Knowledge, Skills, and Triage Practices in Emergency Nurses in Mafraq

This cross-sectional study of 50 emergency nurses in Mafraq, Jordan, reveals that while most possess sufficient triage knowledge, their skills and practices are often moderate to poor, highlighting a critical need for enhanced training, simulation programs, and clear protocols to improve triage competency, particularly in rural settings.

The Gist

Imagine the Emergency Department (ED) as a busy airport control tower. In this tower, the nurses are the air traffic controllers. Their most critical job isn't just to help every plane (patient) land immediately, but to decide which plane needs to land right now because it's about to run out of fuel, and which one can safely wait on the runway for a bit. This decision-making process is called triage.

This study is like a report card given to the air traffic controllers in Mafraq, Jordan, to see how well they are doing their job.

The Mission

The researchers wanted to know: Do these nurses have the right knowledge (the rulebook), the right skills (the ability to use the radio and radar), and the right practices (actually making the right calls) to sort patients effectively?

The Test

They didn't just guess; they gave 50 nurses from three different hospitals (two public, one private) a quiz and a skills check. Think of it like a driving test where you have to answer questions about traffic laws and then actually drive the car.

The Results: The Good, The Okay, and The Needs Improvement

Here is how the "air traffic controllers" scored:

• Knowledge (The Rulebook): 92% of the nurses knew the rules perfectly. They had read the manual and understood the theory. They knew what to do.
• Skills (The Hands-On Ability): This is where it got tricky. While most had "moderate" skills (like a driver who knows the rules but sometimes stalls the car), 14% were struggling. They knew the theory but couldn't quite execute the practical steps fast enough or accurately enough.
• Practices (The Real-World Performance): This is the most important part—what they actually did on the job. About 32% were rated as "poor." Imagine a pilot who knows how to fly but forgets to check the fuel gauge before takeoff. These nurses weren't consistently applying their knowledge when it mattered most.

The Secret Ingredient: The study found that experience and where you work mattered a lot. Nurses who had been in the ED longer and those working in specific types of hospitals tended to be better at the whole process. It's like how a veteran pilot handles turbulence better than a rookie.

The Takeaway: How to Fix the Runway

The study concludes that just knowing the rules isn't enough. To make the "airport" run smoothly, we need to:

1. More Flight Simulators: Nurses need regular training and simulations. Just like pilots practice emergency landings in a simulator, nurses need to practice triage scenarios so they don't freeze in real life.
2. Mentorship: Pairing new nurses with experienced ones (like a co-pilot system) helps transfer that "street smarts."
3. Clear Checklists: Hospitals need to make sure the "flight plans" (protocols) are clear and easy to follow.
4. School Prep: Future nurses should learn these skills while they are still in school, not just after they graduate.

In short: The nurses in Mafraq are smart and know the theory, but they need more practice, better tools, and ongoing support to turn that knowledge into life-saving action when the emergency room gets chaotic.

Technical Summary

Technical Summary: Knowledge, Skills, and Triage Practices in Emergency Nurses in Mafraq

1. Problem Statement

Emergency departments (EDs) globally face the critical challenge of efficiently allocating scarce medical resources. Triage serves as the cornerstone of emergency nursing, functioning as a rapid assessment mechanism to prioritize patients based on the severity of their conditions. The efficacy of this process relies heavily on the triage nurse's ability to accurately assess vital signs, gather patient history, and determine intervention urgency. However, there is a need to evaluate whether emergency nurses, particularly in specific regional contexts like Mafraq, Jordan, possess the requisite knowledge, skills, and practical adherence to triage protocols to ensure optimal patient outcomes and minimize waiting times.

2. Methodology

The research employed a cross-sectional study design to assess the current state of triage competency among emergency nurses.

• Participants: The sample consisted of 50 emergency nurses recruited from three hospitals in Mafraq, Jordan (two public and one private).
• Instrumentation: Data collection utilized a previously validated questionnaire designed to measure three distinct domains:
  1. Knowledge: Theoretical understanding of triage principles.
  2. Skills: Practical ability to execute triage procedures.
  3. Practices: Self-reported adherence to triage protocols in clinical settings.
• Data Collection & Analysis: Data was gathered via an online survey and subsequently analyzed using SPSS (Statistical Package for the Social Sciences) to determine frequencies, percentages, and correlations.

3. Key Contributions

This study provides a localized empirical assessment of emergency nursing competencies in a rural Jordanian setting (Mafraq). Its primary contributions include:

• Quantitative Baseline: Establishing specific metrics for triage knowledge, skills, and practices among a defined cohort of nurses in the region.
• Contextual Analysis: Identifying the relationship between demographic/professional variables (specifically length of experience and hospital type) and triage competency.
• Gap Identification: Highlighting specific disparities between theoretical knowledge and practical application, particularly regarding skill proficiency and practice adherence.

4. Key Results

The analysis yielded the following statistical findings:

• Knowledge: The majority of participants demonstrated sufficient theoretical knowledge, with 92% scoring $\ge$60%.
• Skills: A significant gap was observed in practical skills. Only 14% exhibited deficient skills (<60%), while the vast majority (**86%**) possessed moderate skills (60–80%). Notably, no participants were categorized as having "sufficient" or "high" skills (>80%) based on the provided breakdown, suggesting a ceiling effect or a need for advanced training.
• Practices: Clinical practice adherence was lower than theoretical knowledge. 32% of nurses were rated as having "poor" practices (<60%), while **68%** were rated as "adequate" (>60%).
• Correlates: Statistical analysis revealed that both the length of time working in emergency care and the type of hospital (public vs. private) were significantly related to variations in nurses' triage knowledge, skills, and practices.

5. Significance and Recommendations

The study underscores a critical disconnect between theoretical knowledge and practical execution in emergency triage within the Mafraq region. While nurses generally understand the concepts, their practical skills and adherence to protocols require enhancement.

Strategic Recommendations:

• Continual Training: Implementation of ongoing training programs specifically targeting the transition from theory to practice.
• Simulation and Mentorship: Introduction of simulation-based learning and mentorship programs to bridge the gap in practical skills, with a specific focus on rural settings where resources may be more constrained.
• Protocol Standardization: Development and enforcement of clear, standardized triage protocols across all hospital types.
• Curriculum Integration: Integration of triage competencies into nursing educational curricula to ensure new graduates enter the workforce with robust foundational skills.

In conclusion, the study advocates for a systemic approach to improving triage competency through education, simulation, and structural support to enhance the efficiency and safety of emergency care delivery in Jordan.