Advertisement

Perspective of Emergency Pediatric Nurses Triaging Pediatric Patients in the Emergency Department: A Phenomenographic Study

Published:November 21, 2022DOI:https://doi.org/10.1016/j.jen.2022.10.007

      Abstract

      Introduction

      Triage, a process to determine illness severity, is implemented by emergency nurses to prioritize treatment and provide care for a maximum number of patients using limited resources. The competency of emergency nurses and a highly reliable triage are crucial for the provision of emergency care. Pediatric patients are different from adult patients in certain aspects, such as growth-phase characteristics, communication ability, and the onset of disease; these aspects often pose challenges during their primary triage. This study explored how emergency nurses triage pediatric patients using the Korean Triage and Acuity Scale.

      Methods

      Eleven emergency nurses (N = 11) working in the pediatric emergency department of a university hospital in Seoul, South Korea, were recruited using purposive sampling methods. Phenomenography was used to investigate the strategies by which these nurses use the Korean Triage and Acuity Scale to triage pediatric patients.

      Results

      The findings comprised 2 descriptive categories: 6 approaches on how to triage patients (categories of how) and 3 strategies (categories of what) used by pediatric emergency nurses to triage pediatric patients with the Korean Triage and Acuity Scale.

      Discussion

      The experience and proficiency of emergency nurses are essential factors for the effective triage of pediatric patients. Our findings qualitatively elucidate different ways of understanding pediatric triage and indicate the need for pediatric triage education programs.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Emergency Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Alshaibi S.
        • AlBassri T.
        • AlQeuflie S.
        • Philip W.
        • Alharthy N.
        Pediatric triage variations among nurses, pediatric and emergency residents using the Canadian triage and acuity scale.
        BMC Emerg Med. 2021; 21: 146https://doi.org/10.1186/s12873-021-00541-0
        • Leeies M.
        • Ffrench C.
        • Strome T.
        • Weldon E.
        • Bullard M.
        • Grierson R.
        Prehospital application of the Canadian triage and acuity scale by emergency medical services.
        CJEM. 2017; 19: 26-31https://doi.org/10.1017/cem.2016.345
        • Hinson J.S.
        • Martinez D.A.
        • Cabral S.
        • et al.
        Triage performance in emergency medicine: a systematic review.
        Ann Emerg Med. 2019; 74: 140-152https://doi.org/10.1016/j.annemergmed.2018.09.022
        • Choi D.H.
        • Hong W.P.
        • Song K.J.
        • et al.
        Modification and validation of a complaint-oriented emergency department triage system: a multicenter observational study.
        Yonsei Med J. 2021; 62: 1145-1154https://doi.org/10.3349/ymj.2021.62.12.1145
        • Manguy A.M.
        • Joubert L.
        • Oakley E.
        • Gordon R.
        Psychosocial care models for families of critically ill children in pediatric emergency department settings: a scoping review.
        J Pediatr Nurs. 2018; 38: 46-52https://doi.org/10.1016/j.pedn.2017.10.014
        • Fernández A.
        • Ares M.I.
        • Garcia S.
        • Martinez-Indart L.
        • Mintegi S.
        • Benito J.
        The validity of the pediatric assessment triangle as the first step in the triage process in a pediatric emergency department.
        Pediatr Emerg Care. 2017; 33: 234-238https://doi.org/10.1097/PEC.0000000000000717
        • Lee B.
        • Chang I.
        • Kim D.K.
        • Park J.D.
        • Korean Society of Pediatric Emergency Medicine
        Factors associated with triage modifications using vital signs in pediatric triage: a nationwide cross-sectional study in Korea.
        J Korean Med Sci. 2020; 35e102https://doi.org/10.3346/jkms.2020.35.e102
        • Oh B.Y.
        • Kim K.
        Factors associated with the undertriage of patients with abdominal pain in an emergency room.
        Int Emerg Nurs. 2021; 54100933https://doi.org/10.1016/j.ienj.2020.100933
        • Recznik C.T.
        • Simko L.M.
        Pediatric triage education: an integrative literature review.
        J Emerg Nurs. 2018; 44 (e9. https://doi.org/10.1016/j.jen.2018.01.003): 605-613
        • de Magalhães-Barbosa M.C.
        • Robaina J.R.
        • Prata-Barbosa A.
        • Lopes C.S.
        Validity of triage systems for paediatric emergency care: a systematic review.
        Emerg Med J. 2017; 34: 711-719https://doi.org/10.1136/emermed-2016-206058
        • Ebrahimi M.
        • Mirhaghi A.
        • Najafi Z.
        • Shafaee H.
        • Hamechizfahm Roudi M.
        Are pediatric triage systems reliable in the emergency department?.
        Emerg Med Int. 2020; 20209825730https://doi.org/10.1155/2020/9825730
        • Heffernan R.W.
        • Lerner E.B.
        • McKee C.H.
        • et al.
        Comparing the accuracy of mass casualty triage systems in a pediatric population.
        Prehosp Emerg Care. 2019; 23: 304-308https://doi.org/10.1080/10903127.2018.1520946
        • Bazyar J.
        • Farrokhi M.
        • Khankeh H.
        Triage systems in mass casualty incidents and disasters: a review study with a worldwide approach.
        Open Access Maced J Med Sci. 2019; 7: 482-494https://doi.org/10.3889/oamjms.2019.119
        • Genisca A.E.
        • Sampayo E.M.
        • Mackey J.M.
        • Johnson L.
        • Crouse H.L.
        Assessment of attitudes toward the emergency triage system in Belize.
        Glob Pediatr Health. 2020; 7https://doi.org/10.1177/2333794X20911581
        • Moon S.H.
        • Shim J.L.
        Triage accuracy of pediatric patients using the Korean triage and acuity scale in emergency departments.
        J Korea Acad Industr Coop Soc. 2018; 19: 626-634https://doi.org/10.5762/KAIS.2018.19.11.626
        • Akbayram H.T.
        • Coskun E.
        Paediatric emergency department visits for non-urgent conditions: can family medicine prevent this?.
        Eur J Gen Pract. 2020; 26: 134-139https://doi.org/10.1080/13814788.2020.1825676
        • ENA
        Position statement: Triage qualifications and competency.
        J Emerg Nurs. 2017; 43: 571-574https://doi.org/10.1016/j.jen.2017.08.008
        • Johnson K.D.
        • Schumacher D.
        • Lee R.C.
        Identifying strategies for the management of interruptions for novice triage nurses using an online modified Delphi method.
        J Nurs Scholarsh. 2021; 53: 718-726https://doi.org/10.1111/jnu.12683
        • Peng L.
        • Luo Z.
        • Wu L.
        Triage practice in emergency departments in tertiary hospitals across China: a multicenter national descriptive survey.
        Nurs Health Sci. 2021; 23: 490-497https://doi.org/10.1111/nhs.12833
        • Reay G.
        • Smith-MacDonald L.
        • Then K.L.
        • Hall M.
        • Rankin J.A.
        Triage emergency nurse decision-making: incidental findings from a focus group study.
        Int Emerg Nurs. 2020; 48100791https://doi.org/10.1016/j.ienj.2019.100791
        • Marton F.
        Phenomenography–describing conceptions of the world around us.
        Instr Sci. 1981; 10: 177-200https://doi.org/10.1007/BF00132516
        • Barnard A.
        • McCosker H.
        • Gerber R.
        Phenomenography: a qualitative research approach for exploring understanding in health care.
        Qual Health Res. 1999; 9: 212-226https://doi.org/10.1177/104973299129121794
        • Stolz S.A.
        Phenomenology and phenomenography in educational research: a critique.
        Educ Philos Theory. 2020; 52: 1077-1096https://doi.org/10.1080/00131857.2020.1724088
        • Yates C.
        • Partridge H.
        • Bruce C.
        Exploring information experiences through phenomenography.
        Libr & Inf Res. 2012; 36: 96-119https://doi.org/10.29173/lirg496
        • Kwak Y.H.
        • Kim D.K.
        • Jang H.Y.
        Utilization of emergency department by children in Korea.
        J Korean Med Sci. 2012; 27: 1222-1228https://doi.org/10.3346/jkms.2012.27.10.1222
        • Polit D.F.
        • Beck C.T.
        • Owen S.V.
        Is the CVI an acceptable indicator of content validity? Appraisal and recommendations.
        Res Nurs Health. 2007; 30: 459-467https://doi.org/10.1002/nur.20199
        • Dahlgren L.O.
        • Fallsberg M.
        Phenomenography as a qualitative approach in social pharmacy research.
        J Soc Adm Pharm. 1991; 8: 150-156
        • Dreher-Hummel T.
        • Nickel C.H.
        • Nicca D.
        • Grossmann F.F.
        The challenge of interprofessional collaboration in emergency department team triage-an interpretive description.
        J Adv Nurs. 2021; 77: 1368-1378https://doi.org/10.1111/jan.14675
        • Jang J.H.
        • Kim S.S.
        • Kim S.
        Educational simulation program based on Korean triage and acuity scale.
        Int J Environ Res Public Health. 2020; 17: 9018https://doi.org/10.3390/ijerph17239018
        • Recznik C.T.
        Comparison of Two Methods of Pediatric Triage Education.
        Dissertation. Duquesne University, 2018
        • Recznik C.T.
        • Simko L.C.
        • Travers D.
        • Devido J.
        Pediatric triage education for the general emergency nurse: a randomized crossover trial comparing simulation with paper-case studies.
        J Emerg Nurs. 2019; 45: 394-402https://doi.org/10.1016/j.jen.2019.01.009
        • Janes G.
        • Mills T.
        • Budworth L.
        • Johnson J.
        • Lawton R.
        The association between health care staff engagement and patient safety outcomes: a systematic review and meta-analysis.
        J Patient Saf. 2021; 17: 207-216https://doi.org/10.1097/PTS.0000000000000807
        • Moura B.R.S.
        • Nogueira L.S.
        Performance of the rapid triage conducted by nurses at the emergency entrance.
        Rev Lat Am Enfermagem. 2020; 28: e3378https://doi.org/10.1590/1518-8345.3467.3378

      Biography

      Ji Ae Yoon is a Nurse, Department of Nursing, Seoul National University Hospital, Seoul, South Korea. ORCID identifier: https://orcid.org/0000-0001-5654-2296.

      Biography

      Boo Hyo Park is a Nurse, Department of Nursing, Korea University Guro Hospital, Seoul, South Korea. ORCID identifier: https://orcid.org/0000-0002-1453-202X.

      Biography

      Sung Ok Chang is Professor, College of Nursing, and BK21 FOUR R and E Center for Learning Health Systems, Korea University, Seoul, South Korea. ORCID identifier: https://orcid.org/0000-0003-2710-4291.