ArticleInternational journal of emergency medicine2019
Implementation and performance of the South African Triage Scale at Kenyatta National Hospital in Nairobi, Kenya.
Article in International journal of emergency medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Paediatric trauma education in low- and middle-income countries: A systematic literature review.Journal of global health · 2022Pooled it
- Emergency triage in coastal Kenya: a survey of public Emergency Departments.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2026Article
- Effectiveness of the South African Triage Scale in improving patient outcomes: a qualitative exploration of Ghanian nurses' experiences.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2026Article
- Effectiveness of Standardized Nurse-Led Triage Protocols in Improving Outcomes, Timeliness, and Accuracy in Road Traffic and Trauma Care in Low-Resource Settings: A Systematic Review.Journal of multidisciplinary healthcare · 2026Review
- Quality Improvement Initiatives in Pediatric Emergency Care in Low-Resource Settings: Addressing Patient Safety and Outcomes.International journal of pediatrics · 2026Review
- Assessment of the HIV Enhanced Access Testing in the Emergency Department (HEATED) program in Nairobi, Kenya: a quasi-experimental prospective study.HIV research & clinical practice · 2024Article
- Characteristics of Interpersonal Violence and Intimate Partner Violence Among Injured Adults Seeking Emergency Care in Nairobi, Kenya.Rhode Island medical journal (2013) · 2024Article
- Implementation and Assessment of the HIV Enhanced Access Testing in the Emergency Department (HEATED) Program in Nairobi, Kenya: A Quasi-Experimental Prospective Study.medRxiv : the preprint server for health sciences · 2024Article
- Triage implementation in resource-limited emergency departments: sharing tools and experience from the Pacific region.International journal of emergency medicine · 2024Article
- HIV self-testing acceptability among injured persons seeking emergency care in Nairobi, Kenya.Global health action · 2023Article
- A qualitative assessment of stakeholder perspectives on barriers and facilitators to emergency care delays in Northern Tanzania through the Three Delays.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2023Article
- Is the Triage System Welcomed in the Tertiary Hospital of the Limpopo Province? A Qualitative Study on Patient's Perceptions.Nursing reports (Pavia, Italy) · 2023Article
- Machine learning models to predict traumatic brain injury outcomes in Tanzania: Using delays to emergency care as predictors.PLOS global public health · 2023Article
- Assessment of substance use among injured persons seeking emergency care in Nairobi, Kenya.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2022Article
- Implementation of the South African Triage Scale (SATS) in a New Ambulance System in Beira, Mozambique: A Retrospective Observational Study.International journal of environmental research and public health · 2022Observational
- The accuracy of nurse-led triage of adult patients in the emergency centre of urban private hospitals.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2022Article
- Implementing a new emergency medical triage tool in one health region in Norway: some lessons learned.BMJ open quality · 2022Article
- Assessment of standard HIV testing services delivery to injured persons seeking emergency care in Nairobi, Kenya: A prospective observational study.PLOS global public health · 2022Article
- A descriptive study of demographics, triage allocations and patient outcomes at a private emergency centre in Pretoria.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2021Article
- Validation of the Interagency Integrated Triage Tool in a resource-limited, urban emergency department in Papua New Guinea: a pilot study.The Lancet regional health. Western Pacific · 2021Article
Corrections and comments
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Authors and funding
13 authors at 10 institutions in 3 countries.
Funding
Abstract
introductionTriage protocols standardize and improve patient care in accident and emergency departments (A&Es). Kenyatta National Hospital (KNH), the largest public tertiary hospital in East Africa, is resource-limited and was without A&E-specific triage protocols.
objectivesWe sought to standardize patient triage through implementation of the South African Triage Scale (SATS). We aimed to (1) assess the reliability of triage decisions among A&E healthcare workers following an educational intervention and (2) analyze the validity of the SATS in KNH's A&E.
methodsPart 1 was a prospective, before and after trial utilizing an educational intervention and assessing triage reliability using previously validated vignettes administered to 166 healthcare workers. Part 2 was a triage chart review wherein we assessed the validity of the SATS in predicting patient disposition outcomes by inclusion of 2420 charts through retrospective, systematic sampling.
resultsHealthcare workers agreed with an expert defined triage standard for 64% of triage scenarios following an educational intervention, and had a 97% agreement allowing for a one-level discrepancy in the SATS score. There was "good" inter-rater agreement based on an intraclass correlation coefficient and quadratic weighted kappa. We analyzed 1209 pre-SATS and 1211 post-SATS patient charts and found a non-significant difference in undertriage and statistically significant decrease in overtriage rates between the pre- and post-SATS cohorts (undertriage 3.8 and 7.8%, respectively, p = 0.2; overtriage 70.9 and 62.3%, respectively, p < 0.05). The SATS had a sensitivity of 92.2% and specificity of 37.7% for predicting admission, death, or discharge in the A&E.
conclusionHealthcare worker triage decisions using the SATS were more consistent with expert opinion following an educational intervention. The SATS also performed well in predicting outcomes with high sensitivity and satisfactory levels of both undertriage and overtriage, confirming the SATS as a contextually appropriate triage system at a major East African A&E.
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