Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Science

Program

Nursing

Supervisor

Kerr, M.

2nd Supervisor

Hurlock-Chorostecki, C.

Abstract

In 2017, several hospitals in Ontario implemented the Electronic Canadian Triage and Acuity Scale (eCTAS). This new technology affects a critical area of the Emergency Department: triage. There is no research on Registered Nurses’ (RNs) perceptions of eCTAS. A quantitative non-experimental descriptive survey obtained and quantified RN perceptions of eCTAS at a hospital with a 23 bed Emergency Department. The Diffusion of Innovation Theory was used as the theoretical framework to help guide study development. Results indicate both positive and negative perceptions of eCTAS and that younger RNs are more likely to think eCTAS cues them to collect the relevant patient information required at triage (P=0.008). The findings suggest that eCTAS is easy to use and is organized logically. eCTAS needs to be further studied ideally using a larger sample size with control groups and with a focus on RNs who are learning how to triage.

Summary for Lay Audience

Emergency Departments (ED) typically deal with large numbers of patients every day, including many with severe health problems. To help ensure the sickest patients are prioritized, all people entering an ED are first triaged. Triage is a short process where a Registered Nurse (RN) assesses how critical the patient is and how long they can safely wait to see a doctor. If an RN makes a mistake at triage, it can be detrimental to a patient’s outcome. In Canada, the triage process is based on the Canadian Triage and Acuity Scale (CTAS), which is a set of guidelines to use when assessing patients that helps to define a patient’s level of urgency. Recently, at a hospital in Ontario, RNs transitioned from a paper-based triage document to an online platform that provided decision support, called the Electronic Canadian Triage and Acuity Scale (eCTAS). This was a major change in practice for the RNs in an already high stress and critical environment.

Many hospitals within Ontario are transitioning to eCTAS with minimal understanding of RNs’ perceptions of the new online program, highlighting a knowledge gap which was explored in the current study. Using a questionnaire, a quantitative descriptive study was conducted to examine and quantify RNs’ perceptions of eCTAS after one year of use at a community hospital.

The results indicated both positive and negative perceptions of eCTAS. RNs suggested eCTAS was easy to learn, organized logically, and they liked that the document was a typed legible printout. Additionally, younger RNs were more likely to feel that eCTAS cued them to collect the relevant patient information required at triage. RNs expressed concerns that they might be more likely to make a triage mistake with eCTAS, that it may negatively impact critical thinking, and that there were difficulties relating to slow computers and a slow logon process.

Future research needs to focus on how eCTAS is impacting RNs who are learning triage for the first time and how eCTAS impacts critical thinking. Additionally, a larger sample size and multicenter study will allow for more robust and powerful results.


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