Provider factors influencing 48-hour management outcomes of triaged patients in the accident and emergency department at Kenyatta National Hospital: A cross-sectional study

Résumé

Triage prioritizes patients by urgency to ensure timely care, with Kenyatta National Hospital (KNH) using the South African Triage Scale (SATS)/Triage Early Warning Score (TEWS) system, though low-resource settings face challenges like staff shortages and limited equipment. The study sought to examine the issues of provider-related variables in terms of treatment outcomes of triaged patients after the 48 hours of treatment at the Accident and Emergency Department, Kenyatta National Hospital. This research used a cross-sectional design. All targeted patients were coded patients at the A&E unit with a sample size of 385 patients calculated using the Fisher formula. Structured questionnaires and an observation checklist were used to collect data for the 3-month duration of the study. Kakamega County Referral Hospital was used as a pilot study to assess the reliability of their instruments. The SPSS version 25 was used to analyze data with odds ratios calculated to evaluate the relationship between provider factors and patient outcomes, and one-way ANOVA was used to compare mean differences between provider-related factors. The researchers were able to identify that there were significant provider-related factors that impacted management outcomes of triaged patients (t = 13.055, p = 0.002 < 0.05). This is evidenced by the fact that the enhancement of provider characteristics in the areas of experience, training, and clinical decision-making has a positive impact on patient outcomes in the 48-hours post-care period. Also, institutional-related and patient-related factors were also presented to influence the efficiency of triage. The results highlight the significance of investing in human resource capacity, proper equipment and medication, and infrastructure enhancement to improve the emergency care outcome. In order to maximize patient management, it is necessary to strengthen the skills of the providers with specific training, to enhance the institutional resources, and to monitor the triage processes.