Effectiveness of Triage patient-based accident and emergency patient screening criteria of Registered Nurse, Accident and Emergency Department, Mae Ramat Hospital, Tak Province

Abstract

The triage of service recipients in the emergency department is based on grading severity and urgency to ensure quality service. This quasi-experimental study aimed to examine the effectiveness of implementing the emergency patient triage model at Mae Ramat Hospital. The sample included eleven registered nurses and the medical records of patients admitted to accident and emergency departments during August 1, 2020, to August 31, 2021, before and after implementing the triage model training,with 550 patients in each group. Descriptive statistics were used to evaluate the data, and the Wilcoxon- Signed rank test was adopted to compare the data before and after the experiment. The results showed that the sample group was 25-48 years old (Mean=31.8, SD=7.6), with 2 - 17 years of experience working in the accident and emergency department (Mean=5.8 years, SD=4.5). Altogether 18.2 percent had completed training in emergency medicine; and 9.1 percent had completed general practice training. With statistical significance at the 0.05 level, registered nurses were able to screen patients more accurately after the trial than they had been able to before. Accurate triage increased from 47.6 percent to 68.2 percent. The proportion of patients under-triaged (categorized as less severe than their actual condition) decreased from 28.0 to 17.1 percent; while over-triage (categorized as more severe) also decreased from 24.4 to 14.7 percent compared to the actual severity of the condition. It could be concluded that the MOPD ED Triage training program could effectively improve the triage accuracy of nurses and emergency medical staff. In conclusions, the triage of emergency patients using criteria established by nurses affected triage efficiency. Therefore, continuous review of patient separation criteria with nurses should be encouraged and could be applied in other community hospitals.