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Determinants influencing triage system at tertiary care centre as perceived by triage nurse: a qualitative study
Sumana Bajracharya1, Ashis Shrestha2, Sushant Regmi1
1Department of General Practice and Emergency Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal.
Objectives:
The objective of this study is to explore the lived experiences of triage nurses.
Primary And Secondary Outcomes:
The primary and secondary outcomes are the identification of barriers and facilitators that influence effective triage practice in a tertiary care centre in a low- and middle-income country.
Design:
A qualitative phenomenological study was conducted, grounded in a realistic ontology, which assumes that reality is subjective and constructed through individual experiences. Semi-structured interviews were conducted with nursing staff until data saturation was achieved. Interviews were audio-recorded, transcribed, translated and analysed using Colaizzi's phenomenological analysis method. Member checking ensured credibility.
Setting:
The study was conducted in the triage unit of the emergency department at Patan Academy of Health Sciences, Nepal, where approximately 40 000 patients are served annually.
Participants:
In-depth interview was conducted among the staff working in the triage unit. The study required nine in-depth interviews to attain saturation.
Results:
Staff demonstrated a thorough understanding of the triage system and severity-based prioritisation tool used in triage. Training, protocols, teamwork and experience facilitated effective practice; however, resource limitations, overcrowding, staffing shortages, training gaps, communication challenges and social hierarchy adversely affected triage efficiency.
Conclusions:
Triage is practised with conceptual understanding; however, performance is constrained by resource limitations, workforce insufficiencies, administrative and sociocultural challenges.
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