Regression to Middle Effect May Threaten Validity of Triage Scales; a Letter to Editor

Triage is sorting patients based on acuity in order to manage care in the emergency department (ED) {Mirhaghi, 2017 #60}(1). Medical institutes are trying to develop triage scales compatible with their own culture of care. A triage scale must be precise and comprehensive enough to guide triage nurses and eliminate uncertainty

The Australasian Triage Scale Level 5 Criteria may Need to be Revised

Australasian Triage Scale (ATS) is used to prioritize incoming patients in the emergency department (ED) according to patient acuity. It`s a five-level triage scale endorsed by the Australasian College for Emergency Medicine (ACEM). The ATS categories are defined by physiological predictors (airway, breathing, circulation, and disability) and maximum waiting time to treatment (1: immediate, 2: 10 minutes, 3: 30 minutes, 4: 60 minutes and 5: 120 minutes). Triage scales should be valid and reliable to ensure safe practice and promote clinical applicability in ED. Ebrahimi et al. reported that the pooled coefficient for ATS is fair: 0.390 (95% CI 0.307–0.466).

Does peer education increase academic achievement in first year students? A mixed-method study

Research on the impact of peer education (PE) on learning outcomes has produced inconclusive results, partly due to the methodology employed in such studies. There is a necessity to design blind, controlled studies. Further, quantitative approaches to evaluating PE may not provide a complete picture of the impact of PE on learning outcomes. The aim of the study was to determine the effect of peer education on students\u27 academic achievement and to explain students\u27 lived experience of participating in a PE program. The study employed an exploratory, sequential mixed-method design and occurred in two distinct and consecutive phases. The first phase consisted of a cluster-controlled, double-blind educational trial; the second, of a qualitative conventional content analysis. Data was collected during the second semester from February to July 2015 from undergraduate students. Analysis of the pre- and post-tests has been performed to evaluate the program among those enrolled in nursing and midwifery (intervention groups) and anaesthesia nursing (control group) in physiology and anatomy courses. PE resulted in significant differences in the physiology post-test scores and the anatomy post-test scores in favour of midwifery and nursing students respectively (intervention groups). Statistically significant improvement was not achieved based on formal academic exams. Themes were identified by analysing the content of qualitative feedback, with “facilitated learning” being the main theme emerging from the data. The PE program promoted learning based on the facilitator-based examination (based on post-test scores). However, PE did not improve learning in blinded condition in the current study (formal academic exam)

Hospital Triage Standards: A Qualitative Study and Content Analysis based on Experts’ Experiences in Iran

Introduction: The lack of a fixed and clear protocol causes confusion for nurses resulting in care performance delay in the emergency room (ER). Given that the purpose of triage is to examine the patient upon arrival in ER for the rapid classification and prioritization of emergency patients in need of treatment, it seems that the development and implementation of hospital triage standards can greatly affect this purpose. Objective: The present study was conducted to review the experiences of experts in hospital triage in terms of determining the standards of hospital ER triage. Methods: This qualitative research was conducted through content analysis method based on Donabedian model. Participants include experts (Politician, Nurse Supervisor, Nurse, Midwife, Faculty of Nursing, Emergency Medicine Specialist) working in educational and private hospitals and single-specialized ERs. Data were collected through in-depth and semi-structured interviews lasting between 25-60 minutes. The main interview questions were: What are the structural standards of a good triage?  What are the process standards for a good triage?  What are the standards of a good triage? Data analyzed through Content Directed Analysis with Shannon and Hsieh approach. Results: Totally, 21 experts the mean age of 46.9±1.8 (ranged from 30 to 57) years and the mean work experience of 18.9± 8.21 years were participated, of whom 16 (76.2%) persons were male. From the analysis, we extracted 48 codes, 14 subcategories and 3 main categories of "structural standards", "process standards" and "outcome standards". Conclusions: Guidelines are needed so that the nurse in charge of triage can quickly and accurately undertake the important responsibility of patient triage. Additionally, having structure and process and outcome standards improves triage performance

The Role Descriptions of Triage Nurse in Emergency Department: A Delphi Study

Background. Triage nurses play a pivotal role in the emergency department. However some researchers have attempted to expand triage nurse's role; remarkable discrepancies exist among scholarly communities. The aim was to develop a role description of triage nurse relying on the experts. Methods. A modified Delphi study consisting of 3 rounds was performed from March to October 2014. In the first round, an extensive review of the literature was conducted. Expert selection was conducted through a purposeful sample of 38 emergency medicine experts. Results. Response rates for the second and third rounds were 37% and 58%. Average age of panelists was (38.42 ± 5.94) years. Thirty-nine out of 54 items reached to the final round. Prioritizing had the higher agreement rate and least agreement on triage related interventions. Conclusion. Triage nursing as a relatively new role for nurses needs significant development to be practiced. Comprehensive educational programs and developmental research are required to support diagnostic and therapeutic interventions in triage practice by nurses

Therapeutic Relationship: Is It Still Heart of Nursing?

Relationship was introduced as an essential element of care since the beginning of theorizing in nursing. However therapeutic relationship has been conceptualized by different theorists, an integrated approach is not provided. This study aimed to perform a systematic review to explain the therapeutic relationship in the contemporary nursing practice. Electronic databases were searched from conception to October 2015 using keywords including therapeutic, relationship, communication, nurse, and patient. We used PRISMA guideline to report data. Original studies relevant to the therapeutic relationship were included. Exclusion criteria include abstracts that were irrelevant to the concept of study, grey literature and review and commentary articles. Disagreements between researchers were solved by consensus. Twenty studies were finally included into the review process. Data were organized into three categories including composition of therapeutic relationship, context of therapeutic relationship and confirmation of therapeutic relationship. The therapeutic relationship is composed of significant knowing and meaningful connecting with patients. Few studies confirmed applicability of therapeutic relationship in nursing practice. Therapeutic relationship ensures humanity to be preserved during nursing care and patients’ hospital stay; it faces with strong barriers such as nursing shortage. The nursing shortage seriously threatens the heart of nursing. Therapeutic relationship needs to be investigated further in order to be supported by evidence-based nursing in order to confirm the applicability of relationshipbased caring theories

Does peer education increase academic achievement in first year students? A mixed-method study

Research on the impact of peer education (PE) on learning outcomes has produced inconclusive results, partly due to the methodology employed in such studies. There is a necessity to design blind, controlled studies. Further, quantitative approaches to evaluating PE may not provide a complete picture of the impact of PE on learning outcomes. The aim of the study was to determine the effect of peer education on students\u27 academic achievement and to explain students\u27 lived experience of participating in a PE program. The study employed an exploratory, sequential mixed-method design and occurred in two distinct and consecutive phases. The first phase consisted of a cluster-controlled, double-blind educational trial; the second, of a qualitative conventional content analysis. Data was collected during the second semester from February to July 2015 from undergraduate students. Analysis of the pre- and post-tests has been performed to evaluate the program among those enrolled in nursing and midwifery (intervention groups) and anaesthesia nursing (control group) in physiology and anatomy courses. PE resulted in significant differences in the physiology post-test scores and the anatomy post-test scores in favour of midwifery and nursing students respectively (intervention groups). Statistically significant improvement was not achieved based on formal academic exams. Themes were identified by analysing the content of qualitative feedback, with “facilitated learning” being the main theme emerging from the data. The PE program promoted learning based on the facilitator-based examination (based on post-test scores). However, PE did not improve learning in blinded condition in the current study (formal academic exam)

Vital Sign Assessment Directives Have Not Associated With Diagnostic Validity

No Abstrac