Assessment of Emergency Triage Knowledge, Practices, and Perceived Barriers to Effective Care Delivery Among Acute Care Staff in a Kenyan Tertiary Hospital
Keywords:
triage, emergency department, knowledge, nursing practice, resource-limited settings, KenyaAbstract
Background: Triage ensures patients receive timely emergency care based on severity, but inadequate knowledge and training in resource-limited settings are linked to inconsistent prioritization and adverse outcomes. In Kenya, standardized triage protocols remain fragmented, particularly in county-level referral hospitals. This study assessed triage knowledge and described triage practices among emergency department staff at Nakuru County Referral and Teaching Hospital (NCRTH), Kenya. Methods: A facility-based descriptive cross-sectional study was conducted among the 62 eligible emergency department and acute care nursing staff at NCRTH. Data were collected using a structured, self-administered questionnaire assessing triage knowledge, training status, systems familiarity, and practices (Cronbach's alpha 0.81), and analysed in SPSS version 27 using descriptive statistics and multiple-response analysis. Results: Of 62 questionnaires distributed, 55 were returned (88.7% response rate). Most respondents were female (63.6%), aged 26-35 years (54.6%), and diploma-qualified (56.4%); 60.0% had received formal triage training. Colour-coded protocols were the most recognized system (34.5%), followed by the Emergency Severity Index (21.8%) and SATS/START (14.5%). Of the 55 nurses assessed, 49 (89.1%) accurately defined triage, most often citing patient prioritization (33.3%), outcome improvement (22.7%), and saving lives (12.1%) as its main importance. Practice was more variable: classification accuracy was 55.8%, category-assignment accuracy 66.7%, and intervention-identification accuracy 70.5%. Understaffing (42.6%), limited resources (31.9%), and inadequate training (29.8%) were the main barriers. Conclusion: Staff showed general awareness of triage, but practical application remained inconsistent, with gaps in training, systems familiarity, and uniformity of practice. Structured training and context-appropriate protocols are needed to strengthen emergency care delivery.
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Copyright (c) 2026 Valerie SUGE, Eunice OMONDI, Dorcas MAINA
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