses has an impact on the quality of medical services and patient treatment outcomes. However, research on learning objectives and educational content aimed at cultivating the core competencies of emergency triage nurses is limited.

DESIGN

A Delphi study.

METHODS

To develop a draft of the teaching objectives and content for emergency triage nurses based on core competencies, a literature review, semistructured interviews and expert group meetings were conducted. Then, 24 experts were invited to provide feedback on the draft and suggest revisions through two rounds of Delphi consultation.

RESULTS

Consensus was reached on six core competencies, 30 learning objectives and 43 educational contents. The response rate for the two rounds of expert questionnaires was 100 %, with 79.2 % and 54.2 % of the experts providing feedback in the first and second rounds, respectively. The judgement coefficient (Ca) was 0.910, the familiarity coefficient (Cs) was 0.917 and the authority coefficient (Cr) was 0.914. The Kendall's W coefficients for the two rounds of expert inquiry were 0.321 and 0.334, indicating a statistically significant difference (P<0.05).

CONCLUSIONS

Constructing learning objectives and educational content for emergency triage nurses based on core competencies is scientific and reliable and can provide a reference for the training and management of emergency triage nurses.

Expectations of emergency patients regarding triage system knowledge upon arrival: an interpretive study

BACKGROUND

One of the most important aspects of healthcare knowledge is having a thorough understanding of the triage system which is used in emergency departments. This study aims to assess the level of awareness of Jordanian patients who visit the ED about the triage procedure.

METHODS

A descriptive, cross-sectional design was utilized in the emergency department at the biggest public hospital in Jordan. A convenience sample of a self-administrated questionnaire utilizing a Discounted Cash Flow Interview (DCF) survey was filled out.

RESULTS

A total of 726 participants were recruited with a response rate of 90.8%. The mean age of the participants was M = 38.1 (SD = 12.9), and the age of the participants varied from 18 to 89 years. More than half of the participants were male (n = 383, 52.8%) and married (n = 425, 58.5%). A significant relationship between the overall perception of knowing what a teaching hospital is and patients' educational level (X2 = 11.9, P < 0.003), current job (X2 = 25.2, P < 0.001), nationality (X2 = 7.20, P < 0.007), and family income (X2 = 15.9, P < 0.001).

CONCLUSION

More investigation is required to determine the causes of the low knowledge of the triage system. The study suggests increasing staffing levels, giving nursing staff ongoing education and training, and integrating technology and automation to reduce the load of patient care.

How simulation training for nursing students in emergency internships affects triage decision-making and anxiety: A quasi-experimental study

Purpose

This study aimed to determine the effects of simulation-based training on triage decision-making skills and anxiety in fourth-year nursing students.

Methods

This study employed an experimental pretest-posttest design and randomly assigned 90 nursing students from adult and pediatric emergency internships to control (n = 48) and intervention groups (n = 42). Although both groups underwent triage decision-making training, only the intervention group received simulation-based triage training.

Results

A significant difference in posttest triage decision-making knowledge and anxiety scores was observed between the control and intervention groups (p < 0.05). The posttest triage decision-making knowledge score of the intervention group was significantly higher than the pretest score, whereas the posttest anxiety score was significantly lower.

Conclusion

Theoretical triage decision-making training was effective, whereas simulation-based triage training improved the nursing students' knowledge and performance. Therefore, simulation-based training should be integrated into traditional learning methods to improve the triage decision-making skills of nursing students.

Using primary healthcare facilities and patients' expectations about triage system: Patients' perspective from multisite Jordanian hospitals

BACKGROUND

Using primary healthcare facilities can decrease the tension and workload in emergency departments (EDs). This study aim to examine the patient's use of primary healthcare facilities before EDs visits and their expectations about the triage.

METHODS

A cross-sectional design was utilized in at various EDs in different hospitals. A convenience sample of 726 patients were enrolled and completed a self-administrated questionnaire.

RESULTS

The mean age of the participants was 38.1 (SD = 12.9). Most participants (68.2 %) did not have primary care physicians and did not want to know how long other patients waited (61.4 %). There are significant relationships between participants' desired to know how long other patients have been waiting and their age (X2 = 4.02, P < .05), education level (X2 = 13.5, P < .001), and current job (X2 = 9.90, p < .05). Also, periodic updates from EDs staff about the delays were significantly related to participants' age (X2 = 3.29), current job (X2 = 28.4), marital status (X2 = 8.93), and residency place (X2 = 9.94).

CONCLUSION

Educating patients about the triage system and the importance of using primary healthcare facilities is recommended to reduce ED waiting times and overload.

Assessing the Level of Electrocardiographic Interpretation Competency among Emergency Nurses in Palestine

Introduction

The use of electrocardiograms (ECGs) is widespread among emergency room (ER) nurses for diagnosis and triage, making it crucial for them to have the appropriate level of competency in interpreting ECGs. This can lead to better healthcare and patient outcomes.

Objectives

This study aims to assess the competency level of emergency nurses in Palestine in interpreting normal ECG and certain cardiac arrhythmias, and to explore the association between socio-demographic characteristics and their ECG interpretation competency.

Methods

The study used a cross-sectional descriptive design, and 196 ER nurses were conveniently recruited to fill out a self-administered questionnaire based on previous literature. The data collected were analyzed using SPSS with strict adherence to ethical considerations.

Results

The results showed that 70.9% of the nurses were males, 65.3% held a bachelor's degree in nursing, 46.9% had 1-5 years of experience, and 60.7% had received previous courses on ECG interpretation. The mean competency level of the ER nurses was satisfactory at 60.714%, but 38.8% had a poor level of competency. This was significantly higher among nurses with higher educational levels (p-value < 0.001), those who had taken previous ECG courses (p-value = 0.045) and life support (p-value < 0.05), and those who were exposed to more ECG interpretations per day (p-value = 0.001).

Conclusion

There is a need to focus more on ECG competency levels in Palestinian literature and compare them between different departments. It is also essential to evaluate nurses' needs for continuous education.