Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Dec;14(4):506-511.
doi: 10.1016/j.afjem.2024.10.001. Epub 2024 Dec 7.

Triage implementation audit at the adult emergency department of Debre Tabor Comprehensive Specialized Hospital in Ethiopia

Belayneh Dessie Kassa  1 , Mebratu Libanos  2 , Kumlachew Geta  3 , Natnael Moges  4
Affiliations
Review

Triage implementation audit at the adult emergency department of Debre Tabor Comprehensive Specialized Hospital in Ethiopia

Belayneh Dessie Kassa et al. Afr J Emerg Med. 2024 Dec.

Abstract

Introduction: In an emergency room, triage is a crucial element that determines the clinical urgency of patients. Triage can dictate important decisions on the use of resources and the treatment that patients need. Many patients are seen later than necessary, wasting resources and time, and some may even be discharged without being seen, risking their lives. This study aimed to determine whether the triage tool was fully completed, properly measured, and documented, the triage early warning score (TEWS) was calculated, and whether patients were examined, distributed, and managed in appropriate areas.

Methods: An institution-based cross-sectional study with a retrospective chart review was conducted at Debre Tabor Comprehensive Specialized Hospital by selecting patients' charts using simple random sampling among patients who visited the adult Emergency Department from January 1, 2021, to December 31, 2023. The descriptive statistics were presented to characterize individual variables, and cross-tabulation was used to see the relationship between individual patient-related factors and their final triage status.

Results: From the randomly selected 345 patients' charts, 67 (19.4 %) didn't contain a triage sheet. The total triage early warning score was correctly calculated for only 21 (7.6 %) patients and properly triaged. Most of the patients were improperly triaged (92.4 %, n = 257), of which 253 (91 %) were under-triaged and four (1.4 %) were over-triaged. Fischer's exact test revealed a statistically significant relationship between patients' color-coding category, triage early warning score documentation, and the use of clinical discriminators and final triage assessment (p = 0.007, p = 0.000, and p = 0.000 respectively).

Conclusion: The status of our triage implementation is alarming and specifically the level of under-triage. There is a significant gap regarding the application of clinical discriminators and TEWS calculations.

Keywords: Debre Tabor Comprehensive Specialized Hospital; Implementation; Triage; Under-triage.

PubMed Disclaimer

Conflict of interest statement

The authors declared no conflict of interest.

Figures

Fig. 1:
Fig. 1
final triage assessment status for patients who visited the adult Emergency Department of Debre Tabor Comprehensive Specialized Hospital.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. George S., Read S., Westlake L., Williams B., Pritty P., Fraser-Moodie A. Nurse triage in theory and in practice. Arch Emerg Med. 1993;10(3):220–228. - PMC - PubMed
    1. Iserson K.V., Moskop J.C. Triage in medicine, part I: concept, history, and types. Ann Emerg Med. 2007;49(3):275–281. - PubMed
    1. ElGammal M.E. Emergency department triage. Why and How? Saudi Med J [Internet] 2014;35(8):789–790. https://smj.org.sa/content/35/8/789 [cited 2022 Oct 26]Available from. - PubMed
    1. FitzGerald G., Jelinek G.A., Scott D., Gerdtz M.F. Emergency department triage revisited. Emerg Med J EMJ. 2010;27(2):86–92. - PubMed
    1. Jiménez J.G., Murray M.J., Beveridge R., Pons J.P., Cortés E.A., Garrigós J.B.F., et al. Implementation of the Canadian Emergency Department Triage and Acuity Scale (CTAS) in the Principality of Andorra: can triage parameters serve as emergency department quality indicators? CJEM. 2003;5(5):315–322. - PubMed

LinkOut - more resources