scholarly journals Pediatric triage variations among nurses, pediatric and emergency residents using the Canadian triage and acuity scale

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saleh Alshaibi ◽  
Tala AlBassri ◽  
Suliman AlQeuflie ◽  
Winnie Philip ◽  
Nesrin Alharthy

Abstract Background Emergency care continues to be a challenge, since patients’ arrival is unscheduled and could occur at the same time which may fill the Emergency Department with non-urgent patients. Triaging is an integral part of every busy ED. The Canadian Triage and Acuity Scale (CTAS) is considered an accurate tool to be used outside Canada. This study aims to identify the chosen triage level and compare the variation between registered nurses, pediatric and adult emergency residents by using CTAS cases. Method This study was conducted at King Abdulaziz Medical City,Saudi Arabia. A cross-sectional self-administered questionnaire was used, and which contains 15 case scenarios with different triage levels. All cases were adopted from a Canadian triage course after receiving permission. Each case provides the patient’s symptoms, clinical signs and mode of arrival to the ED. The participants were instructed to assign a triage level using the following scale. A non-random sampling technique was used for this study. The rates of agreement between residents were calculated using kappa statistics (weighted-kappa) (95%CI). Result A total of 151 participants completed the study questionnaire which include 15 case scenarios. 73 were nurses and 78 were residents. The results showed 51.3, 56.6, and 59.9% mis-triaged the cases among the nurses, emergency residents, and pediatric residents respectively. Triage scores were compared using the Kruskal Wallis test and were statistically significant with a p value of 0.006. The mean ranks for nurses, emergency residents and pediatric residents were 86.41, 73.6 and 59.96, respectively. The Kruskal Wallis Post-Hoc test was performed to see which groups were statistically significant, and it was found that there was a significant difference between nurses and pediatrics residents (P value = 0.005). Moreover, there were no significant differences found between nurses and ER residents (P value> 0.05). Conclusion The triaging system was found to be a very important tool to prioritize patients based on their complaints. The results showed that nurses had the greatest experience in implementing patients on the right triage level. On the other hand, ER and pediatric residents need to develop more knowledge about CTAS and become exposed more to the triaging system during their training.

2021 ◽  
Author(s):  
Saleh Alshaibi ◽  
Tala AlBassri ◽  
Suliman AlQeuflie ◽  
Winnie Philip ◽  
Nesrin Alharthy

Abstract BackgroundEmergency care continues to be a challenge, since patients’ arrival is unscheduled and could occur at the same time which may fill the Emergency Department with non-urgent patients. Triaging is an integral part of every busy ED. The Canadian Triage and Acuity Scale (CTAS) is considered to accurate tool to be used outside Canada. This study aims to identify the chosen triage level and compare the variation between registered nurses, pediatric and adult emergency residents by using CTAS cases.MethodThis study was conducted at King Abdulaziz Medical City, Saudi Arabia. A cross-sectional self-administered questionnaire was used, and which contains 15 case scenarios with different triage levels. All cases were adopted from a Canadian triage course after receiving permission. Each case provides the patient’s symptoms, clinical signs and mode of arrival to the ED. The participants were instructed to assign a triage level using the following scale: 1=resuscitation, 2=emergent, 3=urgent, 4=less urgent, and 5=non-urgent. A non-random sampling technique was used for this study.ResultA total of 151 participants completed the study questionnaire. 73 (48.34%) were nurses and 78 (51.66%) were residents (42 pediatric residents and 36 emergency residents).Each participant was given a score based on the correct answer for the case scenario. A mean score was compared among the nurses, pediatric residents and emergency residents. Since our data were not normally distributed, we used the Kruskal-Wallis test to observe statistical differences between the groups. The Kruskal Wallis Post-Hoc test was performed to see which groups were statistically significant, and it was found that there was a significant difference between nurses and pediatrics residents (P value < 0.001). Moreover, there were no significant differences found between nurses and ER residents (P value > 0.05).ConclusionThe triaging system was found to be a very important tool to prioritize patients based on their complaints. The results showed that nurses had the greatest experience in implementing patients on the right triage level. On the other hand, ER and pediatric residents demonstrated a need to develop more knowledge about CTAS and become exposed more to the triaging system during their training.


2020 ◽  
Author(s):  
Saleh Alshaibi ◽  
Tala AlBassri ◽  
Suliman AlQeuflie ◽  
Winnie Philip ◽  
Nesrin Alharthy

Abstract Background Emergency care continues to be a challenge, since patients’ arrival is unscheduled and simultaneous which may fill the Emergency Department with non-urgent patients. Triaging is an integral part of every busy ED. The Canadian Triage and Acuity Scale (CTAS) is considered to be the most accurate and reliable tool for patient assessment worldwide. This study aims to identify the chosen triage level and compare the variation between registered nurses, pediatric and adult emergency residents by using CTAS cases. Methodology This study was conducted at King Abdulaziz Medical City, Saudi Arabia. A prospective self-administered questionnaire was used, and which contains 15 case scenarios with different triage levels. All cases were adopted from a Canadian triage course after receiving permission. Each case provides the patient’s symptoms, clinical signs and mode of arrival to the ED. The participants were instructed to assign a triage level using the following scale: 1=resuscitation, 2=emergent, 3=urgent, 4=less urgent, and 5=non-urgent. A non-random sampling technique was used for this study. Result A total of 151 participants completed the study questionnaire. 73 (48.34%) were nurses and 78 (51.66%) were residents (42 pediatric residents and 36 emergency residents). Each participant was given a score based on the correct answer for the case scenario. A mean score was compared among the nurses, pediatric residents and emergency residents. Since our data were not normally distributed, we used the Kruskal-Wallis test to observe statistical differences between the groups. The Kruskal Wallis Post-Hoc test was performed to see which groups were statistically significant, and it was found that there was a significant difference between nurses and pediatrics residents (P value < 0.001). Moreover, there were no significant differences found between nurses and ER residents (P value > 0.05). Conclusion The triaging system was found to be a very important tool to prioritize patients based on their complaints. The results showed that nurses had the greatest experience in implementing patients on the right triage level. On the other hand, ER and pediatric residents demonstrated a need to develop more knowledge about CTAS and become exposed more to the triaging system during their training.


2020 ◽  
Author(s):  
Kristin Natal Riang Gea

AbstrakKeselamatan pasien merupakan dasar dari pelayanan kesehatan yang baik. Pengetahuan tenaga kesehatan dalam sasaran keselamatan pasien terdiri dari ketepatan identifikasi pasien, peningkatan komunikasi yang efektif, peningkatan keamanan obat yang perlu diwaspadai, kepastian tepat lokasi, prosedur, dan tepat pasien operasi, pengurangan risiko infeksi, pengurangan risiko pasien jatuh. Tujuan penelitian untuk mengetahui hubungan antara pengetahuan dengan penerapan keselamatan pasien pada petugas kesehatan di Puskesmas Kedaung Wetan Kota Tangerang. Metode Penelitian menggunakan deskriptif korelasi menggunakan pendekatan cross sectional. Populasi sebanyak 50 responden. Teknik pengambilan sampel menggunakan total sampling. Instrumen yang digunakan berupa lembar kuesioner. Teknik analisa diatas menggunakan analisa Univariat dan Bivariat. Hasil Penelitian ada Hubungan Pengetahuan dengan Penerapan Keselamatan Pasien pada Petugas Kesehatan, dengan hasil, p value sebesar 0,013 &lt; 0,05 maka dapat disimpulkan bahwa ada Hubungan Pengetahuan dengan Penerapa Keselamatan Pasien pada Petugas Kesehatan. Kesimpulan penelitian ada Hubungan Pengetahuan dengan Penerapan Keselamatan Pasien.. AbstrackPatient safety is the basis of good health services. Knowledge of health personnel in patient safety targets consists of accurate patient identification, increased effective communication, increased safety of the drug that needs to be watched, certainty in the right location, procedure, and precise patient surgery, reduction in risk of infection, reduction in risk of falling patients. The purpose of this study was to determine the relationship between knowledge and the application of patient safety to health workers in the Kedaung Wetan Health Center, Tangerang City. The research method uses descriptive correlation using cross sectional approach. The population is 50 respondents. The sampling technique uses total sampling. The instrument used was a questionnaire sheet. The analysis technique above uses Univariate and Bivariate analysis. The results of the study there is a Relationship of Knowledge with the Implementation of Patient Safety in Health Officers, with the result, p value of 0.013 &lt;0.05, it can be concluded that there is a Relationship between Knowledge and Patient Safety Implementation in Health Officers. The conclusion of the study is the Relationship between Knowledge and the Implementation of Patient Safety.Keywords Knowledge, Patient safety, Health workers


2020 ◽  
Vol 8 (1) ◽  
pp. 62
Author(s):  
Indah Jayani ◽  
Fatma Sayekti Ruffaida

Approach to PLWHA by providing interpersonal counseling is the right thing to do to overcome psychological problems including social, emotional and spiritual aspects of PLWHA. This study aims to look at the effect of interpersonal counseling on social, emotional and spiritual responses in HIV/ AIDS patients. This research is a type of non-experimental research with a cross-sectional approach. The sample is post-test people and tested positive for HIV in the Kediri region, which is 32 with purpossive sampling technique. Data on social, emotional and spiritual responses were obtained based on the results of data recapitulation from the instrument in the form of a questionnaire. The results of the study with the non-parametric Wilcoxon test showed there were differences between social responses of HIV/AIDS patients before and after given interpersonal counseling with p value = 0,000, there were differences between the emotional responses of HIV/AIDS patients before being given interpersonal counseling and after being given counseling with p value = 0,000, and there is a difference between spiritual responses in HIV/AIDS patients before being given interpersonal counseling and after being given interpersonal counseling with p value = 0,000. It can be concluded that interpersonal counseling influences social, emotional and spiritual responses of HIV/AIDS patients. It is recommended that the mentoring of HIV/AIDS patients through interpersonal counseling can continue so as to enhance physiological responses that will have an impact on disease prognosis, prevention of opportunistic infections and reduce mortality rates for HIV patients/ AIDS.


Author(s):  
Lensi Natalia Tambunan ◽  
Lelly Oktarina ◽  
Nita Kusuma Lindarsih

Latar Belakang: Mobilisasi dini pada ibu nifas bertujuan untuk membantu menguatkan otot-otot perut, sehingga memperbaiki sirkulasi darah ke seluruh tubuh. Hal ini harus dipenuhi ibu selama masa nifas untuk mengembalikan organ-organ reproduksi, terutama untuk ibu yang post sectio caesaria. Mobilisasi pada ibu post sectio caesaria adalah suatu pergerakan, posisi atau adanya kegiatan yang dilakukan ibu setelah beberapa jam melahirkan dengan persalinan Caesar Namun, kenyataannya masih banyak ibu post sectio caesaria yang tidak mau melakukan mobilisasi dini karena merasa takut, malas untuk bergerak, merasa sakit dan lelah. Faktor fisiologis seperti kenaikan suhu tubuh (hipertermi), perdarahan yang berlebihan, nyeri, faktoe emosional seperti terjadinya kecemasan dan factor perkembangan seperti usia dan paritas.Tujuan: Penelitian untuk mengetahui hubungan paritas dengan pengetahuan ibu post Sectio caesaria tentang mobilisasi dini di RSUD Doris Sylvanus Palangka Raya Provinsi Kalimantan Tengah.Metode: Desain penelitian  ini  bersifat kuantitatif analitik observasional dengan menggunakan jenis desain cross sectional dengan tehnik pengambilan sampel yang digunakan adalah Accidental Sampling. Populasi pada penelitian ini adalah seluruh ibu post sectio caesaria  di RSUD dr. Doris Sylvanus Palangka Raya. Pengumpulan data dilakukan dengan menggunakan data primer.Data dianalisis secara chi square. Hasil: Hasil uji statistik diperoleh P value 0,964, berarti tidak ada perbedaan secara bermakna sehingga dapat disimpulkan tidak ada hubungan antara paritas dengan pengetahuan ibu post sectio caesaria tentang mobilisasi dini.Simpulan: Ibu post sectio caesaria dengan paritas 2 agar tetap diberikan informasi mengenai mobilisasi dini post sectio caesaria agar ibu memiliki pengetahuan yang baik, jika ibu memiliki pengetahuan yang baik mengenai mobilisasi maka ibu akan melaksanakan mobilisasi diniKata Kunci: Paritas, Ibu post sectio caesaria, Mobilisasi Dini. Background: Early mobilization of the postpartum mother aims to help strengthen the abdominal muscles, thereby improving blood circulation throughout. This must be fulfilled by the mother during puerperium to restore the reproductive organs, especially for mothers who are post sectional caesaria.  Mobilization of post sectio caesaria mothers is a movement, position or activity carried out by the mother after several hours of childbirth with caesarean delivery. However, in reality there are still many post sectio caesaria mothers who do not want to make early mobilization because they are afraid, lazy to move, feel sick and tiredPhysiological factors such as increased body temperature (hypertension), excessive bleeding, pain, emotional factors such as anxiety and developmental factors such as age and parity. Objective: The study was to find out the relationship between parity and post Sectio caesaria mother's knowledge about early mobilization in Doris Sylvanus Hospital in Palangka Raya, Central Kalimantan Province.Method: The design of this study was quantitative analytic observational using a cross sectional design with the sampling technique used was accidental sampling. The population in this study were all post sectio caesaria mothers in RSUD dr. Doris Sylvanus Palangka Raya.  Data collection was done using primary data. Data was analyzed by chi square.Result: The result of statistical tests obtained p value 0.964 means that there is no significant difference so that it can be concluded there is no relationship between parity and post-caesaria maternal knowledge about early mobilization.Conclusion: Post-caeserean mothers with parity 2 keep informed about early post-caesarean mobilization so that mothers have good knowledge about mobilization, mothers will carry out early mobilization.Keywords: Parity, Maternal Caesarean section, Early Mobilization. 


2019 ◽  
Vol 5 (1) ◽  
pp. 41
Author(s):  
Anny Thuraidah ◽  
Misbawati Misbawati ◽  
Nurlailah Nurlailah ◽  
Haitami Haitami

The kidneys are organs of the body that function to regulate water balance in the body, the concentration of electrolytes in the blood and acid-base balance and secretion of waste material. If the kidney fails to function, the patient will need immediate treatment and even undergo hemodialysis (HD) therapy. A critical indicator in determining whether a person with impaired kidney function requires HD therapy is to know the creatinine level. The study aimed to ascertain the differences in creatinine levels pre and post HD also study the relationship between the age, gender, duration and frequency of HD therapy of respondents with the decrease of creatinine levels pre and post. Type of research detailed survey with a cross-sectional design. The sample was taken using a total sampling technique of 35 respondents from H BadaruddinKasimHospitalin Tanjung with a sample examination technique using the Jaffe method. The examination results of creatinine levels average for pre and post hemodialysis was11,36 and 5,58 mg/dl, which decreased 51%. The analysis statistically used Paired T-Test has a p-value = 0,000, indicating a significant difference for creatinine levels pre and post HD. Relationship between Age, Gender, Duration, and Frequency of HD Therapy with the decrease of creatinine levels pre and post HD was analyzed with Spearmen correlation and had p values more than 0,05. It means there was no relation between them. Conclusion there were significant differences in creatinine levels reduction pre and post HD while the relationship between the four of respondent characteristics to the magnitude of creatinine reduction show that there was no significant relationship.


Author(s):  
Edza Aria Wikurendra ◽  
Muhammad Shafly Rabbani ◽  
Globila Nurika

Introduction: Good intensity of light dramatically affects the eyes. If there is less intensity of light. the eye muscles contract as much as possible to see objects or vice versa. If this happens continuously, it will cause damage to the eyes. Based on the preliminary study, it was found that as the auto welder operators have the task to observe the results of the auto welder engine to determine the quality of the welder, this type of work needs accuracy so that the right lighting intensity is required. This study aimed to determine the association between the lighting level and subjective visual fatigue complaints on operators in the auto welder section. Methods: The research method used was quantitative, with a cross- sectional approach and observational method. The samples in this study were 18 respondents from the total sampling technique. The instrument used was the Visual Fatigue Index (VTI) questionnaire. Moreover, the analysis of the study results used the one sample T-test statistical test to determine the association between the dependent and independent variables. Results: The one sample T-test results showed p-value = 0.012 < α = 0.05. This result showed an association between the lighting leveland subjective visual fatigue complaints on operators in the auto welder section. Conclusion: In this research, it was found that the majority of lighting levels that did not meet the standards had an association with subjective complaints of visual fatigue on the operators in the auto welder section.Keywords: auto welder, lighting, visual fatigue


2021 ◽  
Vol 2 (1) ◽  
pp. 39-44
Author(s):  
Munsara Khalid Khan ◽  
Khalid Rahim Khan

Background: People suffering from imposter syndrome despite being competent consider themselves less skillful and incapable. Such individuals are also more prone to regret their choice of career with consequent early drop out, experience burnout, more prone to medical errors, absenteeism and low job satisfaction.  The current study aims to determine the difference in the characteristics of imposter syndrome in dental students of preclinical and clinical phase and its gender predisposition. Objectives: 1. To find out the frequency and characteristics of imposter syndrome among dental students. 2. To evaluate the differences in the characteristics of imposter syndrome among dental students of preclinical and clinical year. 3. To determine gender predisposition of imposter syndrome among dental students. Methods: The cross-sectional study was conducted on 138 dental students of CMH Lahore Medical and Dental College. A validated questionnaire (Clance IP Scale) containing 20 items with 5-point Likert scale was used to collect data by convenient sampling technique. The characteristics of IP were determined by adding the scores of all items. Descriptive statistics were done, chi-square applied, p-value <0.05 was considered significant. Results: One hundred and thirty-eight students filled the IP Scale. The frequency of imposter syndrome is found to be 52.1% among Dental Students. Majority (72) of the dental students have frequent to intense imposter feelings. There is non-significant difference in the IP characteristics of male and female students. No significant difference in the characteristics of imposter syndrome is found between dental students of preclinical and clinical year. Conclusions: There frequency of imposter syndrome is high among Dental students. Non-significant difference in the IP characteristics is found between male and female students as well as students of preclinical and clinical year.


2020 ◽  
Vol 9 (1) ◽  
pp. 12-16
Author(s):  
Qurat ul Ain Khalid ◽  
Imran Mahmood Khan ◽  
Wajeeha Amber ◽  
Aqmal Laeeq Chishti ◽  
Khawaja Amjad Hassan

Background: Goal of the expanded program on immunization (EPI) is to ensure full immunization of children under one year of age to globally eradicate poliomyelitis, tetanus, measles-related deaths and to extend all new vaccines and preventive health interventions to children in all parts of the world. Demographic and health survey 2012-13 showed that in Pakistan complete immunization coverage is very low (54%) to achieve this goal. The objective of this study was to assess any improvement in terms of vaccination coverage in Pakistan in the last 3-4 years.Material and Methods: This descriptive cross-sectional study was carried out at outpatient department of Pediatric Medicine of Mayo Hospital Lahore from May, 2016 till November, 2016. The non-probability purposive sampling technique was used to include patients after taking informed consent. Demographic details were collected and parents were questioned about different vaccinations received and confirmed through vaccination card. Data analysis was done through SPSS version 20 and results were presented as frequencies and percentages. Chi-square test was applied for association among categorical variables.Results: Complete coverage of expanded program on immunization was achieved in 86% children. A statistically significant difference was noted between mother’s education and immunization coverage of children (P-value 0.013).Conclusions: Education of mother and socioeconomic status were two significant factors affecting immunization coverage. In order to meet target of 95% immunization coverage rate set by WHO, more awareness should be created among people with low socioeconomic status along with improvement of immunization facilities in these areas.Key words: Children, Expanded Program on Immunization, Immunization Coverage


Author(s):  
Beatriz Araújo Cassane Martins ◽  
Haydée Serrão Lanzillotti ◽  
Maria Elisa Barros

Objective: To verify the replicability of the questionnaire Assessing the Addition of IN NATURA Vegetable Oil to the Child’s Diet”. Study design: observational cross-sectional study. Place and Duration of Study: The study was carried out in two pediatric outpatient clinics, one of which refers to a health plan operator (SJM), municipality of São João de Meriti (RJ) and the other, at the Polyclinic Piquet Carneiro of the University from the State of Rio de Janeiro (PPC/UERJ), municipality of Rio de Janeiro (RJ), from March 2017 to January 2019. Sample: Responsible for children feeding, that is, those who buy the food prepare it or serve meals. SJM, n=150 and PPC/UERJ; n=150. Methodology: Doornik-Hansen test verified the Multivariate normality of the scores distribution of the items according to Likert scale. Kaiser-Meyer-Olkin was used as a criterion for identify the adequately of sample for the data adjustment. Conbrach's alpha indicated the internal consistency (coherence) between items on each dimension. The reproducibility by reliability was tested by test-retest by using the weighted Kappa coefficient. Results: Multivariate normality of the SJM scores: (chi2 (22)=602.969 Prob chi2=.0000) and PPC/UERJ: (chi2(22)=411.666 Prob chi2=.0000), adequacy of the samples, KMO: SJM=0.78 to 0.92 and PPC/UERJ=0.76 to 0.92, internal consistency of dimensions (Dimension 1 and 2) by Cronbach's alpha greater than 0.75 for SJM and PPC/UERJ, reproducibility of the questionnaire by weighted Kappa: 0.90 (p value.008), t test for two independent samples, SJM and PPC/UERJ: significant difference for Dimension 1, but not for Dimension 2.


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