The Current Situation Of Triage Nurses Competency And Related Factors In The Emergency Department In Tertiary General Hospitals In Hunan Province

Objective (1) To understand the current situation of emergency triage nurses’ positions setting and the staffing status quo in tertiary general hospitals in Hunan Province;(2) To understand the triage nurses’s competency about disease classification and decision-making of the tertiary general hospitals in Hunan Province;(3) To explore the factors that affect the triage nurse’s competency in tertiary general hospitals in Hunan Province;Methods204triage nurses from tertiary general hospitals in Hunan were investigated by filling out Demographic Data Recording Form, Emergency Department Triage General Information Questionnaire, Triage Decision Making Inventory and Triage Competency Assessment Tool from September to December,2013. Statistic analysis methods included statistic description, t-test, analysis of variance, Spearman rank correlation analysis and multiple linear regressions, conducted by SPSS18.0.Results (1) There are9out of35tertiary general hospitals in Hunan Province who has not yet set standardized pre-triage nurse jobs in the emergency departments;36(17.6%) nurses work as full-time triage nurses,106(52.0%) triage nurse had received triage training in different degrees and content;41(20.1%) triage nurse had learning experience in other hospitals;71(34.1%) were conducted assessments before becoming triage nurses.(2) Triage Competency Assessment Tool of204nurses scored (5.55±1.60). The correct rate of the four disease conditions assessment was statistically significant (P=0.000), where cases of the first condition<the second, the third<the forth. For the correct classification rate, arranged before the three were the fourth question, the first question, the tenth question, respectively, which are arranged in the three ninth question, the eighth question and third question.The percentage of the accuracy ratings among204nurses was55.5%, and34.2%of nurses’ triage ratings were under-triaged and10.3%were over-triaged. Triage nurses’s competency is poor at patients with shock. (3) Univariate analysis revealed that the triage competency was different significantly by ages (P=0.008), nursing seniority (P=0.036), Emergency nursing seniority (P=0.006) and triage seniority (P=0.002) and the following factors also influence the triage nurses competency: whether holding Emergency Nurse Specialist certificates (P=0.000) whether full-time triage nurse (P=0.016), with or without special triage training (P=0.000), different training time (P=0.000), having learning experience in other hospitals or not (P=0.000), whether conducting assessment and accreditation before becoming triage nurses (P=0.000) the frequency of assessment after becoming triage nurses (P=0.000), and the differences were statistically significant.The different gender (P=0.748), first academic degree (P=0.155), highest academic degree (P=0.694), professional post (P=0.215) of triage nurses revealed no significant difference.(4) Correlation analysis revealed that score of triage decision making inventory, score of experience dimension, score of intuition dimension, score of critical thinking dimension, age, nursing seniority, emergency seniority, triage seniority, professional post, with or without emergency specialist nurse license, whether full-time pre-triage nurse, with or without learning experience in other hospitals, the time of training, frequency of training were all correlated with triage competency positively (P<0.05)(5) Multiple stepwise regression indicated that>8h of triage education (β=0.378), learning experience in other hospitals(β=0.189), assessment frequency after becoming a triage nurse (β=0.152) and emergency seniority (β=0.116) were major influencing factors and explained30.8%of the variance in triage competency.Conclusions (1) Nine of thirty five tertiary general hospitals of Hunan Province have not conducted-triage positions setting or their members of this position are non-nursing stuff. In addition, they need to standardize the work of triage.(2) The overall triage nurse competency of disease classification in tertiary general hospitals in Hunan Province lie in a general level, and the triage decision-making skills are below the level of foreign studies. (3) The main factors that affect the triage nurses capabilities are>8h of triage education, learning experience in other hospitals, assessment frequency after becoming a triage nurseand emergency seniority...