Challenges and Barriers Affecting the Quality of Triage in Emergency Departments: A Qualitative Study

Bijani, Mostafa; Khaleghi, Ali

doi:10.31661/gmj.v8i0.1619

Cited by 28 publications

(32 citation statements)

References 21 publications

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“…Another category of the major challenges which affect emergency care personnel' clinical decision-making is inefficient organizational management. According to the study of Bijani et al, employment of inexperienced personnel who lack the required expertise, lack of facilities and equipment, inadequate support for the personnel, absence of clear instructions, conflicts in the regulations, and failure to hold workshops for the professional empowerment of emergency nurses are the most significant challenges which affect the quality of triage in emergency departments [31]. These findings are consistent with the results of the present study.…”

Section: Discussionsupporting

confidence: 92%

Major challenges and barriers in clinical decision-making as perceived by emergency medical services personnel: a qualitative content analysis

et al. 2021

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Background Having to work in unpredictable and critical conditions, emergency care services (EMS) personnel experience complicated situations at the scene of accidents which, inevitably, influence their clinical decisions. There is a lack of research into the challenges which these professionals encounter. Accordingly, the present study aims to explore the major challenges and barriers which affect clinical decision-making from the perspective of EMS personnel. Methods The present study is a qualitative work with a content analysis approach. Selected via purposeful sampling, the subjects were 25 members of the EMS personnel in Iran who met the inclusion criteria. The study lasted from December 2019 to July 2020. Sampling was maintained to the point of data saturation. Data were collected using semi-structured, in-depth, individual interviews. The collected data were analyzed via qualitative content analysis. Results The results of data analysis were categorized into four themes and eight categories. The main themes were professional capabilities, occupational and environmental factors, inefficient organizational management, and ethical issues. Conclusion The results of the present study show that clinical knowledge, experience, and skills contribute to emergency care personnel’s professional capabilities in making clinical decisions. Good teamwork skills and time management can prevent feelings of confusion when the number of the injured to be attended to is large. Effective clinical decision-making skills can not only help the personnel make the right decision, but enhances their resilience and enables them to adapt to hard and unpredictable conditions. Professional factors, organizational management, and ethical matters constitute the other major factors which influence the clinical decision-making of emergency care personnel at the scene of accidents and determine the quality of their clinical performance. Thus, it is essential that pre-hospital emergency care managers improve the quality of EMS personnel’s clinical decision-making skill.

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Section: Discussionsupporting

confidence: 92%

Major challenges and barriers in clinical decision-making as perceived by emergency medical services personnel: a qualitative content analysis

et al. 2021

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“…Another category of the major challenges which affect emergency care personnel' clinical decisionmaking is ine cient organizational management. According to the study of Bijani et al (2019), employment of inexperienced personnel who lack the required expertise, lack of facilities and equipment, inadequate support for the personnel, absence of clear instructions, con icts in the regulations, and failure to hold workshops for the professional empowerment of emergency nurses are the most signi cant challenges which affect the quality of triage in emergency departments [22]. These ndings are consistent with the results of the present study.…”

Section: Discussionsupporting

confidence: 91%

Major Challenges and Barriers in Clinical Decision-making as Perceived by Emergency Medical Services Personnel: A Qualitative Content Analysis

Bijani

Abedi

Karimi

et al. 2020

Preprint

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Background: Having to work in unpredictable and critical conditions, emergency care services (EMS) personnel experience complicated situations at the scene of accidents which, inevitably, influence their clinical decisions. There is a lack of research into the challenges which these professionals encounter. Accordingly, the present study aims to explore the major challenges and barriers which affect clinical decision-making from the perspective of EMS personnel. Methods: The present study is a qualitative work with a content analysis approach. Selected via purposeful sampling, the subjects were 25 members of the EMC personnel in Iran who met the inclusion criteria. The study lasted from December 2019 to July 2020. Sampling was maintained to the point of data saturation. Data were collected using semi-structured, in-depth, individual interviews. The collected data were analyzed via qualitative content analysis. Results: 4 main categories—professional capabilities, occupational and environmental factors, inefficient organizational management, and ethical issues—and 23 subcategories were extracted from the findings of the study. Conclusion: The results of the present study show that personal and occupational factors, organizational management, and ethical issues are the most significant sources of challenge which affect the clinical decision-making and, consequently, the performance of EMC personnel at the scene of accidents. Thus, it is essential that pre-hospital emergency care managers improve the quality of EMC personnel’s clinical decision-making skills and the reliability of care provided by them by creating the right professional and organizational settings, free of occupational distress.

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“…As for the rest of the hospitals in our study there was no objective triage or a triage scale in rst place for the staff to follow which was also reported in a study conducted in Iran [35].…”

Section: Discussionmentioning

confidence: 63%

“…In Malaysia, paramedic medical o cer assistants and registered nurses, both of whom have completed 3 years of training, become eligible to perform triage roles in the ED [30]. Meanwhile, in Iran, the various performance challenges that were identi ed affecting the quality of triage units in ED were the lack of clinical competency of the triage nurses, encouragement to motivate staff by the administration, speci c instructions and policies for triage patients and specialist training workshops to motivate triage nurses [35].…”

Section: Discussionmentioning

confidence: 99%

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Sudanese emergency departments: a study to identify the barriers to a well-functioning triage

Ibrahim

2021

Preprint

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Background: Triage system is a sorting system that categorizes patients on the basis of the severity of their condition and the availability of the resources in the emergency department. There has been little attention in the public literature to triage systems in Sudan. The aim of this study was to explore the triage system and identify the barriers in its application in hospitals in Sudan. Methods: A cross-sectional hospital based study was conducted at eight hospitals in Khartoum during December 2020. A multi-stage cluster sampling was applied. Data were obtained by interviewing emergency department staff using a structured questionnaire. The data were analyzed using statistical package for social sciences to find the association between various variables by chi-square test. Results: Most of the respondents stated that the triage system was deficient. Most of the participants of this study agreed that the role played by the administration in taking legislative decisions is crucial in improving the triage system. Among the factors found to be significant to a well-functioning triage system were, the need for substantial capital expenditure, p-value: 0.026, prudent legislative decisions, p-value: 0.026, adequate training of staff on means of performing efficient triaging, p-value: 0.017 and raising the awareness of the staff on the correct application of triage guidelines, p-value: 0.007. Conclusion: Currently there is no formal triage system in the State of Khartoum and has yet to be established. Policy making by administrators will play an important role in its implementation. It is suggested that prompt executive orders on improving the current triage system in Khartoum, should be carried out sooner than later, as the ripple effects of a well-functioning triage will decrease the average length of stay, mortality and morbidity rates and will eventually increase the patient’s satisfaction.

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Challenges and Barriers Affecting the Quality of Triage in Emergency Departments: A Qualitative Study

Cited by 28 publications

References 21 publications

Major challenges and barriers in clinical decision-making as perceived by emergency medical services personnel: a qualitative content analysis

Major challenges and barriers in clinical decision-making as perceived by emergency medical services personnel: a qualitative content analysis

Major Challenges and Barriers in Clinical Decision-making as Perceived by Emergency Medical Services Personnel: A Qualitative Content Analysis

Sudanese emergency departments: a study to identify the barriers to a well-functioning triage

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