Practice of Triage Decisions Among Healthcare Providers in Emergency Departments of Malaysia After Educational Program

Phase 1 is a based line survey to identify level of skill and accuracy of triage decision making. A total of 10 EDs hospital with 274 participants were invited to participate in the study project. A number of 202 were enrolled into the study. Phase 2 is an intervention study. All the 10 EDs of the hospital with participants who have obtained low TDMI score were identified. They were invited to enrol into phase 2 of the study. There was 143 HCPs of the 10 EDs, after excluding 59 participants who obtained a high score. The EDs of the 10 hospitals were divided into two categories: specialist (four) and non-specialist (six) hospitals. These EDs of the 10 hospitals (with participants who scored low) were randomized into control (5 hospitals) and intervention group (5 hospitals) using balloting method. The hospitals of control group comprised of 74 participants while 69 participants for the intervention group. The intervention was a form of lectures and discussions in a group, which were conducted in 140 minutes in each hospital and completed in one session. Intervention group was exposed to the intervention and not for control group. Measurement of skills and accuracy of triage for both groups were measured at 2 week and 4 weeks interval after intervention group exposed to the intervention. The intervention provided by nursing lecturer who expert in the field or trauma and emergency. The topic included was related with triage decision of adult trauma patient, participant's opinions based on survey in phase 1, such as Triaging, factors that may contribute to adjustment of triage decision such as mechanism of injury, type of injury. Pain and Glascow Coma Score assessment, the severity and triage categorization. Assessment of patient at triage desk and discussion of triage categorization using patient's scenaro-based questions.