Determinants influencing triage system at tertiary care centre as perceived by triage nurse: a qualitative study.

Abstract

The objective of this study is to explore the lived experiences of triage nurses. The primary and secondary outcomes are the identification of barriers and facilitators that influence effective triage practice in a tertiary care centre in a low- and middle-income country. A qualitative phenomenological study was conducted, grounded in a realistic ontology, which assumes that reality is subjective and constructed through individual experiences. Semi-structured interviews were conducted with nursing staff until data saturation was achieved. Interviews were audio-recorded, transcribed, translated and analysed using Colaizzi's phenomenological analysis method. Member checking ensured credibility. The study was conducted in the triage unit of the emergency department at Patan Academy of Health Sciences, Nepal, where approximately 40 000 patients are served annually. In-depth interview was conducted among the staff working in the triage unit. The study required nine in-depth interviews to attain saturation. Staff demonstrated a thorough understanding of the triage system and severity-based prioritisation tool used in triage. Training, protocols, teamwork and experience facilitated effective practice; however, resource limitations, overcrowding, staffing shortages, training gaps, communication challenges and social hierarchy adversely affected triage efficiency. Triage is practised with conceptual understanding; however, performance is constrained by resource limitations, workforce insufficiencies, administrative and sociocultural challenges.