Purpose To identify emergency department triage accuracy using the Korean Triage and Acuity Scale (KTAS) and evaluate the causes of mistriage. Methods This cross-sectional retrospective study was based on 1267 systematically selected records of adult patients admitted to two emergency departments between October 2016 and September 2017. Twenty-four variables were assessed, including chief complaints, vital signs according to the initial nursing records, and clinical outcomes. Three triage experts, a certified emergency nurse, a KTAS provider and instructor, and a nurse recommended based on excellent emergency department experience and competence determined the true KTAS. Triage accuracy was evaluated by inter-rater agreement between the expert and emergency nurse KTAS scores. The comments of the experts were analyzed to evaluate the cause of triage error. An independent sample t-test was conducted to compare the number of patient visits per hour in terms of the accuracy and inaccuracy of triage. Results Inter-rater reliability between the emergency nurse and the true KTAS score was weighted kappa = .83 and Pearson’s r = .88 ( p < .001). Of 1267 records, 186 (14.7%) showed some disagreement (under triage = 131, over triage = 55). Causes of mistriage included: error applying the numerical rating scale (n = 64) and misjudgment of the physical symptoms associated with the chief complaint (n = 47). There was no statistically significant difference in the number of patient visits per hour for accurate and inaccurate triage (t = -0.77, p = .442). Conclusion There was highly agreement between the KTAS scores determined by emergency nurses and those determined by experts. The main cause of mistriage was misapplication of the pain scale to the KTAS algorithm.

Our TCS is useful for the objective assessment of triage competency among emergency nurses and the evaluation of triage education programs.

The study examined predictors of male nurse turnover intention in Korea using data collected from Korean hospitals. The results were obtained based on a secondary analysis of data previously collected from 306 male nurses in 16 regions of Korea from December 2014 to February 2015. Our findings suggest that male nurse turnover intention is predicted by (1) individual factors: single (B = 0.93, p = 0.008); (2) organizational factors: organizational commitment (B = −0.36, p < 0.001), job satisfaction (B = −0.27, p = 0.001), and job stress (B = 0.24, p < 0.001); and (3) social factors: hospital location in medium-categorized cities (B = 0.70, p = 0.012) and kinship responsibility (B = 0.13, p = 0.026). These factors accounted for 56.9% of the total variance. To lower the rate of turnover intention among male nurses, strategic interventions should be implemented based on the factors identified in this study.

Since 2016, the Korean Triage and Acuity Scale (KTAS) algorithm has been applied to the triage process in the emergency departments (EDs) of Korea. This study aimed to investigate the facilitators of and barriers to a well-run triage function based on how Korean emergency nurses perceived the triage process and their experiences with it. Methods: Data were collected using focus group interviews from June 2018 to January 2019. Twenty emergency nurses were divided into two junior and four senior groups based on their level of clinical experience. All interviews were recorded as they were spoken and transcribed. Data were analyzed using qualitative content analysis. Results: The participants recognized the need for the KTAS algorithm to efficiently classify emergency patients and were working on it properly. According to the data, we extracted 4 themes and 20 subthemes. Four themes were as follows: (1) awareness about the necessity of triage, (2) facilitators to triage process, (3) barriers to triage process, and (4) suggestions for the establishment and development of triage. Conclusion:From the findings of this study, various vulnerabilities of the triage process were identified, and solutions were suggested from the emergency nurses' perspective. Educational, staffing, financial support, and periodic updates of the KTAS are needed to promote the triage process in the future.

This study examined the mediating and moderating effects of family cohesion on the relationship between positive psychological capital and health promotion behaviors among dual working parents of young children during the COVID-19 pandemic. We collected data from 214 dual working parents and analyzed the results using the IMB SPSS version 26.0 software. We found that positive psychological capital had significant effects on both family cohesion (β = 0.19, p < 0.001) and health promotion behaviors (β = 0.26, p < 0.001), while family cohesion showed a significant mediating effect on health promotion behaviors (β = 0.34, p = 0.002). Positive psychological capital (independent variable) also had significant effects on health promotion behaviors (β = 0.19, p < 0.001). Finally, a Sobel test showed that family cohesion had a significant partial mediating effect on the relationship between positive psychological capital and health promotion behaviors (Z = 2.70, p = 0.005) but no moderating effect. Thus, it is necessary to enhance health promotion behaviors through programs focused on both family cohesion and positive psychological capital. However, the fact that participants in this study were only from South Korea highlights the requirement for future research that includes participants from different cultural contexts and social systems.