The effectiveness of the South African Triage Toll use in Mahalapye District Hospital – Emergency Department, Botswana

Abstract

BackgroundThe study aimed to determine the proportion of each priority level of patients, time of performance in each priority level, and the reliability of the South African Triage Scale (SATS) tool at the Mahalapye District Hospital - Emergency Department (MDH-ED), a setting where the majority of the nurses were not formally trained on the use of the SATS.MethodsThis was a cross-sectional study using case records in MDH-ED from 1 January 2014 to 31 December 2014. A panel of experts from the Mahalapye site of the Family Medicine Department, University of Botswana, reviewed and scored each selected case record that was compared with the scores previously attributed to the nurse triage.ResultsFrom the 315 case records, both the nurse triage and the panel of expert triage assigned the majority of cases in the routine category (green), 146 (46%) and 125 (40%), respectively, or in the urgent category (yellow), they assigned 140 (44%) and 111 (35%) cases, respectively.Overall, there was an adequate agreement between the nurse triage and the panel of expert triage (k = 0.4, 95% confidence interval: 0.3–0.5), although the level of agreement was satisfactory.ConclusionFindings of the study reported that the profile of the priority-level categories in MDH-ED was made in the majority of routine and urgent patients, only the routine and the emergency patients were seen within the targeted time and they had a satisfactory level of reliability (between 0.4 and 0.6).

Burden, Characteristics and Process of Care Among the Pediatric and Adult Trauma Patients in Botswana’s Main Hospitals

“…Most Emergency Department visits for trauma patients constituted non-urgent conditions (green and yellow), and the pattern was similar for both pediatric and adult groups. The proportion of more severely injured patients (orange and red categories) was only about a third; comparable trends of triage categories have been reported in Botswana [27,40] as well as in South Africa [41,42], while there were no data from other African countries on this variable. Patients in green category have non-urgent injuries that are recommended to be treated within 4 h, while the yellow category has a target waiting time of 60 min and very urgent(orange) and critical(red) categories are recommended to be attended in 'less than 10 min' and 'immediate,' respectively [25].…”

Health-related reasons patients transfer from a clinic or health post to the Emergency Department in a District Hospital in Botswana

“…The district hospital triage system was adapted from the Princess Marina Hospital triage system, which was validated in Princess Marina Hospital and Mahalapye district hospital in Botswana [ 27 , 28 ]. Validation of the triage system in the study context is necessary [27] . There was a disproportion in the triage score and disposition in the study setting.…”

“…The average length of stay in the EC is four and half hours, and this is quite a long time considering that it is a district hospital, even though the median length of stay in a referral hospital was 9.6 hours. The increased length of stay in the EC is primarily due to other factors such as the laboratory results and radiological imaging turnaround times [27] . Similarly, in a Botswana tertiary hospital, organizational variables such as multiple referrals and investigations were the leading causes of a lengthy stay in the EC [15] .…”

Validation of a modified South African triage scale in a high-resource setting: a retrospective cohort study

“…The performance of the original SATS has mainly been studied in resource-limited settings [14][15][16][17][18][19]. The validity and reliability of the SATS Norway (SATS-N) have not yet been established.…”