Triage Training Research Articles

Knowledge and Skills on Triage among Nurses Working in Emergency Departments in Referral Hospitals in Rwanda

BackgroundUnpredictable numbers of patients attending emergency departments highlight the need for Triage. Triage which is the prioritization of patient care based on severity of illness or injury, prognosis, and availability of resources is effective when clinicians are knowledgeable and skilled to perform it.ObjectiveTo assess knowledge and skills on triage among nurses working in emergency departments of Rwandan referral hospitals.MethodsCross-sectional analytical design was adopted. ninety-six (96) nurses working in emergency departments were selected using proportionate stratified sampling method. Each hospital was considered as a stratum. A self-administered questionnaire and observation checklist were use as instruments. Inferential and descriptive statistics were used in analysis.ResultsThe majority of participants (63.6%) demonstrated low level of triage knowledge and almost a half (47.9%) of participants had low level of triage skills. Nurses experience in emergency department, level of education and triage training were not found to significantly influence triage knowledge and skills positively (P>0.05).ConclusionDeficit in triage knowledge and skills were revealed among nurses working in emergency departments in Rwanda. Accredited continuous educational training on triage should be regularly provided to enhance knowledge and skills of emergency department nurses on Triage.Rwanda J Med Health Sci 2021;4(3):398-405

Training of clinical triage of acute radiation casualties: a performance comparison of on-site versus online training due to the covid-19 pandemic

A collection of powerful diagnostic tools have been developed under the umbrellas of NATO for ionising radiation dose assessment (BAT, WinFRAT) and estimate of acute health effects in humans (WinFRAT, H-Module). We assembled a database of 191 ARS cases using the medical treatment protocols for radiation accident victims (n = 167) and the system for evaluation and archiving of radiation accidents based on case histories (n = 24) for training purposes of medical personnel. From 2016 to 2019, we trained 39 participants comprising MSc level radiobiology students in an on-site teaching class. Enforced by the covid-19 pandemic in 2020 for the first time, an online teaching of nine MSc radiobiology students replaced the on-site teaching. We found that: (a) limitations of correct diagnostic decision-making based on clinical signs and symptoms were experienced unrelated to the teaching format. (b) A significant performance decrease concerning online (first number in parenthesis) versus on-site teaching (reference and second number in parenthesis) was seen regarding the estimate time (31 vs 61 cases per hour, two-fold decrease, p = 0.005). Also, the accurate assessment of response categories (89.9% vs 96.9%, p = 0.001), ARS (92.4% vs 96.7%, p = 0.002) and hospitalisation (93.5% vs 97.0%, p = 0.002) decreased by around 3%–7%. The performances of the online attendees were mainly distributed within the lower quartile performance of on-site participants and the 25%–75% interquartile range increased 3–7-fold. (c) Comparison of dose estimates performed by training participants with hematologic acute radiation syndrome (HARS) severity mirrored the known limitations of dose alone as a surrogate parameter for HARS severity at doses less than 1.5 Gy, but demonstrated correct determination of HARS 2–4 and support for clinical decision making at dose estimates >1.5 Gy, regardless of teaching format. (d) Overall, one-third of the online participants showed substantial misapprehension and insecurities of elementary course content that did not occur after the on-site teaching.

Infection Control in the Era of COVID-19: A Narrative Review.

COVID-19 quickly became a pandemic causing millions of infections and mortalities. It required real-time adjustments to healthcare systems and infection prevention and control (IPC) measures to limit the spread and protect healthcare providers and hospitalized patients. IPC guidelines were adopted and developed based on experience gained during the MERS-CoV and SARS-CoV outbreaks. The aim of this narrative review is to summarize current evidence on IPC in healthcare settings and patients with COVID-19 to prevent nosocomial infections during the actual pandemic. A search was run on PubMed using the terms (‘COVID-19’ [Mesh]) AND (‘Infection Control’ [Mesh]) between 2019 and 2021. We identified 86 studies that were in accordance with our aim and summarized them under certain themes as they related to COVID-19 infection control measures. All the guidelines recommend early diagnosis and rapid isolation of COVID-19 patients. The necessary precautions should be taken comprising the whole process, starting with an infectious disease plan, administrative and engineering controls, triage, and PPE training. Guidelines should target modes of transmission, droplet, aerosol, and oral–fecal, while recommending control precautions. Healthcare facilities must promptly implement a multidisciplinary defense system to combat the outbreak.

The Oncological Emergency of Intestinal Obstruction: ED Recognition and Treatment Outcomes

Gastrointestinal complications, like blockage, are among the most common oncological emergencies. We investigated whether individuals with cancer presenting at the emergency department (ED) with intestinal obstruction were triaged accurately, and we further evaluated the triage decisions' effect on their ED treatment outcomes. A retrospective review was completed on all available records of adult cancer patients who were admitted with intestinal obstruction to a tertiary referral hospital. Over 3 years, 46 cancer patients were admitted from the ED with a provisional diagnosis of intestinal obstruction, confirmed by radiological examination. More than half the patients were undertriaged, which often resulted in these patients experiencing a series of risky time delays in the ED. Patients were significantly delayed in reaching five treatment outcomes: first assessment with a physician, initiation of treatment, decision to admit, length of ED stay, and length of hospital stay. The application of triage in practice was inconsistent, inaccurate, and had a significant negative impact on patient treatment outcomes. The study results indicated the need to critically analyze current triage training and policies to increase their effectiveness. Improvement strategies are identified in the literature, and several are discussed. Involving triage nurses in this work is essential.

Oncology Nursing Telephone Triage Workshop: Impact on Nurses' Knowledge, Confidence, and Skill.

Outpatient oncology nurses are responsible for symptom assessment/management and care coordination during telephone triage. Nursing telephone triage interventions can improve patient outcomes and clinical efficiency. Therefore, the lack of education and training in telephone triage can greatly impact patient care. Using a prospective pretest/posttest design, we sought to determine if a telephone triage educational workshop would improve oncology nurses' knowledge, confidence, and skill over 12 weeks. The educational intervention incorporated an online didactic lecture, group case scenario, and feedback on a virtual triage simulation. Evaluation was conducted before and after the intervention through an online, 13-item survey (knowledge and confidence) and simulation utilizing a 56-item checklist (skills). Thirteen oncology nurses were enrolled; 54% did not have telephone triage experience before this job. A total of 12 participants completed the workshop. From pretest to posttest, there was a median 1.0 out of 5.0 (interquartile range, 2.8) improvement in confidence (P = .008) and a 26.3% (interquartile range, 15.2) improvement in skills (P = .002). There was no difference in knowledge scores from pretest to posttest (P = .11). This workshop was associated with an improvement in oncology nurse confidence and skill, using telephone triage models. It benefits an existing process within the outpatient center and it highlights a new educational strategy that may optimize nursing practice and improve patient care and experience. This workshop contributes to existing evidence of telephone triage models and nursing education. The findings can guide future research, nursing orientation, and educational activities within the field of nursing and telehealth.

Letting Residents Lead: Implementing Resident Admission Triage Call Curriculum and Practice.

Graduating residents are expected to be competent in triaging patients to appropriate resources. Before 2017, pediatric residents were not involved in admission triage decisions. In 2017, after implementing an admission triage curriculum (ATC), residents had opportunities to be involved in overnight admission calls with the emergency department (ED), which were initially supervised (joint calls), and as skills progressed, residents conducted calls and admitted patients independently. We implemented and evaluated the impact of a graduated ATC intervention bundle on pediatric resident opportunities to participate in admission triage, while monitoring resident confidence, the ED experience, and patient safety. We evaluated the impact of our ATC using quality improvement methodology. The primary outcome was the frequency of resident participation in joint and independent triage calls. Other measures included resident confidence, the ED clinician experience, and patient safety. Resident confidence and the ED clinician experience were rated via surveys. Safety was monitored with daytime hospitalist morning assessments and postadmission complications documented in the medical record. The percent of joint calls with the hospitalist increased from 7% to 88%, and 125 patients were admitted independently. Residents reported significant increases in adequacy of triage training and confidence in 3 triage skills (P < .001) after ATC. There were no complications or safety concerns on patients admitted by residents. ED clinicians reported increased admitting process efficiency and satisfaction. Our ATC intervention bundle increased the number of admission decision opportunities for pediatric residents, while increasing resident triage confidence, maintaining safety, and improving ED clinician experience.

Triage practice in emergency departments in tertiary hospitals across China: A multicenter national descriptive survey

Triage procedure remains at a developing stage in mainland China, and few studies have reported the current status. This study aimed to explore the triage practices presently implemented in emergency departments in mainland China. A descriptive online national survey was administered to nurses with experience in emergency department triage who worked in 64 hospitals in 2019. A total of 361 participants completed the survey. Only 210 nurses (58.2%) used triage systems. Approximately 5% of the participants reported that no nurse was allocated to triage during the evening and night shifts in their emergency departments. Most participants had fewer than 5 years of nursing experience (47%) and emergency nursing experience (58.2%) before fulfilling the triage role. This study shows the variability in triage guidelines as well as the inconsistency between different hospitals in nurses' entry qualifications to triage, in hospital workforce arrangements, and in triage training. These problems underscore the need to unify triage guidelines and to establish reasonable entry qualifications and appropriate workforce arrangements for triage nurses that ensure high triage quality and high levels of patient safety.

Strategies to Enhance Knowledge and Practical Skills of Triage amongst Nurses Working in the Emergency Departments of Rural Hospitals in South Africa.

Purpose: Lack of knowledge and practical skills on triage remains a global problem, especially within rural hospitals, and very little is known about enhancing the knowledge and skills of emergency nursing staff in rural hospitals of South Africa. The objective was to describe the perceived strategies for enhancing knowledge and practices of triage among nurses working in the emergency departments (EDs) of rural hospitals in South Africa. Research methods: A descriptive qualitative research design was applied to achieve the research objective. A non-probability sampling method was applied to select 17 professional nurses from rural hospitals. An unstructured face-to-face interview method was used to collect data. Data collected were analyzed using Tesch’s method of data analysis. Results: The study findings highlighted the academic needs of nurses working in the ED of rural hospitals. Two themes emerged from this study; (1) The consistent description of the importance of triage training for emergency unit staff, and (2) The description of measures to enhance triage practices amongst emergency unit staff. Findings indicated that triage knowledge and practice remains a challenge, but with formulated strategies like continuous training by workshops, refresher courses, and offering a training module on triage, evaluation of developed guidelines and benchmarks is often enhanced. Conclusions: The study describes the strategies to enhance the conversion of knowledge and practice of triage amongst nurses working in the ED of rural hospitals. The paper argues that the knowledge and practical skills of nurses working in ED are enhanced through the provision of continuous training as workshops, triage module, evaluating the developed guidelines to implement triage, and benchmarking with other hospitals.

Effect of Field Triage Training on Emergency Medical Technicians in Taipei City.

Injury is a leading cause of death among young adults. An accurately implemented fi led triage scheme (FTS) by emergency medical technicians (EMTs) is the first step for delivering right patients to the right hospital. However, the training effect of FTS on EMTs with different levels and backgrounds has scarcely been reported. We evaluated training effects of FTS among EMTs in Taipei. Standard FTS contains physiologic status, anatomical sites of injury, and mechanism of injury criteria. The intervention was a 30-minute lecture and pre-and-post tests, each containing five questions about trauma severity judgment (i.e., mechanism of injury [2 questions], anatomic sites of injury [2 questions], and physiological status [1 question]). The change in EMT accuracy was measured before and after training. Subgroup analyses were performed across EMTs with different levels and seniorities. From September 1, 2015 to March 31, 2016, 821 EMTs were enrolled, including 740 EMT-intermediates and 81 paramedics. Overall, EMT accuracy improved after the intervention in the intermediate (73.2% vs.85.5%, p < 0.05) and paramedic (76.0% vs.85.7%, p <0.01) groups. All trainees showed improvements in physiology and mechanism criteria, but paramedics showed decreased accuracy in anatomic criteria. The subgroup analysis showed that accuracy positively associated with prehospital care experience for major trauma cases 1 year before the training course, and the anatomical criterion accuracy was adversely associated with paramedic seniority. Field triage training can improve EMT accuracy for FTS. The anatomical aspect is more diffi cult to improve and should be emphasized in FTS training courses.

A Continued Professional Development Nursing Partnership in a Remote Bolivian Hospital.

Bolivia's recent enactment of universal health care to increase access and delivery of health services can increase health care demands in underresourced, rural communities. We describe how a global intradisciplinary partnership assessed changing health care needs in a recently expanded hospital in the Bolivian Amazon Basin. The collaboration resulted in designing and implementing an evidence-based triage training program to improve rapid assessment and health outcomes. The interdisciplinary triage training of 19 nurses and physicians showed a significant improvement in their knowledge and implementation capacity, as demonstrated by pre- and posttest scores. As an intradisciplinary team, trainees significantly increased consistency in triage assignments in nine of 10 clinical triage posttraining vignettes. We share insights to overcome unseen challenges and improve future data-driven, evidence-based global implementation projects. [J Contin Educ Nurs. 2021;52(3):142-149.].

Triage Training in Iran from 2010 to 2020: A Systematic Review on Educational Intervention Studies.

Background: Accurate decision-making in triage requires continuous education, so triage nurses should receive annual refresher courses. Identifying the most effective method can make the provision of practical education to triage staff in hospitals possible. This review was conducted with the aim to determine the effectiveness of triage education methods in Iran.Materials and Methods: In this systematic review on educational intervention studies, international and Iranian medical sciences databases were searched using a defined search strategy compatible with each database. PubMed, Scopus, Web of Science, Google Scholar, SID, Islamic Science Center (ISC), and IranDoc databases were searched for literature published from January 2010 to January 2020. The MeSH terms of “health care staff,” “triage,” “education,” and “Iran” in English and Persian were combined to develop a search strategy. Initially, 768 article titles were retrieved. Finally, 16 articles were selected for the review.Results: All conducted studies were quasi-experimental. Half of the studies had used a face-to-face approach for education (workshop, lecture, and simulation), and four studies had used lectures and pamphlets. All studies (except 1) reported that their educational intervention significantly improved nursing knowledge on triage.Conclusions: Almost all studies had reported the effectiveness of an educational intervention in improving nurses' triage knowledge. However, it seems that the non-face-to-face method is superior to the face-to-face method because of its learner-centeredness and cost-effectiveness. Moreover, providing educational content using a blended learning approach (simulation and games) can enhance the effectiveness of triage education.

Urology during COVID-19 Pandemic Crisis: A Systematic Review.

Background Coronavirus disease 2019 (COVID-19) has evolved as a pandemic of unimaginable magnitude. The health care system is facing a tremendous challenge to provide ethical and quality care. The transformation of the patient-based care to population-based care during the COVID-19 pandemic has raised ethical dilemma among urologists. Our objective is to explore the consensus in modified standard urology care, that can be adopted and applied during COVID-19 and similar pandemic. Methods We adopted an exploratory study design using secondary data. The data were extracted from a web-based medical library using keywords “COVID-19,” “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2),” and “urology.” We identify and extrapolate (screening, eligibility, and inclusion) the data using PRISMA protocol, and summarize pandemic standard urology care under four main themes: (1) general urology care, (2) choice of surgical modality, (3) triage, and (4) urology training. Result We identified 63 academic papers related to our research question. The majority are expert opinions and perspectives on urology care. The common consensus is triage-based urology care and surgeries. Life or organ threatening conditions need immediate attention. Universal protective measures (personal protective equipment, safe operative environment) and protocol-based patient care are necessary to prevent and control SARS-CoV-2 infection. Conservation of the resources and its rational distribution provide an ethical basis for population-based health care during a pandemic. Informed decision making serves best to patients, families, and society during the public health crisis. Conclusion COVID-19 pandemic tends to transform standard urology practice into crisis standard population-based care. The consensus in crisis is drawn from evolving pieces of medical evidence and public health ethics. The provision of urology care during a pandemic is based on the availability of resources; severity of the disease, consequences of deferment of service, and dynamics of the pandemic.

"Flipped Learning" in Disaster Triage: Polarizing Medical Student Attainment?

"Flipped learning" has become increasingly popular in medical education as a means of developing independent learning skills in students. The article by Zheng at al. (2020) highlights the potential utility of this approach in disaster triage training. However, the article also highlights to us some concerns regarding how "flipped learning" may favor certain learners over others in the provision of disaster triage education. Specifically, the article demonstrates the necessity for increased preclassroom preparation when a "flipped classroom" model is used, which inevitably privileges those with a higher ability to engage with self-directed learning. Although such a skill is important to develop in medical education, we fear it may lead to polarized student attainment rather than ensuring a maximum number of students achieve the requisite standard required. More research is consequently needed to inform the most efficacious means of facilitating disaster triage training that supports all students sufficiently, while also helping to nurture their independent learning skills.

Pediatric Critical Care Transport: Survey of Current State in Latin America. Latin American Society of Pediatric Intensive Care Transport Committee.

An electronic, anonymous, multicenter survey housed by Monkey Survey was sent to physicians in LA and included questions about hospital and pediatric critical transport, resources available and level of car. Nineteen Latin-American countries were asked to complete the survey. A total of 212 surveys were analyzed, achieving a representativity of 19 LA countries, being most participants (59.4%, n = 126) from South America (Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Uruguay and Venezuela). Most surveys were conducted by physicians of tertiary level centers (60.8%, n = 129), most of the institutions were classified by the participants as public health care centers (81.6%, n = 173). Most of the surveyed physicians (63.7%, n = 135) reported that there is a coordination center for critical care transport (CCT). In most cases, physicians report that a unified transport system for pediatric critical patients does not exist in their countries (67.45%, n = 143). Only 59 (30.7%) surveys reported the use of an exclusively pediatric critical care transport system. Most of these transport systems are described as a mixture of public and private efforts (51.56%, n = 99), but there is also a considerable involvement of government-funded critical transport systems (43.75%, n = 84). Specific training for personnel devoted to transportation of critically ill patients is reported in 55.6% (90), and the medical equipment necessary to carry out the transport is available in 67.7%. The majority (83.95%, n = 136) mentioned that access to advanced life support courses is possible. Training in triage and disaster is available in 44.1%. Physicians and registered nurse were identified as the transport providers in 41.5%, and only one third were made by pediatricians-pediatric nurse. The main reasons for transfers were respiratory illness, neonatal pathologies, trauma, infectious diseases, and neurological conditions. Overall, pediatric transport was reported as insufficient (70.19%, n = 148) by the surveyed physicians in LA and nonexisting by some of them (6.83%, n = 15). There were no regulations or laws in the majority of the surveyed countries (63.13%), and in the places where physicians reported regulatory laws, there were no dissemination (84.9%) by the local authorities. In LA, there is a great variability in personnel training, equipment for pediatric-neonatal transport, transport team composition, and characterization of critical care transport systems. Continued efforts to improve conditions in our countries by generating documents that standardize practices and generating scientific information on the epidemiology of pediatric transfers, especially of critically ill patients, may help reduce patient morbidity and mortality.

Sort, Assess, Life-Saving Intervention, Triage With Drone Assistance in Mass Casualty Simulation: Analysis of Educational Efficacy.

IntroductionMass casualty incident (MCI) simulation and triage are educational methods used to provide high fidelity training to first response teams. Simulation and triage need to be as effective as possible to train professionals for true emergencies involving mass casualty. Although MCI simulation and triage have been used in the pre-professional setting (i.e. medical school, nursing school, etc.), more data is required regarding quality improvement of these simulations. This study focuses on quality improvement of MCI simulation and triage in the pre-professional training. In order to evaluate simulation quality to optimize future triage simulations, this study had three specific aims: (1) assess participant accuracy of triage after training in Sort, Assess, Life-Saving Interventions, Triage/Transport (SALT); (2) evaluate the role of stress and confidence in participants of triage simulation; (3) determine trainees’ perception of unmanned aerial vehicles (drones) in the setting of mass casualty simulation.MethodsA total of 44 attendees of the University of Central Florida (UCF) College of Medicine Global Health Conference participated in this study across three groups. Each group was provided a 15-minute lecture on SALT protocol. After the training, the participants continued to a 30-minute simulation in which they were asked to accurately triage up to 46 patient-actors. Each participants’ triage designations were compared to the previously assigned designations of each patient-actor. Pre- and post-simulation surveys were collected and analyzed using Statistical Package for the Social Sciences (SPSS) (IBM Corp., Chicago, IL). All other data were analyzed using descriptive statistics. ResultsQualitative and Likert data for the simulation were collected from 44 participants. Given a total of 1,113 triage scores (average of 25.29 triage designations per person), there was data to support that novice learners in this study tended to under-triage using the SALT protocol after 15-minute SALT training, with an overall accuracy of 52.43%. Survey data showed that confidence in mass casualty triage improved post-simulation, improving from median 3/10 to 5/10. Most participants were unaware of the use of unmanned aerial vehicles in MCI but most had positive opinions of their usefulness in MCI after the simulation, with a median score of 8/10.ConclusionsParticipant accuracy of triage after undergoing a 15-minute training in SALT triage was 52.43%, with a non-statistically significant tendency to under-triage. This accuracy level is consistent with other studies of SALT triage in MCI, but the tendency to undertriage requires further study for validation. Stress levels during the simulation were significantly elevated, while post-simulation confidence increased significantly from pre-simulation. The perception of drone utility in MCI was favorable among participants in this study, indicating drones may be useful for first response teams in future mass casualty simulations.

Optimizing Scarce Resource Allocation During COVID-19: Rapid Creation of a Regional Health-Care Coalition and Triage Teams in San Diego County, California.

Successful management of an event where health-care needs exceed regional health-care capacity requires coordinated strategies for scarce resource allocation. Publications for rapid development, training, and coordination of regional hospital triage teams to manage the allocation of scarce resources during coronavirus disease 2019 (COVID-19) are lacking. Over a period of 3 weeks, over 100 clinicians, ethicists, leaders, and public health authorities convened virtually to achieve consensus on how best to save the most lives possible and share resources. This is referred to as population-based crisis management. The rapid regionalization of 22 acute care hospitals across 4500 square miles in the midst of a pandemic with a shifting regulatory landscape was challenging, but overcome by mutual trust, transparency, and confidence in the public health authority. Because many cities are facing COVID-19 surges, we share a process for successful rapid formation of health-care care coalitions, Crisis Standard of Care, and training of Triage Teams. Incorporation of continuous process improvement and methods for communication is essential for successful implementation. Use of our regional health-care coalition communications, incident command system, and the crisis care committee helped mitigate crisis care in the San Diego and Imperial County region as COVID-19 cases surged and scarce resource collaborative decisions were required.

Prevention and Control Strategies for Coronavirus Disease-2019 in a Tertiary Hospital in the Middle East of China.

BackgroundCoronavirus disease-2019 (COVID-19) is a new infectious disease. The COVID-19 outbreak has quickly spread globally and now is having remarkable effects on public health and national economies.PurposeEffective measures for prevention and control of nosocomial infection are urgently needed to control COVID-19 infection among medical staff.MethodsHerein, we described COVID-19 prevention and control strategies that have been implemented in a tertiary hospital in the middle east of China. Hospital layout was adjusted to prevent and control transmission. Other procedures were then implemented to prevent the spread of the virus, including specialized training and evaluation of medical staff, pre-testing and triage, measures to promote early identification of patients, environmental cleaning and disinfection, new medical waste processing procedures, new patient management procedures, timely disinfection of potential sources of nosocomial infection, and strict protective measures.ResultsSince the new measures were implemented, to date there have only been three new confirmed cases of COVID-19 infection, no cases of medical staff infection, and no COVID-19-related deaths at the hospital.ConclusionThe current report provides a protocol that could be implemented in medical departments in similar cities worldwide.

Flipped Classroom Approach Used in the Training of Mass Casualty Triage for Medical Undergraduate Students.

The aim of this study was to explore the application of the flipped classroom approach in the training of Mass Casualty Triage (MCT) to medical undergraduate students. In this study, 103 fourth-year medical students were randomly divided into a Flipped Classroom (FC) group (n = 51) and a Traditional Lecture-based Classroom (TLC) group (n = 52). A post-class quiz, simulated field triage (SFT) and feedback questionnaires were performed to assess both groups of students for their learning of the course. In the post-quiz, the median (IQR) scores achieved by students from the FC and TLC groups were 42(5) and 39(5.5), respectively. Significant differences were found between the two groups. In the SFT, overall triage accuracy was 67.06% for FC, and 64.23% for TLC students. Over-triage and under-triage errors occurred in 18.43% and 14.50% of the FC group, respectively. The TLC group had a similar pattern of 20.77% over-triage and 15.0% under-triage errors. No significant differences were found regarding overall triage accuracy or triage errors between the two groups. The FC approach could enhance course grades reflected in the post-quiz and improve students' satisfaction with the class. However, there was no significant difference of competency between the two groups demonstrated in the SFT exercise.

The impact of adult trauma triage training on decision-making skills and accuracy of triage decision at emergency departments in Malaysia: A randomized control trial

IntroductionPatients who visit emergency departments need to undergo a precise assessment to determine their priority and accurate triage category to ensure they receive the right treatment. AimTo identify the effect of triage training on the skills and accuracy of triage decisions for adult trauma patients. MethodA randomized controlled trial design was conducted in ten emergency department of public hospitals. A total of 143 registered nurses and medical officer assistants who performed triage roles were recruited for the control group (n = 74) and the intervention group (n = 69). The skill and accuracy of triage decisions were measured two weeks and four weeks after the intervention group were exposed to the intervention. ResultsThere was a significant effect on the skill of triage decision-making between the control and the intervention group p < 0.001, η2partial = 0.31. Concerning the accuracy of triage decisions, the effect was significantly different between the control group and the intervention group p < 0.001, η2partial = 0.66 across time. ConclusionThe triage training improved the skills of the participants and the accuracy of triage decision-making across time.

The effect of the emergency severity index triage training on the knowledge and decision-making of the medical interns

Introduction: We investigated the effect of education on the knowledge and decision-making of medical interns, based on emergency severity index (ESI) triage. Methods: In this pre and post-interventional study, 155 medical students who were passing their internship course of the emergency ward were enrolled with convenience sampling from July 2018 to June 2019. The students were randomly classified into two groups (103 cases and 52 controls). The questionnaire was administered twice in the control group (before initiating the educational class and 1 month after completion of the educational course). In the case group, the test was conducted at three times (before the educational class, immediately after completion of classes, and one month after completion of the educational course). The data were analyzed by using t test and ANOVA. Results: The total score of the students in the case group in the pre- and post-training stage (posttest 1) was 17.13±4.26 and 24.93±3.20 respectively, which had a significant difference (P&lt;0.001). The total score of the students in the posttest 2 was 23.38±5.66. Statistical test showed that there was a significant difference between the two groups of the students in terms of the test in the one month after completion of the educational course (P&lt;0.001) except for under triage (P=0.236). Conclusion: The findings indicated that education based on ESI triage was effective on the knowledge and decision-making of medical interns. Based on the results of this research and given the importance of triage, theoretical and practical educational courses are proposed for medical students