Strategies to Enhance Knowledge and Practical Skills of Triage amongst Nurses Working in the Emergency Departments of Rural Hospitals in South Africa
Abstract
:1. Introduction and Background
2. Research Materials and Methods
2.1. Study Site
2.2. Population and Sampling
2.3. Data Collection
3. Analysis
4. Results and Discussion of Findings
5. Theme 1: The Consistent Description of the Importance of Triage Training for Emergency Unit Staff
5.1. Sub-Themes 1.1: Participants Emphasized the Upskilling of Emergency Nurses on Triage as an Important Enhancement Factor of the Existing Triage Knowledge through Various Training Platforms
- Participant 3 (<5 years of experience): “By offering Training to all Emergency Department staff, and offer refresher courses annually.”
- Participant 1 (>10 years of experience): “Training and reinforcing information so that nurses don’t forget and evaluations, and correctional measures to help nurses know and be sure of what they are doing to be able to sort outpatients and save lives.”
- Participant 16 (>10 years of experience): “Providing training, re-triage, and assessment after each training using a questionnaire and providing emergency drills, delegate each one to triage, then discuss how it was after each case in Casualty will reinforce triage skills.”
- Participant 12 (<less than % years of experience): “On-going in-service training is key in enhancing the knowledge of triage.”
- Participant 10 (<5 years of experience): “Through continuous learning and development this includes in-service training, emergency drills, workshops, and on-going assessment (performance management systems).”
5.2. Sub-Theme 1.2: Triage Course/Module as an Orientation Course and Guidelines for Implementation Triage Suggested
- Participant 11 (>10 years of experience): “Having a training module not only to enrolled nurse’s auxiliary but to all the ranks who deal with patient’s care. They need to familiarize themselves with the meaning of priority when you are doing triage. There should be workshops about triage situations”.
- Participant 4 (Between 6–10 years of experience): “There should be a triage module for a workshop with specifying objectives and strategies of triage for emphasis and evaluation of the triage skill should be conducted at the end of the workshop.”
- Participant 8 (Between 6–10 years of experience): “yearly educational course to all nurses in emergency departments about triage, particularly the new nurses in the emergency department, is vital.”
6. Theme 2: Description of Measures to Enhance Practices amongst Emergency Unit Staff
6.1. Sub-Theme 2.1: Formulation of Clear Guidelines for Handling Patients in the Triage Area Viewed as Important
- Participant 3 (<5 years of working experience): “By having guidelines and algorithms available in the department, then have quarterly audits for the correct implementation of the guide, and evaluating the effectiveness.”
- Participant 4 (>10 years of working experience): “There should be information available to the public on the interpretation of triage colors about their urgency and waiting times.”
- Participant 17 (>10 years of working experience): “Having pamphlets on halls that elaborate different emergency care services, or rather procedures.”
“I found hospital audit helpful and engaging, as I could see what was done wrong, and discussed with others what could have been done based on [ETAT+ clinical practice guidelines] recommendations.”
“Using the while booklet [Rwanda basic pediatrics protocols] as we were auditing medical records helped to integrate [ETAT+] materials.”
“The audit here [in ETAT+ training] seems friendly. We are learning not blaming.”
6.2. Sub-Theme 2.2: Benchmarking on the Management of the Triage Area to Improve Practice Suggested
- Participant 7 (>10 years of working experience): “should also benchmark at other hospitals such as tertiary hospitals and see how it works.”
- Participants 10 (<5 years of working experience): “...including a...rotation of all nurses within the unit to the triage room.”
- Participant 13 (Between 5–10 years of working experience): “by allowing nurses who are working in rural emergency hospitals to come and work in the Provincial emergency department for exposure enhances triage knowledge and practice.”
- Participant 16 (>10 years of working experience): “Nurses can rotate from between the Casualty units of the hospitals annually; this will enhance their knowledge.”
6.3. Sub-Theme 2.3: Importance of Supervisors Allocated in the Triage Area Outlined
- Participant 13 (<6 years of working experience): “Supervision of newly employed nurses, encouraging nurses to do in-service (sometimes in your presence) so that you can identify the gaps, put complete triage form on triage board or wall so that it will aid them on how to complete triage form and also encouraging subordinates to ask questions where they don’t understand.”
- Participant 11 (<6 years of working experience: “There should be a supervisor who always checks triage forms so that the department improves from the loopholes.”
- Participant 5 (<6 years of working experience: “…having a leader/supervisor give feedback that will enhance the triage practice from the feedback.”
- Participant 16 (>10 years of working experience: “Shift leader to give feedback every day re-performance of staff and corrections where needed.”
7. Limitations of the Study
8. Recommendation
9. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Hospitals | Municipal Type |
---|---|
Dilokong Hospital | Greater Tubatse Municipality |
Mecklenburg | Greater Tubatse Municipality |
Jane Furse Hospital | Makhuduthamaga Municipality |
Groblersdal Hospital | Elias Motswaledi Municipality |
Matlala Hospital | Greater Marble Hall Municipality |
Variables | Totals (%) |
---|---|
Gender(M/F) | |
Female | 9(53%) |
Male | 8(47%) |
Qualification type | |
General professional nurse | 9 (53%) |
M.Cur (Masters in Nursing), Trauma speciality | 1 (6%) |
Diploma in Nursing (Trauma Specialty) | 7(41%) |
Working Experience | |
Less than 5 years | 6 (35%) |
6–10 years | 4 (24%) |
Above 10 years | 7 (41%) |
Themes | Sub-Themes | Categories |
---|---|---|
1. The consistent description of the importance of triage training for emergency unit staff | 1.1 Participants emphasized the upskilling of emergency nurses on triage as an important enhancement factor of the existing triage knowledge through various training platforms 1.2 Triage course/module as an orientation course and guidelines for implementation suggested |
|
2. The description of measures to enhance triage practices among emergency unity staff | 2.1. Formulation of clear guidelines for handling patients in the triage area viewed as important 2.2. Benchmarking on the management of the triage area to improve practice suggested 2.3. Importance of supervisors allocated in the triage area outlined |
|
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Phukubye, T.A.; Mbombi, M.O.; Mothiba, T.M. Strategies to Enhance Knowledge and Practical Skills of Triage amongst Nurses Working in the Emergency Departments of Rural Hospitals in South Africa. Int. J. Environ. Res. Public Health 2021, 18, 4471. https://doi.org/10.3390/ijerph18094471
Phukubye TA, Mbombi MO, Mothiba TM. Strategies to Enhance Knowledge and Practical Skills of Triage amongst Nurses Working in the Emergency Departments of Rural Hospitals in South Africa. International Journal of Environmental Research and Public Health. 2021; 18(9):4471. https://doi.org/10.3390/ijerph18094471
Chicago/Turabian StylePhukubye, Thabo Arthur., Masenyani Oupa. Mbombi, and Tebogo Maria. Mothiba. 2021. "Strategies to Enhance Knowledge and Practical Skills of Triage amongst Nurses Working in the Emergency Departments of Rural Hospitals in South Africa" International Journal of Environmental Research and Public Health 18, no. 9: 4471. https://doi.org/10.3390/ijerph18094471