Journal of Korean Academy of Nursing

Original Articles

Effects of a Web-Based Korean Triage and Acuity Scale Learning Program on Triage Self-Efficacy and Triage Performance Ability for Nurses in Emergency Department: Hyo-Jin Kim, Hee-Young Kang; J Korean Acad Nurs 2019;49(2):171-180. Published online April 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.2.171

Purpose

The Korean Triage and Acuity Scale (KTAS) is a tool used to classify the severity and urgency of emergency department (ED) patients, focusing on their symptoms. In consideration of the importance of the KTAS, a web-based learning program has emerged as a new mode of education; it enables ED triage nurses to access it anytime and anywhere, and according to their own learning abilities. This study aimed to develop a web-based KTAS learning program and evaluate its effects on self-efficacy and triage performance ability in ED nurses.

Methods

A quasi-experimental design with a non-equivalent control group pretest-posttest was used. The conceptual framework was Bandura's self-efficacy theory. There were 30 participants in the experimental group and 29 in the control group. The experimental group attended an orientation and 4 sessions of a web-based KTAS learning program. The learning program lasted 280 minutes over five weeks, consisting of 40 minutes of orientation and four 60-minute sessions.

Results

The scores of self-efficacy, triage performance ability in KTAS level, and chief complaints significantly increased in the experimental group compared to the control group. In addition, the numbers of under-triage in KTAS significantly decreased in the experimental group in comparison to the control group.

Conclusion

The results suggest that the learning program was effective in improving ED nurses' level of self-efficacy and triage performance ability (KTAS level and KTAS chief complaint). Accordingly, the web-based KTAS learning program can be applied as an education intervention to improve ED nurses' triage skill.

Citations

Citations to this article as recorded by

Optimizing triage education for emergency room nurses: A scoping review
Hui Ju Shin, Subin Park, Hyun Joo Lee
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Linyuan Zhang, Bo Gao, Fang He, Chao Wu, Juan Du, Li Zhang, Juan Liang, Hongjuan Lang
Nurse Education in Practice.2024; 80: 104145. CrossRef
Effectiveness of the Patient’s Severity Classification Competency Promotion Virtual Reality Program of Nursing Students during the COVID-19 Pandemic Period
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Effects on Triage Competency Based on Nursing Task Performance and Self-Efficacy of Nurses in Regional Emergency Medical Institutions
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Korean Journal of Adult Nursing.2022; 34(3): 304. CrossRef
The Effect of Competency-Based Triage Education Application on Emergency Nurses’ Triage Competency and Performance
Sun-Hee Moon, In-Young Cho
Healthcare.2022; 10(4): 596. CrossRef
Factors Influencing Patient Satisfaction in an Emergency Department Based on the Use of the Korea Triage and Acuity Scale
Keun Hee Park, Min Yoon, Myoung Soo Kim
Korean Journal of Adult Nursing.2022; 34(3): 338. CrossRef
Factors associated with the undertriage of patients with abdominal pain in an emergency room
Boo Young Oh, Kisook Kim
International Emergency Nursing.2021; 54: 100933. CrossRef
Facilitators and Barriers of the Triage Process based on Emergency Nurses’ Experience with the Korean Triage and Acuity Scale: A Qualitative Content Analysis
Sun-Hee Moon, Mi-Kyeong Jeon, Deok Ju
Asian Nursing Research.2021; 15(4): 255. CrossRef
Effect of problem-based learning on severity classification agreement by triage nurses
Kyeongmin Jang, Eunmi Jo, Kyoung Jun Song
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Remote Diagnosis System of Uremia Complicated with Sleep Disorder and Effectiveness of Nursing Intervention
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Comparing the Effect of Web-based Networking Education and Lectures on Learning of Hospital Triage in Nursing Students in Armed Forces Universities of the Islamic Republic of Iran in the Covid-19 Pandemic
Ashkan Morovati, Zahra Farsi, Nahid Rajai, Seyede Azam Sajadi
Military Caring Sciences.2021; 8(2): 127. CrossRef

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Evaluation of Validity of the Korean Triage and Acuity Scale: Heejung Choi, Jong Sun Ok, Soo Young An; J Korean Acad Nurs 2019;49(1):26-35. Published online February 28, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.1.26

Abstract PDF

Purpose

The aim of this study was to identify the predictive validity of the Korean Triage and Acuity Scale (KTAS).

Methods

This methodological study used data from National Emergency Department Information System for 2016. The KTAS disposition and emergency treatment results for emergency patients aged 15 years and older were analyzed to evaluate its predictive validity through its sensitivity, specificity, positive predictive value, and negative predictive value.

Results

In case of death in the emergency department, or where the intensive care unit admission was considered an emergency, the sensitivity, specificity, positive predictive value, and negative predictive value of the KTAS were 0.916, 0.581, 0.097, and 0.993, respectively. In case of death in the emergency department, or where the intensive or non-intensive care unit admission was considered an emergency, the sensitivity, specificity, and positive predictive value, and negative predictive value were 0.700, 0.642, 0.391, and 0.867, respectively.

Conclusion

The results of this study showed that the KTAS had high sensitivity but low specificity. It is necessary to constantly review and revise the KTAS level classification because it still results in a few errors of under and over-triage. Nevertheless, this study is meaningful in that it was an evaluation of the KTAS for the total cases of adult patients who sought help at regional and local emergency medical centers in 2016.

Citations

Citations to this article as recorded by

Predictive validity of resource-adjusted Korean Triage and Acuity Scale in pediatric gastrointestinal tract foreign body patients
Jin Hee Lee, Jin Hee Jung, Hyun Noh, Mi Jin Kim
Scientific Reports.2024;[Epub] CrossRef
Effect of storage duration on outcome of patients receiving red blood cell in emergency department
Yu-Kyung Koo, Sol Ji Choi, Soon Sung Kwon, Jinwoo Myung, Sinyoung Kim, Incheol Park, Hyun Soo Chung
Scientific Reports.2024;[Epub] CrossRef
Inter hospital external validation of interpretable machine learning based triage score for the emergency department using common data model
Jae Yong Yu, Doyeop Kim, Sunyoung Yoon, Taerim Kim, SeJin Heo, Hansol Chang, Gab Soo Han, Kyung Won Jeong, Rae Woong Park, Jun Myung Gwon, Feng Xie, Marcus Eng Hock Ong, Yih Yng Ng, Hyung Joon Joo, Won Chul Cha
Scientific Reports.2024;[Epub] CrossRef
A novel deep learning algorithm for real-time prediction of clinical deterioration in the emergency department for a multimodal clinical decision support system
Arom Choi, Kwanhyung Lee, Heejung Hyun, Kwang Joon Kim, Byungeun Ahn, Kyung Hyun Lee, Sangchul Hahn, So Yeon Choi, Ji Hoon Kim
Scientific Reports.2024;[Epub] CrossRef
Validity of the Korean triage and acuity scale in older patients compared to the adult group
Ho Sub Chung, Myeong Namgung, Dong Hoon Lee, Yoon Hee Choi, Sung Jin Bae
Experimental Gerontology.2023; 175: 112136. CrossRef
Predictive indicators for determining red blood cell transfusion strategies in the emergency department
Junhyup Song, Sinyoung Kim, Hyun Soo Chung, Incheol Park, Soon Sung Kwon, Jinwoo Myung
European Journal of Emergency Medicine.2023; 30(4): 260. CrossRef
Development and Validation of Simple Age-Adjusted Objectified Korean Triage and Acuity Scale for Adult Patients Visiting the Emergency Department
Seung Wook Kim, Yong Won Kim, Yong Hun Min, Kui Ja Lee, Hyo Ju Choi, Dong Won Kim, You Hwan Jo, Dong Keon Lee
Yonsei Medical Journal.2022; 63(3): 272. CrossRef
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Ye Lim Lee, Sang Ook Ha, Young Sun Park, Jeong Hyeon Yi, Sun Beom Hur, Ki Ho Lee, Ki Yong Hong, Ju Young Sin, Duk Hwan Kim, Jun Kwon Cha, Jin Hyuck Kim
Hong Kong Journal of Emergency Medicine.2021; 28(2): 85. CrossRef
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Pediatric Emergency Medicine Journal.2021; 8(2): 57. CrossRef
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Pediatric Emergency Department Utilization and Coronavirus Disease in Daegu, Korea
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Characteristics of children with trauma compared to those with disease in the emergency department: a Korean single regional emergency medical center study
Yosub Hwang, Ha Young Jo, Hye Won Yoo, Young Mi Kim, Hye-Young Kim
Pediatric Emergency Medicine Journal.2020; 7(2): 108. CrossRef
Alert Override Patterns With a Medication Clinical Decision Support System in an Academic Emergency Department: Retrospective Descriptive Study
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JMIR Medical Informatics.2020; 8(11): e23351. CrossRef

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Development of a Triage Competency Scale for Emergency Nurses: Sun Hee Moon, Yeon Hwan Park; J Korean Acad Nurs 2018;48(3):362-374. Published online January 15, 2018; DOI: https://doi.org/10.4040/jkan.2018.48.3.362

Abstract PDF

Abstract Purpose

This study aimed to develop a triage competency scale (TCS) for emergency nurses, and to evaluate its validity and reliability.

Methods

Preliminary items were derived based on the attributes and indicators elicited from a concept analysis study on triage competency. Ten experts assessed whether the preliminary items belonged to the construct factor and determined the appropriateness of each item. A revised questionnaire was administered to 250 nurses in 18 emergency departments to evaluate the reliability and validity of the scale. Data analysis comprised item analysis, confirmatory factor analysis, contrasted group validity, and criterion-related validity, including criterion-related validity of the problem solving method using video scenarios.

Results

The item analysis and confirmatory factor analysis yielded 5 factors with 30 items; the fit index of the derived model was good (χ ²/df =2.46, Root Mean squared Residual=.04, Root Mean Squared Error of Approximation=.08). Additionally, contrasted group validity was assessed. Participants were classified as novice, advanced beginner, competent, and proficient, and significant differences were observed in the mean score for each group (F=6.02, p=.001). With reference to criterion-related validity, there was a positive correlation between scores on the TCS and the Clinical Decision Making in Nursing Scale (r=.48, p<.001). Further, the total score on the problem solving method using video scenarios was positively correlated with the TCS score (r=.13, p=.04). The Cronbach's α of the final model was .91.

Conclusion

Our TCS is useful for the objective assessment of triage competency among emergency nurses and the evaluation of triage education programs.

Citations

Citations to this article as recorded by

Effects of Critical Thinking Disposition, Clinical Judgement, and Nurse–Physician Collaboration on Triage Competency Among Triage Nurses
Ji-Won Song, Hyung-Ran Park
Healthcare.2025; 13(4): 405. CrossRef
Triage—clinical reasoning on emergency nursing competency: a multiple linear mediation effect
Won-Oak Oh, Myung-Jin Jung
BMC Nursing.2024;[Epub] CrossRef
Korean Triage and Acuity Scale education using role-playing and its effects on triage competency: A quasi-experimental design
Yon Hee Seo, Sun-Og Lim, Vanessa Carels
PLOS ONE.2024; 19(10): e0311892. CrossRef
Construction of learning objectives and content for emergency triage nurses in tertiary general hospitals: A Delphi study
Linyuan Zhang, Bo Gao, Fang He, Chao Wu, Juan Du, Li Zhang, Juan Liang, Hongjuan Lang
Nurse Education in Practice.2024; 80: 104145. CrossRef
Concept analysis of psychiatric nursing competency in psychiatric nursing
Hwa-Bok Choi
Archives of Psychiatric Nursing.2024; 52: 130. CrossRef
Patient Satisfaction With the Level of Competence of the Triage Nurse in Hospital Emergency Departments
Meritxell López Hernández, Montserrat Puig‐Llobet, Sergio Higon Fernández, Marta Franco Freirut, Yolanda Moreno Mateos, Jordi Galimany Masclans
Journal of Clinical Nursing.2024;[Epub] CrossRef
Enhancing triage accuracy in emergency nurses: The impact of a game-based triage educational app
Sun-Hee Moon, Su Ol Kim
International Emergency Nursing.2024; 72: 101398. CrossRef
Emergency nurses’ communication experiences with patients and their families during the COVID-19 pandemic: A qualitative study
Soyoung Shin, Hye Jin Yoo
International Emergency Nursing.2023; 66: 101240. CrossRef
Influence of Emergency Department Nurses' Grit, Self-Leadership, and Communication on Their Triage Competencies: A Descriptive Survey Study
Gwiseon Jeong, Hyeongsuk Lee
Korean Journal of Adult Nursing.2023; 35(4): 356. CrossRef
Factors affecting triage competence among emergency room nurses: A cross‐sectional study
Seokhwa Hwang, Sujin Shin
Journal of Clinical Nursing.2023; 32(13-14): 3589. CrossRef
Professional Self-Concept, Job Stress, and Triage Competency Among Emergency Nurses: Secondary Data Analysis of a Cross-Sectional Survey
You-Jin Cho, Young-Ran Han, Yeo-Won Jeong
Journal of Emergency Nursing.2022; 48(3): 288. CrossRef
The Effect of Competency-Based Triage Education Application on Emergency Nurses’ Triage Competency and Performance
Sun-Hee Moon, In-Young Cho
Healthcare.2022; 10(4): 596. CrossRef
Factors Associated with School Nurses’ Triage Competency in South Korea
Jaehee Yoon, Heesook Son
International Journal of Environmental Research and Public Health.2021; 18(16): 8279. CrossRef
Development of emergency nursing care competency scale for school nurses
Jaehee Yoon
BMC Nursing.2021;[Epub] CrossRef
Factors associated with the undertriage of patients with abdominal pain in an emergency room
Boo Young Oh, Kisook Kim
International Emergency Nursing.2021; 54: 100933. CrossRef
Development and validity of the Korea psychiatric triage algorithm
Jeongmin Ha, Kyeongmin Jang, Misuk An
BMC Nursing.2021;[Epub] CrossRef

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A Study on the Triage and Statitical Data of Patients in the Emergency Room, PNU: Young Hae Kim, Hwa Ja Lee, Seok Ju Cho; Journal of Korean Academy of Nursing 2001;31(1):68-80. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2001.31.1.68

Abstract PDF

The purpose of this study is to analyze ER patient's Triage and other statistical data. The subjects were 12,618 patients who visited the ER during the year 1998. The study showed the following results; 1. The male vs female ratio was 1.3 : 1.0, the male were in the majority (56.6%), and the age range of 20-29 old was the majority (15.3). The patients who visited ER at 8-10 pm were the majority (11.5%). On Sunday the number of patients who visited the ER were 2,189, and the majority were 17.4%. On Saturday the number of patients was visited the ER were 1,944 patients the second majority (15.4%). Their traffic means : the general passenger cars (75.5%), 119 or hospital ambulance (11.3%). 2. The reasons of visiting ER were : diseases (59.2%), injuries (23.7%). The disease vs injury ratio was 100 : 69. 3. Triage : urgent 40.7%, non-urgent 38.2%, acute 17.8%, and critical 3.2%. 4. The time of waiting and staying in the ER by the Triaget: the average time was 572 minutes (9.53 hrs.). The majority of critical patients (20.5%), acute patients (24.7%) and urgent patients (21.2%) stayed 12-24 hrs., but the majority of non-emergent (27.8%) stayed not longer than one hour. 5. Treatments by the Triage : the 42.9% of critical patients, and 61.3% of acute patients, 57.5% of urgent patients were admitted. But 91.8% of the non-emergents were discharged and 4.7% was admitted. Mortality of total ER visiter were 1.7%. DAA portion was 0.86%. 26.6% of the critical patients were DAA. DAA vs DOA ratio was 1.3 : 1.0. 6. Visiting time, monthly and seasonal distribution by the Triage : the majority of critical patients (12.2%), visited 10-12 am. The majority of acute (12.9%) and urgent (11.7%) visited 4-6 pm, but the majority of non-emergents (15.1%) visited during 8-10 pm. Autumn visiter were the majority (27.6%). The percentage of non-emergent visited in Spring was 41.4% and Autumn was 41.3%. The percentage of urgents who visited in the Summer was 45.3% and the Winter was 40.4%. By clinical departments: the 48.0% of critical patients was NS. The 45.5% of acute and the 33.6% of urgent patients were IM. But the majority of non-emergent patients was PS (21.2%), and the second majority of non-emergent patients was oral Surgery (12.8%).

Citations

Citations to this article as recorded by

A Study of Patients Who Visited the Emergency Department at a Korean Medical Hospital: A Retrospective Chart Review
Hae-rang Ryu, Yoon-jung Kim, Young-kyun Kim, Kyoung-min Kim
The Journal of Internal Korean Medicine.2018; 39(3): 350. CrossRef

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