Implementation Of Triage Research Articles

American emergency room wait times for psychiatric conditions from 2019 to 2021

Use of Emergency Departments (EDs) for psychiatric complaints has increased significantly in past decades. The onset of the COVID-19 pandemic saw large shifts in ED usage, with a relative increase in mental health complaints in EDs. This paper will investigate the difference in ED wait times for psychiatric and non-psychiatric complaints over this period. Utilized National Hospital Ambulatory Medical Care Survey (NHAMCS), from 2019 to 2021, for average wait times for psychiatric versus non-psychiatric complaints. Compared the average wait times for psychiatric complaints by region, triage status, and ICD-10 F code. There was no significant difference in the average wait times overall between these conditions (P = 0.57). People with schizophrenia or psychosis had a significantly higher wait time (P = 0.03) compared to mental health symptoms secondary to physiologic conditions. Northeastern American EDs also had prolonged wait times for psychiatric conditions (P < 0.01) Research into factors of prolonged wait times can advise quality improvements such as the implementation of evidence-based triage and workup tools, and directed psychiatric education.

Time to ECG diagnosis delays inter-hospital transfer to revascularization in STEMI patients presenting to a regional emergency department: a five-year audit

BackgroundReducing the door-to-balloon time (D2BT) in ST-elevation myocardial infarction (STEMI) patients maximizes myocardial salvage and mitigates morbidity/mortality.AimsTo assess the D2BT in STEMI patients requiring inter-hospital transfer for revascularization and identify any potential causes of delay.MethodsConsecutive patients presenting to the Connolly Hospital Blanchardstown (CHB) emergency department (ED) who were transferred to the Mater Misericordiae University Hospital in Dublin for primary percutaneous coronary intervention from January 2018 to October 2022 were identified in a regional database and their D2BTs calculated. D2BTs were further sub-categorized into key intervals to identify any potential causes of delay.ResultsA total of 90 patients were included for analysis, with a median D2BT of 117.5 min (interquartile range [IQR]: 99.3–170.8 min) and 52.5% of patients achieving the ≤ 120 min target. Despite being the shortest interval considered, the time from arrival at the CHB ED to diagnostic electrocardiogram (ECG) was a substantial contributor to the overall delay to revascularization given its wide variability (median: 18.0 min; IQR: 9.0–46.8 min), with only 28.8% of patients achieving the ≤ 10 min target.ConclusionsNearly half of the patients studied failed to achieve the overall target D2BT for revascularization. The time from arrival at the CHB ED to diagnostic ECG was identified as a substantial contributor to this failure, with a median time almost twice that of the target and a quarter of all patients spending longer than 46.8 min. These findings highlight a need to improve the implementation of ECG triage and interpretation in the ED.

Evaluation of Emergency Severity Index (ESI) triage quality by nurses and associated factors in Iran.

The triage process of patients in emergency departments is done by nurses in Iran. it is necessary to pay attention to the ability of nurses in patients' triage in order to have a correct picture of the status of the emergency department, so the aims of this study is to investigate the quality of nurses' triage using the Emergency Severity Index (ESI) method and related factors. This is a descriptive study which was performed on all 900 patients referring to the emergency department during 12 months from 2019 to 2020 in the Triage unit of two trauma center hospitals affiliated to Isfahan university of medical sciences. Data collection tools included patients' demographic, nurses' demographic and occupational checklist, and ESI Triage Form. To analyze the data, SPSS software was used, descriptive and analytic statistics were used, P < 0.05 was considered statistically significant. No significant difference was observed between the quality level of triage by nurses and physicians (P > 0.05), the results of independent t-test showed that nurses in the over triage group have a higher average age and work experience. In the under triage level, the frequency of female nurses was significantly higher than male nurses (P < 0/05). Accurate and fast triage of patients is the key to successful performance in the emergency department. Therefore correct implementation of triage and identifying the need for nurses for training and identifying existing deficiencies are of utmost importance.

Personalised exercise rehabilitation in cancer survivorship: the percs triage and referral system study protocol

BackgroundTo effectively embed exercise rehabilitation in cancer survivorship care, a co-ordinated system of acute and community exercise rehabilitation services, forming a stepped model of care, is recommended. Patients can be directed to the exercise rehabilitation service which best meets their needs through a system of assessment, triage and referral. Triage and referral systems are not yet widely applied in cancer survivorship practice and need to be evaluated in real-world contexts. The PERCS (Personalised Exercise Rehabilitation in Cancer Survivorship) study aims to evaluate the real-world application of an exercise rehabilitation triage and referral system in cancer survivors treated during the COVID-19 pandemic. Secondary aims are to evaluate change in physical and psychosocial outcomes, and to qualitatively evaluate the impact of the system and patient experiences, at three months after application of the triage and referral system.MethodsThis study will assess the implementation of an exercise rehabilitation triage and referral system within the context of a physiotherapy-led cancer rehabilitation clinic for cancer survivors who received cancer treatment during the COVID-19 pandemic. The PERCS triage and referral system supports decision making in exercise rehabilitation referral by recommending one of three pathways: independent exercise; fitness professional referral; or health professional referral. Up to 100 adult cancer survivors treated during the COVID-19 pandemic who have completed treatment and have no signs of active disease will be recruited. We will assess participants’ physical and psychosocial wellbeing and evaluate whether medical clearance for exercise is needed. Participants will then be triaged to a referral pathway and an exercise recommendation will be collaboratively decided. Reassessment will be after 12 weeks. Primary outcomes are implementation-related, guided by the RE-AIM framework. Secondary outcomes include physical function, psychosocial wellbeing and exercise levels. Qualitative analysis of semi-structured interviews guided by the Consolidated Framework for Implementation Research (CFIR) will provide insights on implementation and system impact.DiscussionThe PERCS study will investigate the real-world application of a cancer rehabilitation triage and referral system. This will provide proof of concept evidence for this triage approach and important insights on the implementation of a triage system in a specialist cancer centre.Trial registrationThis study is registered on ClinicalTrials.gov, registration number: NCT05615285, date registered: 21st October 2022.

Overview Management Triage at The Emergency Room of The Hospital at Jambi

Triage, which comes from the French word trier, means sorting or sorting patients based on the patient's ABCD, the severity of the injury, the priority scale of the disease emergency, and the patient's life expectancy, so that the time needed to assess and stabilize the patient is not too long. The purpose of triage is not only to provide fast action but also to prevent disability and death of the patient. The research purposes to find out the description of nurses' knowledge regarding triage at the Emergency Room of Hospital Jambi. The design used in this study is descriptive quantitative w. here the variables are examined at the same time which aims to obtain an overview of the level of knowledge of nurses regarding triage in the IGD RS Jambi. samples from all existing populations, namely 50 nurses who were all on duty at the Emergency Room of Hospital. Province Jambi. Conclusion, results this research the level of knowledge of respondents about triage, the researcher can explain that the level of knowledge of respondents about triage is mostly good with a total frequency of 33 people or 66%, while respondents with sufficient knowledge are 17 people or 33%, meaning that most of the 33 respondents have good ability about triage. It can be concluded that the better the level of knowledge of the nurses, the better the understanding of nurses in the implementation of triage in the management emergency room

Surviving the Big One: Turkish Neurosurgical Society's Innovative Disaster Management Model for Istanbul Earthquake.

The Turkish Neurosurgical Society (TNS) played a pivotal role in providing critical medical support during the Kahramanmaraş earthquake. Recognizing the urgent need for neurosurgeons, our team collaborated with various institutions to address material shortages and meet medical requirements. However, this experience underscored the necessity of having a comprehensive disaster organization model and a well-defined disaster management plan. TNS should pioneer the creation of a dedicated trauma group to ensure coordination among neurosurgeons in future disasters. Minimize confusion during critical moments, the trauma group will have a regional structure, with smaller subagencies assigned distinct roles and responsibilities. Standardized triage and patient management practices, as defined in the created guidelines, will ensure consistency in trauma response across the board. The wealth of knowledge gained from field experiences will be shared through these guidelines, providing valuable insights for future generations. By proactively establishing a trauma group within the TNS and developing a robust disaster management plan, we aim to strengthen our resilience and enhance the overall effectiveness of neurosurgical response during emergencies. Together, we can pave the way for a more coordinated and efficient approach to disaster relief, ensuring that best neurosurgical care for those in the face of catastrophic events. The establishment of a dedicated trauma group within TNS represents a significant leap forward in enhancing our preparedness and response capabilities during disasters. The invaluable lessons learned in the Kahramanmaraş earthquake have underscored the critical importance of a well-organized and coordinated approach to neurosurgical intervention in times of crisis. The implementation of standardized triage and patient management practices, as outlined in comprehensive guidelines, will further ensure a consistent and effective trauma response across various disaster scenarios.

AI triage or manual triage? Exploring medical staffs’ preference for AI triage in China

ObjectivesThe introduction of AI technology in healthcare presents both opportunities and challenges. The aim of this study was to investigate medical staffs' preference for AI triage and the influencing factors. MethodsA survey was conducted online among medical staffs in China from March 4th to April 28th, 2021. Participants were recruited through multiple channels, including medical professional platforms and social media. A total of 677 valid responses were obtained from medical staff members located in 28 provinces across China. ResultsThe results showed that AI triage had an overall acceptance rate of 77.1%, and 45.2% of the medical staffs surveyed preferred "AI triage exclusively." Direct experience was positively associated with medical staffs' preference for AI triage (β = 0.223, p < .001). Additionally, greater exposure to a variety of media was positively associated with the perceived value of AI technology, which, in turn, increased preference for AI triage (β = 0.040, SE = 0.013, p < .001, 95% CI = [0.017, 0.067]). ConclusionMedical staffs generally hold a favorable attitude towards AI triage, particularly in areas with a high medical burden and during pandemics. In a multimedia environment, media exposure variety impacts medical staffs' preferences through their perceived value of AI technology. This study has implications for the implementation of AI triage on a larger scale.

Development and validation of a novel death risk stratification scale in patients with hemorrhagic fever with renal syndrome: a 14-year ambispective cohort study

ObjectivesTo develop and validate a simple and effective death risk stratification scale for hemorrhagic fever with renal syndrome (HFRS). MethodsIn this ambispective cohort study, we investigated the epidemiological and clinical data of 2245 patients with HFRS (1873 enrolled retrospectively and constituting the training cohort, 372 prospectively recruited as the validation cohort) from September 2008 to December 2021, and identified independent risk factors for 30-day death of HFRS. Using logistic regression analysis, a nomogram prediction model was established and was further simplified into a novel scoring scale. Calibration plot, receiver operating characteristic curve, net reclassification index, integrated discrimination index, and decision curve analysis were used to assess the calibration, discrimination, precision, and clinical utility in both training and validation cohorts. ResultsOf 2245 patients with HFRS, 132 (5.9%) died during hospitalization. The nomogram prediction model and scoring scale were developed using six predictors: comorbid hypertension, hypotensive shock, hypoxemia, neutrophils, aspartate aminotransferase, and activated partial thromboplastin time. Both the scale and nomogram were well calibrated (near-diagonal calibration curves) and demonstrated significant predictive values (areas under receiver operating characteristic curves >0.9, sensitivity and specificity >90% in the training cohort and >84% in the validation cohort). The simplified scoring scale demonstrated equivalent discriminative ability to the nomogram, with net reclassification index and integrated discrimination index of 0.022 and 0.007 in the training cohort, 0.126 and 0.022 in the validation cohort. Decision curve analysis graphically represented significant clinical utility and comparable net benefits of the nomogram and scoring scale across a range of threshold probabilities. DiscussionThis evidence-based, factor-weighted, accurate score could help clinicians swiftly stratify HFRS mortality risk and facilitate the implementation of patient triage and tiered medical services during epidemic peaks.

Imaging Stewardship: Triage for Neuroradiology MR During Limited-Resource Hours

ObjectivesTo decrease call burden on pediatric neuroradiologists, we developed guidelines for appropriate use of MR overnight. These guidelines were implemented using triage by in-house generalist pediatric radiologists. Process measures and balancing measures were assessed during implementation. MethodsFor this improvement project, interdepartmental consensus guidelines were developed using exploratory mixed-methods design. Implementation of triage used plan-do-study-act cycles. Process measures included reduction in the number of telephone calls, frequency of calls, triage decisions, and number and type of examinations ordered. Balancing measures included burden of time and effort to the generalist radiologists. Differences in examination orders between implementation intervals was assessed using Kruskal-Wallis, with significance at P < .05. ResultsConsensus defined MR requests as “do,” “defer,” or “divert” (to CT). Guidelines decreased neuroradiologist calls 74% while adding minimal burden to the generalist radiologists. Most nights had zero or one triage request and the most common triage decision was “do,” and the most common examination was routine brain MR. Number of MR ordered and completed overnight did not significantly change with triage. DiscussionMultidisciplinary consensus for use of pediatric neurological MR during limited resource hours overnight is an example of imaging stewardship that decreased the burden of calls and burnout for neuroradiologists while maintaining a comparable level of service to the ordering clinicians.

Is phased implementation of HPV testing and triage with dual staining the way to transform organized cytology screening?

The substantial material and legislative investments in establishing and maintaining cytological screening in the Czech Republic represent barriers to a direct transition to primary HPV screening. Therefore, the LIBUSE project was implemented to test the efficacy of phasing in HPV DNA testing as a co-test to cytology in routine screening of women >30 years of age. Women aged 30 to 60 years who underwent regular annual Pap smears were co-tested for HPV DNA with selective 16/18 genotyping at 3-year intervals. All HPV 16/18-positive cases and/or cases with a severe abnormality in cytology were sent for colposcopy; HPV non-16/18-positive cases and LSILs were graded using p16/Ki67 dual-stain cytology, and positive cases were sent for colposcopy. Overall, 2409 patients were included. After the first combined screening (year 'zero') visit, 7.4% of women were HPV-positive and 2.0% were HPV16/18-positive; only 8 women had severe Pap smear abnormalities. Triage by dual staining was positive in 21.9% of cases (28/128). Biopsy confirmed 34 high-grade precancer lesions. At the second combined visit (year 'three'), the frequency of HPV infection (5.3% vs. 7.4%) frequency of HPV16/18 (1.1% vs. 2.0%), referrals for colposcopy (35 vs. 83), and biopsy verified high-grade lesions (5 vs. 34) were significantly lower (all P ≤ 0.001). The addition of HPV DNA testing with selective genotyping of HPV16/18 to existing cytology screening significantly increased the safety of the program. The gradual introduction of HPV testing was well received by healthcare professionals and patients, and can facilitate transformation of the cytology-based screening. ClinicalTrials.gov Identifier: NCT05578833.

The Relationship Between The Implementation of Triage and The Incidence of Overcrowded in the Emergency Department of Adi Husada Kapasari Hospital, Surabaya, Indonesia

Introduction: The emergency department (ED) is at the forefront of hospital healthcare and is expected to provide timely and effective care. The imbalance of the need for emergency care and the availability of hospitals to provide health services has an impact on the occurrence of overcrowded situations. This study aims to determine the relationship between the implementation of triage and the incidence of overcrowded in the ED of Adi Husada Kapasari Hospital. Methods: This study uses a correlation study design with a cross sectional approach. The population in the study were all nurses in the ED of Adi Husada Kapasari Hospital, Surabaya, Indonesia, and 14 nurses were involved as respondents through a total sampling technique. The independent variable is the implementation of triage, the dependent variable is the incidence of overcrowded. Data collection using a questionnaire sheet to measure the implementation of triage, and the NEDOCS scale (National Emergency Department Overcrowding Scale) to measure the incidence of overcrowded. Data was analyzed using Spearman rank correlation test with α = 0.05. Results: The results showed that more than half respondents (64.3%) practice triage in moderate level, and the overcrowded assessment showed all respondents (100%) in the level 1, which means it was in category not busy. Spearman rank correlation test showed that there was no relationship between the implementation of triage and the incidence of overcrowded in the ED of Adi Husada Kapasari Hospital (p-value 0.898 and r=0.038). Conclusion: For non-large-scale emergency departments like the ED of Adi Husada Kapasari Hospital, the implementation of triage is not significantly related to the overcrowded incidence, although some studies and theories state otherwise, that the accuracy of emergency room nurses in triaging can help reduce patients overcrowding and treat patients immediately. Further research could explore this gap through a larger sample or by involving or comparing more populations of various type of EDs.

Implementasi of Triage on the Role Attitude of Emergency Instalation Nurses

Triage is a process to determine which patients should receive treatment first based on the severity of the injury or illness. In triage, patients are grouped into 6 categories, blue label, red label, yellow label, green label, white label, and black label. The highest priority is patients with emergency conditions accompanied by disturbances in the airway, breathing, circulation, which are labeled in blue. The second priority is patients with emergency conditions, which are labeled in red. The third priority is given to patients with minimal emergency conditions, which are labeled in yellow. The next priority is cases without emergencies, but if they are not treated immediately they will have a negative impact on the patient, which is labeled in green. The next priority is the white label given to patients whose conditions are not serious, not emergency, and do not require immediate treatment. Last priority is given to patients who died or had serious irreversible injuries who were labeled in black. The purpose of this study was to determine the relationship between the roles and attitudes of emergency room nurses and the implementation of triage based on priority. The research method used is descriptive correlational with cross sectional design. The results showed that the majority of the role of nurses was good with the implementation of triage as many as 25 people (65.8%), the majority of positive attitudes with the implementation of triage as many as 23 people (60.5%) and the majority carried out triage according to SOP as many as 30 people (78.9%) . The results of the study with the chi-square test p-value &lt;0.05. In conclusion, there is a relationship between the role and attitude of the emergency room nurse and the implementation of triage based on priority.

Acceptability of risk-based triage in cervical cancer screening: A focus group study.

Compared to the previous cytology-based program, the introduction of primary high-risk human papillomavirus (hrHPV) based screening in 2017 has led to an increased number of referrals. To counter this, triage of hrHPV-positive women in cervical cancer screening can potentially be optimized by taking sociodemographic and lifestyle risk factors for cervical abnormalities into account. Therefore, it is essential to gain knowledge of the views of women (30-60 years) eligible for cervical cancer screening. The main goal of this qualitative study was to gain insight in the aspects that influence acceptability of risk-based triage in cervical cancer screening. A focus group study in which participants were recruited via four general medical practices, and purposive sampling was used to maximize heterogeneity with regards to age, education level, and cervical cancer screening experiences. The focus group discussions were transcribed verbatim and analyzed using reflexive thematic analysis. A total of 28 women (average age: 45.2 years) eligible for cervical cancer screening in The Netherlands participated in seven online focus group discussions. Half of the participants was higher educated, and the participants differed in previous cervical cancer screening participation and screening result. In total, 5 main themes and 17 subthemes were identified that determine the acceptability of risk-stratified triage. The main themes are: 1) adequacy of the screening program: an evidence-based program that is able to minimize cancer incidence and reduce unnecessary referrals; 2) personal information (e.g., sensitive topics and stigma); 3) emotional impact: fear and reassurance; 4) communication (e.g., transparency); and 5) autonomy (e.g., prevention). The current study highlights several challenges regarding the development and implementation of risk-based triage that need attention in order to be accepted by the target group. These challenges include dealing with sensitive topics and a transparent communication strategy.

Faktor - Faktor yang Berhubungan dengan Pelaksanaan Triase

This study aims to determine what factors influence the implementation of triage in the Emergency Unit. This research method uses a literature review conducted with PRISMA guidance and electronic databases, namely Google Scholar, Pubmed, and Science Direct, with the keywords "Accuracy, " "Affecting, " "Decision Making, " "Emergency Department, "AND " Triage." The results obtained were 12 full-text articles, using Indonesian and English, and publications in the 2020 - 2023 range. The results of a literature review of the reviewed articles found that four factors had the most significant influence on the implementation of triage in the Emergency Unit: aspects of workload, motivation, work experience, and knowledge of nurses in the Emergency Unit. In conclusion, the accuracy of triage implementation is essential in determining patient care priorities based on the level of emergency so that it does not cause death or disability in patients. This literature review found that factors such as workload, motivation, experience, and knowledge of nurses greatly influence the implementation of triage in the Emergency Unit.&#x0D; Keywords: Workload, Motivation, Experience, Knowledge

Accuracy of Triage in Service in The Emergency Department (Literature Review)

Service accuracy is the minimum standard of service that must be achieved by nurses in the emergency room, so that proper triage implementation is needed. Triage is the classification of patients based on the level of emergency by prioritising actions on airway (A), breathing (B), and circulation (C) disorders by considering facilities, human resources and the probability of patient life. The literature search in this literature review uses six databases with high and medium quality criteria, namely scient driect, IEEG, cedekia, Sci-hub, ProQuest, Pubmed. For previous studies using correlational analytics with a cross-sectional study approach, descriptive: combination (mixed methods) with sequential explanatory design. cross sectional. Check Prisma to guide this review. Titles, abstracts, full text and methodology were assessed for study eligibility. Data were tabulated and analysed narratively. Results: Nine journal literature met the inclusion criteria, with the major theme of triage accuracy in the Emergency Department. There were three journals analysing the accuracy of triage implementation, and four journals relating to triage accuracy. Factors that often appear in triage accuracy include nurses' understanding of triage, motivation and workload. Knowledge is one of the most important factors in the accuracy of triage implementation. Proper implementation of triage can reduce morbidity, disability, and mortality so as to improve service quality and customer satisfaction.&#x0D; &#x0D; Keywords: Accuracy of triage.

Prehospital Stroke Triage: A Modeling Study on the Impact of Triage Tools in Different Regions

Background and purpose Direct transportation to a thrombectomy-capable intervention center is beneficial for patients with ischemic stroke due to large vessel occlusion (LVO), but can delay intravenous thrombolytics (IVT). The aim of this modeling study was to estimate the effect of prehospital triage strategies on treatment delays and overtriage in different regions. Methods We used data from two prospective cohort studies in the Netherlands: the Leiden Prehospital Stroke Study and the PRESTO study. We included stroke code patients within 6 h from symptom onset. We modeled outcomes of Rapid Arterial oCclusion Evaluation (RACE) scale triage and triage with a personalized decision tool, using drip-and-ship as reference. Main outcomes were overtriage (stroke code patients incorrectly triaged to an intervention center), reduced delay to endovascular thrombectomy (EVT), and delay to IVT. Results We included 1798 stroke code patients from four ambulance regions. Per region, overtriage ranged from 1-13% (RACE triage) and 3-15% (personalized tool). Reduction of delay to EVT varied by region between 24 ± 5 min (n = 6) to 78 ± 3 (n = 2), while IVT delay increased with 5 (n = 5) to 15 min (n = 21) for non-LVO patients. The personalized tool reduced delay to EVT for more patients (25 ± 4 min [n = 8] to 49 ± 13 [n = 5]), while delaying IVT with 3-14 min (8-24 patients). In region C, most EVT patients were treated faster (reduction of delay to EVT 31 ± 6 min (n = 35), with RACE triage and the personalized tool. Conclusions In this modeling study, we showed that prehospital triage reduced time to EVT without disproportionate IVT delay, compared to a drip-and-ship strategy. The effect of triage strategies and the associated overtriage varied between regions. Implementation of prehospital triage should therefore be considered on a regional level.

Factors Associated with the Implementation of Triage by Nurses in the Emergency Room at Dr. Abdul Rivai Berau

Triage is a rescue action in the emergency room which is carried out by grouping patients based on certain criteria. Knowledge, skills and attitudes of ED nurses are needed in clinical decision making so that mistakes do not occur in sorting based on triage so that patient management can be more optimal and directed. This study aims to determine the factors associated with the implementation of triage by nurses in the Emergency Room of RSUD dr. Abdul Rivai Berau. Analytical quantitative research with a cross sectional approach. A sample of 25 people used the total sampling technique. Shows that there is no relationship between training (ρ value 1.000) and years of service (ρ value 0.554) with the implementation of triage. There is a relationship between knowledge (ρ value 0.002), attitude (ρ value 0.004) and skills (ρ value 0.009) with triage.

EDUKASI PELAKSANAAN TRIAGE TERHADAP TINGKAT PENGETAHUAN KELUARGA PASIEN DI IGD RS ADI HUSADA KAPASARI

Introduction &amp; Aim: The Emergency Department (ED) is one of the spearheads of hospital health services aimed at providing first aid for patients. Providing emergency services to reduce morbidity and mortality rates it requires the ability of nurses to sort out patients who need help first, this sorting is called Triage. This community service aims to provide education on the implementation of triage on the level of knowledge of the patient's family in the ED. Method of Activity: Implementation of community service at the ED of Adi Husada Kapasari Hospital, January 2023, the target is the patient's family. The method of providing education on the implementation of triage to the patient's family is with lectures and media leaflets. The first stage collects the patient's family and gives a questionnaire sheet. The second stage is the delivery of material and discussion of questions and answers about the implementation of triage, as well as giving questionnaires. Results: A total of 10 representatives of the patient's family members participated. Characteristics based on age showed that half (50%) were aged 36-45 years, based on gender the majority (60%) were female, and based on education the majority (80%) had high school/vocational high school education. Knowledge of the patient's family before being given triage education showed that most (60%) had less knowledge, whereas after being given triage education most (60%) had good knowledge about triage. Discussion: Providing education on the implementation of triage to the patient's family is very useful, and has proven to be able to provide information as well as understanding regarding health service procedures in the ED, families better understand the actions given to their family members while in the ED, and can change the behavior and perceptions of the patient's family towards the procedure given by ED health workers.

Weighing up the pros and cons of dysphagia triage in South Africa.

Early identification of dysphagia followed by intervention reduces, length of hospitalisation, degree of morbidity, hospital costs and risk of aspiration pneumonia. The emergency department offers an opportune space for triage. Triaging offers risk-based evaluation and early identification of dysphagia risk. A dysphagia triage protocol is not available in South Africa (SA). The current study aimed to address this gap. To establish the reliability and validity of a researcher-developed dysphagia triage checklist. A quantitative design was used. Sixteen doctors were recruited from a medical emergency unit at a public sector hospital in SA using non-probability sampling. Non-parametric statistics and correlation coefficients were used to determine the reliability, sensitivity and specificity of the checklist. Poor reliability, high sensitivity and poor specificity of the developed dysphagia triage checklist was found. Importantly, the checklist was adequate in identifying patients as not being at risk for dysphagia. Completion time for dysphagia triage was 3 minutes. The checklist was highly sensitive but not reliable or valid for use in identifying patients at risk for dysphagia.Contribution:The study provides a platform for further research and modification of the newly developed triage checklist, which is not recommended for use in its current form. The merits of dysphagia triage cannot be ignored. Once a valid and reliable tool is confirmed, the feasibility of implementation of dysphagia triage must be considered. Evidence to confirm that dysphagia triage can be conducted, when considering the contextual, economic, technical and logistic aspects of the context, is necessary.

Implementation of advanced triage in the Emergency Department of high complexity public hospital: Research protocol.

To evaluate the efficacy of advanced nurse triage based on the quality of care outcomes of patients attending the Emergency Department of a high-complexity hospital. To analyse the concept of advanced triage and the essential elements of the construct. Mixed longitudinal study, divided into 4 steps; which will include an initial qualitative step, two observational studies and finally, a quasi-experimental study. NCT05230108. Step 1 will consist of a concept analysis. Step 2 will include a mapping of advanced practice protocol terminologies. Step 3 will analyse the opinion of health professionals on advanced triage. In step 4: in the retrospective phase (n=1095), sociodemographic and clinical variables and quality indicators such as waiting time will be analysed. After that, in the prospective phase (n=547), advanced triage will be implemented and the two cohorts will be compared. The whole study will be carried out from January 2022 to January 2024. Patients classified as low complexity at triage are more vulnerable to emergency department overcrowding. The implementation of advanced triage would make it possible to respond to patient needs by offering equitable and quality healthcare, facilitating accessibility, safety and humanization of the emergency department.