The Impact of the Clinical Audit Cycle on the Implementation of Hospital Triage in the Emergency Department
Advances in Nursing & Midwifery,
Vol. 33 No. 4 (2024),
15 Mehr 2024
,
Page 1-7
https://doi.org/10.22037/anm.v33i4.47538
Abstract
Abstract
Introduction: As the first step in dealing with patients referring to the emergency department, the triage process prioritizes these patients and classifies them to different levels of triage based on the severity of their clinical conditions. This prioritization is aimed at distinguishing patients whose treatment can be delayed without experiencing any complications from those who need immediate action and delay in whose treatment will cause serious complications. Therefore, this study aimed to determine the effect of the clinical audit cycle on the implementation of hospital triage in the emergency department of Golestan Hospital in Ahvaz in 2018.
Methods: This was a quasi-experimental study the population of which included all events related to the way hospital triage was implemented for patients referring to the emergency department of Golestan Hospital of Ahvaz, southwest of Iran. The research sample included 385 triage events performed for patients referring to the emergency department. A researcher-made triage questionnaire was used to check nurses' accuracy in four dimensions, namely taking history, taking vital signs, determining triage level, and frequency distribution. SPSS version 23 was used to analyze the data. A significance level of α = 0.05 was adopted for this study.
Results: Before the intervention, the mean scores of the intervention group in terms of Checklist dimensions were as follow: taking history (11.26 ± 1.89), vital signs (15.62 ± 2.21), determining triage level (23.56 ± 7.95), determining the level of required facilities (9.11 ± 3.27), and doing the general triage of patients (55.56 ± 10.17). After the intervention, the mean scores in the intervention group were as follows: taking history (12.36 ± 2.71), vital signs (16.81 ± 3.31), determining triage level (30 ± 0.051), determining the level of required facilities (11.99 ± 0.072), and doing the general triage of patients (64.73 ± 10.9), which shows the positive impact of the intervention (P < 0.001).
Conclusions: According to the findings of the present study, appropriate training in triage along with strict control and monitoring of the hospital triage implementation process and its prioritization will lead to provision of better medical services. Also, patients whose treatment can be delayed without experiencing any complications can be distinguished from those who need immediate action.
- Clinical Audit Cycle
- Hospital Triage
- Emergency
How to Cite
References
Abass G, Asery A, Al Badr A, AlMaghlouth A, AlOtaiby S, Heena H. Patient satisfaction with the emergency department services at an academic teaching hospital. J Family Med Prim Care. 2021;10(4):1718-25. doi: 10.4103/jfmpc.jfmpc_8_20 pmid: 34123918
Ohaiba MM, Anamazobi EG, Okobi OE, Aguda K, Chukwu VU. Trends and Patterns in Emergency Department Visits: A Comprehensive Analysis of Adult Data From the National Center for Health Statistics (NCHS) Database. Cureus. 2024;16(8):e66059. doi: 10.7759/cureus.66059 pmid: 39229409
haghdoost z, safari m, yahyavi h. Effect of Triage Education on knowledge, attitude and practice of nurses in Poursina Educational and Therapeutic Emergency center in Rasht. Journal of Holistic Nursing And Midwifery. 2010;20(2):14-21.
Kabir MJ, Heidari A, Khatirnamani Z, Moeeni S, Kazemi SB, Rahimi A. The Prevalence and Costs of Non-urgent Visits to the Emergency Department of Public Hospitals Affiliated to Golestan University of Medical Sciences: A Descriptive Study. Journal of Modern Medical Information Sciences. 2024;9(4):400-9. doi: 10.32598/jmis.9.4. 8
Basir Ghafouri H, Hosseini Kasnavieh M, Sharifi MA, Amini M, Darzi Ramandi A. A Survey of Patients' Length of Stay and Its Effective Predictors in Emergency Departments of TUMS Selected Hospitals. Payavard Salamat. 2017;11(3):18-26.
Gorick H. Ensuring effectiveness and safety in emergency department triage. Emerg Nurse. 2024. doi: 10.7748/en.2024.e2205 pmid: 39039922
Weber EJ. Triage: making the simple complex? Emerg Med J. 2019;36(2):64-5. doi: 10.1136/emermed-2018-207659 pmid: 30327414
Reisi Z, Saberipour B, Adienh M, Hemmatipour A, Shahvali EA. The level of awareness of the emergency department nurses of the triage principles in teaching hospitals. Journal of Nursing and Midwifery Sciences. 2018;5(1):32.
Haghigh S, Ashrafizadeh H, Mojaddami F, Kord B. A survey on knowledge level of the nurses about hospital Triage. Journal of Nursing Education. 2017;5(6):46-52. doi: 10.21859/jne-05067
Hosseini-Irani SJ, Jalalmanesh SJ, Sahbaei F, Mahmoodi M. Role of emergency ward nurses working in triage units at hospitals affiliated with shahrekord university of medical sciences Community Health Journal. 2008;1(4):73-7.
Rostamzadeh A, Mahboob Ahari AR. Surveying the Effect of Clinical Audit Process on Discharge against Medical Advice from Hospital Emergency Ward in Tabriz, Iran. Journal of Health. 2021;12(2):276-84. doi: 10.52547/j.health.12.2.276
Ullman AJ, Ray-Barruel G, Rickard CM, Cooke M. Clinical audits to improve critical care: Part 1 Prepare and collect data. Aust Crit Care. 2018;31(2):101-5. doi: 10.1016/j.aucc.2017.04.003 pmid: 28550968
Piryani Rano Mal P, Suneel P. Clinical Audits are Critical for the Care in Emergency Department. EC Emergency Medicine and Critical care 2018;2(4):136-40.
Abu-Jeyyab M, Al-Jafari M, El Din Moawad MH, Alrosan S, Al Mse'adeen M. The Role of Clinical Audits in Advancing Quality and Safety in Healthcare Services: A Multiproject Analysis From a Jordanian Hospital. Cureus. 2024;16(2):e54764. doi: 10.7759/cureus.54764 pmid: 38523943
khanbabayi gol M, dorosti A, Haghdoost M, alvandfar D. Clinical Audit of Nurses in the Prevention of Ventilator- associated Pneumonia. 2 Journal of Nursing Education. 2019;7(5):31-7.
Okereke IC, Mmerem K, Aly M. Clinical Audit as a Quality Improvement Tool in Measurements of Lying and Standing Blood Pressure for Elderly Patients Admitted With a Hip Fracture. Cureus. 2021;13(7):e16781. doi: 10.7759/cureus.16781 pmid: 34513388
Saie N, Rai B, F. G. The role of clinical audit in improving the quality of pediatric burns in Tabriz Sina Hospital.: Tabriz University of Medical Sciences; 2012.
Robertson-Steel I, Edwards S, Gough M. Clinical governance in pre-hospital care. J R Soc Med. 2001;94 Suppl 39(Suppl 39):38-42. pmid: 11383428
Javadi S, Salimi T, Sareban MT, Dehghani MA. Knowledge and Practice of Nurses Regarding Patients’ Triage in Emergency Department. Iranian Journal of Emergency Medicine. 2016;3(1):22-15. doi: 10.22037/ijem.v3i1.9176
Kimiaimehr F, Riyahi L, Nasiri Pour AA. The relation between medical audit performance and enhancement of nursing care qualities in surgery unit at Tehran Hasheminejad hospital 2013. Nursing Development in Health. 2014;5(8):59-66.
Newton-Brown E, Fitzgerald L, Mitra B. Audit improves emergency department triage, assessment, multi-modal analgesia and nerve block use in the management of pain in older people with neck of femur fracture. Australas Emerg Nurs J. 2014;17(4):176-83. doi: 10.1016/j.aenj.2014.06.001 pmid: 25151180
Arslanian-Engoren C, Hagerty B, Eagle KA. Evaluation of the ACT intervention to improve nurses' cardiac triage decisions. West J Nurs Res. 2010;32(6):713-29. doi: 10.1177/0193945909359410 pmid: 20634399
Khatiban M, Khazaei A, Karampourian A, Soltanian A, Kimiaie asadi H, Salimi R, et al. The effects of the Emergency Severity Index triage education via problem-based learning on the triage nurses' performance and the patients’ length of stay in the Emergency Department. Journal of Clinical Research in Paramedical Sciences. 2014;3(2):e8209.
Kalantarimeibidi M, Yadollahi A, Esfandiari S. The Effect of Education on the Knowledge and Practice of Emergency Department’s Nurses Regarding the Patients’ Triage. Iranian Journal of Emergency Medicine. 2014;1(1):40-4. doi: 10.22037/ijem.v1i1.7274
Mahmoudi H, Mohammadalizadeh A, Khaghanizade M. The Effect of Nurses’ Triage Training Based on Stabilization Model on the Patient’s Waiting Time in Emergency Department. Iran Journal of Nursing. 2017;30(108):44-51. doi: 10.29252/ijn.30.108.44
Kezirian J, Muhammad WT, Wan JY, Godambe SA, Pershad J. Cost analysis and provider satisfaction with pediatrician in triage. Pediatr Emerg Care. 2012;28(10):971-6. doi: 10.1097/PEC.0b013e31826c6dc4 pmid: 23023460
Meretoja R, Isoaho H, Leino-Kilpi H. Nurse competence scale: development and psychometric testing. J Adv Nurs. 2004;47(2):124-33. doi: 10.1111/j.1365-2648.2004.03071.x pmid: 15196186
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