Facilitators and Barriers of the Triage Process based on Emergency Nurses’ Experience with the Korean Triage and Acuity Scale: A Qualitative Content Analysis

Abstract

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.

Emergency nurses’ communication experiences with patients and their families during the COVID-19 pandemic: A qualitative study

“…Recently, crowding in EDs has led to increased emphasis on nurses’ communication skills and cooperation with team members in uncertain and complex clinical settings [3] , [6] . When critical patients are brought, ENs should be able to conduct triage collaboratively and rapidly [7] , [8] . Triage in Korean EDs consists of a team of doctors and nurses or led by nurses, using the Korean Triage and Acuity Scale to evaluate symptoms such as consciousness, hemodynamic status, and degree of respiratory distress to classify the patient's emergency level into one of five levels [4] .…”

“…Nurses communicate with patients and their families to form a therapeutic relationship and address patients’ nursing care needs [11] . Thus, effective communication coupled with responsive and accurate judgment is a vital competency for ENs [3] , [8] , contributing to improved patient safety and nursing quality [12] . Currently, oncology or intensive care units (ICU) nurses caring for terminally ill patients or those with ventilators are increasingly interested in communication; thus, communication education and interventions for listening and empathy are being introduced [13] , [14] , [15] .…”

Barriers to Rapid Triage in Trauma Centers: A Qualitative Content Analysis

“…Triaging can be very challenging for the staff due to insu cient medical resources, limited patient space, overcrowding, and "triage fatigue" (13). Triage nurses experience more stress than other emergency staff because they have to triage large numbers of patients accurately and quickly with limited space and resources (13,14). The resulting burnout leads to incorrect triage and endangers the patient's health (14,15).…”

“…Triage nurses experience more stress than other emergency staff because they have to triage large numbers of patients accurately and quickly with limited space and resources (13,14). The resulting burnout leads to incorrect triage and endangers the patient's health (14,15). Therefore, a careful examination of the triage processes and identi cation of obstacles is essential for nding workable solutions (16).…”

The Role of Preceptor and Knowledge of Students on Triage Skills in The Emergency Unit

“…Triage is a system of classifying patients quickly and precisely according to priority and providing care to patients with urgent conditions first. Through triage, patients can be separated from non-urgent conditions and will not experience life-threatening conditions if they wait for treatment (Moon et al, 2021). The main goal of triage is that patients can be grouped according to treatment needs, and treatment priorities can be determined (Admin et al, 2020).…”