الفهرس 
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Abstract
SUMMARY
Triage is the process that places the emergency patient in the right place at right time to receive the right level of care, in many emergency departments a nurse in triage role has become the gatekeeper to medical care, the triage nurse is responsible for the efficient and effective allocation of ED resources (Bakr & Badawi, 2022).
The basic responsibility of any ED is to provide quality care and optimal patient outcome, the triage nurse is the first point of contact between the patient and the ED, this contact may be a primary determinant in the final outcome. currently a wide variety of triage systems exists, although systems vary, the common element in successful triage systems is a skilled, efficient triage nurse, role of triage nurse is maintaining privacy or confidentiality, maintain good communication between triage or treatment area, and use all resources to maintain high standard of care (Joseph et al., 2023).
Aim of the study:
The study aimed to assess nurses’ performance regarding triage in emergency unit, through the following:
Assess nurses’ knowledge regarding triage in emergency unit.
Assess nurses’ practice regarding triage in emergency unit.
Assess nurses’ attitude regarding triage in emergency unit.
Develope a suggested guideline regarding triage in emergency unit.
The research questions:
The study was formulated to answer the following question:
What is the nurses’ performance level regarding triage in emergency unit?
Subjects and methods:
The research designs:
A descriptive exploratory design has been utilized to achieve the aim of this study and to answer the research question.
The setting:
The study was conducted in three emergency units in Ain Shams University Hospital.
Sample of the study:
A convenient sample included of all available nurses 100 nurses for emergency units at Ain Shams University Hospital.
Tools for data collection:
Tools of gathering data that were used to achieve the purpose of the study included the following:
Tool I: Nurses’ Self-administered Knowledge Assessment Questionnaire:
This tool was developed by the investigator in simple Arabic language based on extensive review of relevant and recent literatures (Ahmed & Ally, 2019, Duko et al., 2019 and Gebire et al., 2019). It was used to assess nurses’ knowledge regarding triage in emergency units. It included the following parts:
First part: it was concerned with demographic characteristics of the nurses under the study. It was consisted of 7 closed questions as regards, age, gender, marital status, educational qualifications, units, years of experience in the emergency units and training course.
Second part: it was concerned with hospital emergency unit data. It was consisted 6 closed questions regards hospitals emergency units’ data as number of beds, official system triage used in unit, standard scale used, categories assessment, area accommodate expected number of patients and needs of immediate resuscitation available.
Third part: it was concerned with the assessment of nurses’ knowledge regarding triage in emergency unit. It was consisted of 73 questions included: the main concepts, meaning, principles and aims of the triage system, preparing for triage system, how to apply triage system, role of nurse in triage process and hypothetical case regarding the triage of cases in the emergency unit.
Tool II: Nurses’ Triage Competencies Observational Checklists:
This tool was developed by the investigator. It was based on recent the review of related literature (Kerie et al., 2018, Society of Trauma Nurses, 2019, Advanced Trauma Life Support, 2020 and Thomas, 2020). It was used to assess nurses’ practice regarding triage in emergency unit. It included four sub checklists:
Primary survey observational checklist: it included 33 steps: Airway and protection of spinal cord, Breathing and ventilation, Circulation, Disability and Exposure and Control of Environment assessment.
Immediate lifesaving intervention observational checklist: it included 38 steps: basic life support, intubation, ventilation, surgical airway, IV fluid resuscitation, cardioversion, defibrillation and first aids intervention,
Secondary survey observational checklist: it included 112 steps: GCS, pain assessment, history taking as AMPLE allergies, medication currently used, past illness, last meal, events/environment, complete neurological exam and head -to-toe evaluation.
Definitive care observational checklist: it included 8 steps: referral, consultation, OR notification and treatment of all injury.
Tool III: Nurses’ Attitude regarding Triage Measuring Scale:
This tool was developed by the investigator, it was used to assess nurses’ attitude regarding triage in emergency unit. (Hemmatipour & Shahvali, 2018 and Reisi et al., 2018). It consisted of 49 steps it included: nurses’ attitudes toward the primary triage area, nurses’ attitudes toward the secondary triage area, nurses’ attitudes toward the final triage area, nurses’ attitudes toward the work environment regarding triage unit and nurses’ attitudes toward the training triage in emergency unit.
Results
53.0% of the studied nurses were in age group 20-30 years old with mean age 30.98 ± 8.22 years, 77.0% of them were females and 68.0% of them were married. Also, 46.0% of them had institute degree, 53.0% of them had 5-<10 years of experiences and 41.0% of them were working at surgical emergency unit. Additionally, 76.0% of them hadn’t attended courses related to patients’ triage.
56.0% of the studied nurses had unsatisfactory level of knowledge while 44.0% of them had satisfactory level of knowledge about patients’ triage in the emergency unit.
51.0% of the studied nurses had inadequate level of practice while, 49.0% of them had adequate level of practice related to patients’ triage in the emergency unit.
54.0% of the studied nurses had negative attitude while 46.0% of them had positive attitude regarding patients’ triage in the emergency unit.
There was a significant positive correlation between total level of knowledge, level of practice and level of attitude regarding patients’ triage in the emergency unit among the studied nurses.
Conclusion
In the light of the current study findings, it can be concluded that:
More than half of the studied nurses had unsatisfactory level of knowledge about patients’ triage in the emergency unit. And slightly more than half of the studied nurses had incompetent level of practice related to patients’ triage in the emergency unit. Also, more than half of the studied nurses had negative attitude regarding patients’ triage in the emergency unit. Additionally, there was a significant positive correlation between total level of knowledge and level of practice and level of attitude regarding patients’ triage in the emergency unit.
Recommendations
Based on the current study finding the following recommendations were proposed:
On-going and regular in –services educational programs regarding evidence –based guidelines should include the nurse performances regarding triage in emergency unit.
Developing and simplified comprehensive booklet and standard nursing procedure book should be designed including guidelines about basic knowledge and skill regarding triage system in emergency unit and should be available in all hospital.
Further study should be suggested to evaluate effect of implementing guidelines based on the studied nurse performance regarding triage in emergency unit on patients’ morbidity & mortality.
Further study should be suggested to applying evaluate factor affecting triage process in emergency unit.