Development and psychometric assessment of the triage nurses’ professional capability questionnaire in the emergency department

摘要

In the qualitative phase of the study, subjects were selected according to purposeful sampling and the inclusion criteria. Data were collected using the personal interviews, focus interviews, and observation. Accordingly, 24 in-depth, semi-structured interviews were conducted in which, 20 nurses (18 triage nurses and two triage head nurses), two general practitioners, and two emergency medicine specialists were interviewed face-to-face. In addition, two focus interview sessions were held with a group of five triage nurses and the triage unit was observed by the researcher for 48 h. The inclusion criteria for the nursing staff were having a bachelor’s degree in nursing and at least 1 year of professional practice; the emergency doctors were required to be at least a General Practitioner (GP) and have working experience of 6 months in the triage. Both nurses and doctors were included only if they were willing to participate in the study. The exclusion criteria were not being physically or emotionally fit for participation and having mental or cognitive disorders. Each individual interview lasted from approximately 60 to 90 min and each focus group interview lasted from approximately 90 to 120 min. All the interviews were conducted in the conference hall of the hospital. To make sure that the main subjects of the study were discussed during the interviews, the researchers devised and used an interview form: the first section of the form addressed the participants’ demographics and the second part was an interview guide. The guide stated that the participants should share their perspectives on and experiences of capabilities in triage. Explanations were provided if a participant found the concept of capability ambiguous. At the beginning of each interview, after the objective of the study had been explained, a few descriptive questions about the work experience, education, etc. of the respondent were asked. Subsequently, questions related to the subject of the study were asked, e.g. “Based on your experiences, what capabilities should triage nurses possess?”, and “As a triage nurse, have you ever had an experience which made you feel that you possess the necessary capabilities in a triage nurse? In addition, to increase the clarity of the information provided by the participants, the researchers included follow-up questions, e.g. “Can you explain that further? “What do you mean by that?, “Can you give an example or share one of your experiences?”. Overall, 12 observation sessions (48 h) were carried out in the present study. Each session lasted 4 h and all work shifts were included for observation. All the verbal and non-verbal communication of the triage nurses and their manner of interaction with the patients and their companions, their colleagues, and the emergency doctors, as well as their cooperation and participation in teamwork were monitored and recorded exactly as they were. In addition, the researchers observed and recorded the nurses’ manner of triaging and prioritizing patients, level of skill in documenting patients’ health status, measuring and recording patients’ vital signs, quick and accurate evaluation of patients’ conditions, manner of responding to the questions of patients and their companions, and observing work discipline. The researchers also monitored the triage nurses’ capacity for managing the situation and remaining calm at critical times when the triage unit was overcrowded. In the quantitative phase, subjects were selected via convenience sampling. The inclusion criteria for the triage nurses were having a bachelor’s degree in nursing and at least 1 year of professional practice. The exclusion criteria were incomplete answers on the questionnaire and having mental or cognitive disorders. (Table 1) shows the demographics of the participants for qualitative and quantitative phases.