Hospital Triage Standards: A Qualitative Study and Content Analysis based on Experts’ Experiences in Iran

Zohre Najafi; Abbas Abbaszadeh; Hassan Vaezi; Maryam Rassouli; Amir Mirhaghi; Sima Zohari Anboohi

doi:10.18502/fem.v5i4.6695

Zohre Najafi Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abbas Abbaszadeh Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Hassan Vaezi Hospital Emergency Management Center, Deputy Minister of Health, Ministry of Health and Medical Education, Tehran, Iran.
Maryam Rassouli Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Amir Mirhaghi Evidence-Based Care Research Center, Mashhad University Medical Sciences, Mashhad, Iran.
Sima Zohari Anboohi School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/fem.v5i4.6695

Keywords: Emergency Nursing; Expert Opinion; Qualitative Research; Standard of Care; Triage

Abstract

Introduction: The lack of a fixed and clear protocol causes confusion for nurses resulting in care performance delay in the emergency room (ER). Given that the purpose of triage is to examine the patient upon arrival in ER for the rapid classification and prioritization of emergency patients in need of treatment, it seems that the development and implementation of hospital triage standards can greatly affect this purpose.

Objective: The present study was conducted to review the experiences of experts in hospital triage in terms of determining the standards of hospital ER triage.

Methods: This qualitative research was conducted through content analysis method based on Donabedian model. Participants include experts (Politician, Nurse Supervisor, Nurse, Midwife, Faculty of Nursing, Emergency Medicine Specialist) working in educational and private hospitals and single-specialized ERs. Data were collected through in-depth and semi-structured interviews lasting between 25-60 minutes. The main interview questions were: What are the structural standards of a good triage? What are the process standards for a good triage? What are the standards of a good triage? Data analyzed through Content Directed Analysis with Shannon and Hsieh approach.

Results: Totally, 21 experts the mean age of 46.9±1.8 (ranged from 30 to 57) years and the mean work experience of 18.9± 8.21 years were participated, of whom 16 (76.2%) persons were male. From the analysis, we extracted 48 codes, 14 subcategories and 3 main categories of "structural standards", "process standards" and "outcome standards".

Conclusions: Guidelines are needed so that the nurse in charge of triage can quickly and accurately undertake the important responsibility of patient triage. Additionally, having structure and process and outcome standards improves triage performance.