Evaluation of triage decision making in relation to early assessment and intervention of trauma cases attended by pre-hospital care providers from emergency department, Hospital Kuala Lumpur

Mohd Aznan, Shahrul Azhar (2012) Evaluation of triage decision making in relation to early assessment and intervention of trauma cases attended by pre-hospital care providers from emergency department, Hospital Kuala Lumpur. [Project Paper] (Submitted)

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Abstract

Project Paper (B.Sc. Nursing) - Universiti Putra Malaysia, 2012. Introduction: Pre-hospital care service in Malaysia is still relatively new and it ]s slowly developing after introduced the Emergency Medicine program. However there is no clear instruction regarding pre-hospital care (PHC) service in Malaysia. With increasing numbers of road traffic accidents and other emergency situations the demand from public requires the best pre-hospital care services. Death and disability due to injury or trauma is top 10 causes of death in low and middle income countries, and 90% road traffic accidents contributed to the major cause of death. Trauma cases need rapid assessment and intervention as the mortality and morbidity incidence depend on pre-hospital care service provided. Objective: The general objective is to evaluate the omission in records, in early assessment, and correctness of intervention practice in trauma cases responded by pre-hospital care providers of the Emergency Department, Hospital Kuala Lumpur (EDHKL). Methods: This cross sectional study used secondary data which were retrieved from patient records at Emergency Department, Hospital Kuala Lumpur (EDHKL). All trauma cases, which fulfilled the inclusion criteria, and responded by pre-hospital care EDHKL during I lan 2011 until 31 December 2011 were considered, and random sampling was done. A data collection instrument proforma was designed to collect data from the standard sheet used by the pre-hospital care provider at EDHKL. The standard sheet includes, section A: Team leader, respond time and trauma type, section B: Assessment, Section C: Intervention, section D triage, and Section E: physician's report. The calculated sam£le size was 432 records. Using the "Statistic Package for Social Science (SPSS )" version 17, descriptive analysis yielded the required frequencies, percentage and standard deviations. Chi-square test and Kappa test were used to determine relationship between dependant variable and independent variable. P value ::; 0.05 was considered as statistically significant. Result: A total of 428 pre-hospital records were obtained and relevant data recorded into standardized proforma. Two hundred and three (47%) cases ware attended by AMO as team leader and 225 (53%) cases were lead by SN. Their working experience were; 1-5 years (34%), 6-10 years (40%) and 11-]5 years (26%). There were omissions found in patient assessment; 4 (2%) was due to consciousness level, 14 (7%) airway, 62 (33%) speech quality and I]] (58%) in GCS assessment. A total of 25] patients had PHC "inadequacies" in term of intervention. These comprised 24 cases (10%) cases related to airway, 22 (9%) in breathing, 38 (15%) in circulation, 8] (32%) in immobilization and 86 (34%) in haemorrhage control intervention. Based upon physicians' decision, PHC providers achieved 98.3% correctness in green triage (non-critical), 9] .6% yellow triage (semi-critical) and 78.9% in red triage (critical) decision. There was significant relationship between GCS assessment and triage decision (p ::; 0.0]) Conclusion: These results can be used by the organization (EDHKL) and other emergency or PHC service providers, to improve the quality PHC services. It is critical to improve efficiencies among PHC providers, to ensure better outcome of relevant trauma cases. Keyword: HKL, trauma, early assessment, intervention assessment, triage decision making

Item Type:	Project Paper
Faculty:	Faculty of Medicine and Health Science
Depositing User:	Ms. Adni Syuhaida Zon
Date Deposited:	22 Nov 2022 07:37
Last Modified:	22 Aug 2023 01:33
URI:	http://psaspb.upm.edu.my/id/eprint/243

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