Effectiveness of Using Triage Guideline with Outpatient in Sung Men Hospital, Sung Men District, Phrae Province

Abstract

This research and development study was conducted in three phases: 1) analyzing the current situation of outpatient screening, 2) developing a clinical practice guidelines (CPGs) for outpatient screening based on urgency levels, and 3) evaluating the effectiveness of the CPGs. The sample consisted of 10 professional nurses working in the outpatient department and 300 patient records, divided into pre- and post-implementation groups, with 150 records in each group. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test. The findings:

1. The initial situation analysis revealed a lack of knowledge and skills among staff, unclear and non-standardized screening processes, and insufficient patient referral pathways. This resulted in incidences of patients deteriorating while waiting for care.

2. The CPGs) divided patients into five priority levels using a color-coded system based on symptoms and clinical signs, providing specific care guidelines for each level.

3. Nurses demonstrated significantly higher knowledge scores after training on the CPGs (Z = 2.81, p = .005). The accuracy rate of patient screening improved to 96.67%, and no cases of patient deterioration while waiting were reported. Nurses evaluated the feasibility and satisfaction with the CPGs as very high (M = 4.54, 4.71; SD = .52, .44, respectively).

The urgency-based outpatient screening CPGs proved to be practical, effectively reduced patient deterioration rates, ensured patient safety, and enhanced nurse satisfaction. These findings support the adoption of the CPGs in outpatient settings to improve care quality and safety.