Assessment of Knowledge and Facility Adequacy in Conducting Triage Among Nurses in Emergency Units of Naguru Hospital and International Hospital Kampala.

Abstract

Background: Triage is an essential function in the emergency units. An effective triage system ensures that patients seeking emergency care receive appropriate attention, in a suitable location, with the requisite degree of urgency and that emergency care is initiated in response to clinical need rather than order of arrival. Triage nurses knowledge and facility adequacy have been cited as influential factors in triage decision making, however there has been no study in Ugandan hospitals undertaken to assess the knowledge of nurses working in the emergency departments on triaging. This study therefore aimed at assessment of knowledge and facility adequacy in conducting triage among nurses in emergency units of Naguru hospital and International Hospital Kampala- Kampala district. Methodology: Both descriptive cross-sectional and observational study designs were used and data was collected using structured questionnaire and observational checklist. The study population was all nurses working in emergency units in International Hospital Kampala (IHK) and Naguru Hospital (NH). Analysis: Data was analyzed using SPSS version 14.00. Results were summarized using frequencies and percentages and presented using tables, figures and text. Results: 74% of the respondents knew the concept of triage although 54% of them had no knowledge on waiting time limits for different triage categories assigned to patients according to the severity of the medical conditions and were also not able to assign proper triage categories of patients based on the scenarios presented to them with various health conditions. More than half of the participants (53.7%) felt that their knowledge is not adequate. 59.2% of the respondents in this study had no in-service training/ education in emergency care. Only 12.9% of the respondents received pre-service training. Regarding the health facilities, there was absence of a triage assessment tool in NH and among those who reported to use the triage assessment tool from IHK, only 37.4% used the scale routinely. Furthermore, 83.3% of the participants felt that their staffing was not adequate versus the patient load. In addition, some of the important equipment’s assisting in patient triage were only available in IHK and these basics were deficient in NH. Conclusion and Recommendations: Nurses who participated in this study demonstrated significant knowledge deficits in patient triage in the emergency units of both hospitals. To correct this deficit and improve the knowledge of these nurses, an in-service training should be carried out. The pre-service nursing curriculum also needs to be reviewed, and emphasis put on the contents of the triage assessment. Up-to-date policy guidelines on emergency triage assessment should be provided, stating actions to be taken and the time limit as per patients’ triage category of medical urgency. Nursing staff numbers need to be reviewed by the policy makers to prevent ineffective triaging of patients since there is a high patient load. Efforts should be made to increase availability of equipment that will assist the nurses to thoroughly assess the patients to improve the quality of emergency care.