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Trial registered on ANZCTR


Registration number
ACTRN12620001082998
Ethics application status
Approved
Date submitted
27/05/2019
Date registered
20/10/2020
Date last updated
20/10/2020
Date data sharing statement initially provided
20/10/2020
Date results information initially provided
20/10/2020
Type of registration
Retrospectively registered

Titles & IDs
Public title
Practice of Triage Decisions Among Healthcare Providers in Emergency Departments of Malaysia After Educational Program
Scientific title
The effect of Educational Program on Skill and Accuracy of Triage Decisions among Registered Nurses and Medical Officer Assistants in Emergency Departments of Malaysia
Secondary ID [1] 291220 0
Nil known
Universal Trial Number (UTN)
U1111-1233-8900
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Triage decisions making in Emergency Department 312938 0
Emergency medicine 315356 0
Condition category
Condition code
Emergency medicine 311428 311428 0 0
Other emergency care

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Phase 1 is a based line survey to identify level of skill and accuracy of triage decision making. A total of 10 EDs hospital with 274 participants were invited to participate in the study project. A number of 202 were enrolled into the study.

Phase 2 is an intervention study. All the 10 EDs of the hospital with participants who have obtained low TDMI score were identified. They were invited to enrol into phase 2 of the study. There was 143 HCPs of the 10 EDs, after excluding 59 participants who obtained a high score.
The EDs of the 10 hospitals were divided into two categories: specialist (four) and non-specialist (six) hospitals. These EDs of the 10 hospitals (with participants who scored low) were randomized into control (5 hospitals) and intervention group (5 hospitals) using balloting method. The hospitals of control group comprised of 74 participants while 69 participants for the intervention group.

The intervention was a form of lectures and discussions in a group, which were conducted in 140 minutes in each hospital and completed in one session.
Intervention group was exposed to the intervention and not for control group. Measurement of skills and accuracy of triage for both groups were measured at 2 week and 4 weeks interval after intervention group exposed to the intervention.

The intervention provided by nursing lecturer who expert in the field or trauma and emergency. The topic included was related with triage decision of adult trauma patient, participant's opinions based on survey in phase 1, such as Triaging, factors that may contribute to adjustment of triage decision such as mechanism of injury, type of injury. Pain and Glascow Coma Score assessment, the severity and triage categorization. Assessment of patient at triage desk and discussion of triage categorization using patient's scenaro-based questions.
Intervention code [1] 297235 0
Treatment: Other
Comparator / control treatment
No treatment
Control group
Active

Outcomes
Primary outcome [1] 320145 0
to identify level of skills and accuracy of triage decision-making at basedline

Outcome assessed using a validated self administration questionnaires, triage decision-making inventory (TDMI), used with permission from the author, Cone (2000) was utilized to measure skills and patient scenario-based questions (PSBQs) for accuracy of triage decision- making at baseline (pre-test)
The cut-off point for TDMI is 184 (out of 222) and the cut off point for PSBQs is 12 (out of 15)


Timepoint [1] 320145 0
March till June 2015 ( baseline survey enrollment)
Primary outcome [2] 320912 0
to evaluate level of skills and accuracy of triage decision-making after exposure to educational

Both were evaluate at post test (two weeks after intervention) and follow-up (4 weeks).

Triage Decision-making Inventory (TDMI) and Patient scenario-based questions (PSBQs) ) used for basedline,both post test and follow-up
Timepoint [2] 320912 0
Mid April (post test) and end of April of 2016 (follow-up)
Secondary outcome [1] 375380 0
there was no more outcome
Timepoint [1] 375380 0
no time point

Eligibility
Key inclusion criteria
Registered nurses and medical officer assistants who experienced triage roles in the EDs
Minimum age
23 Years
Maximum age
60 Years
Sex
Both males and females
Can healthy volunteers participate?
Yes
Key exclusion criteria
Registered nurses and medical officer assistants who refused

Study design
Purpose of the study
Educational / counselling / training
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
numbered containers
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Balloting method used .It was conducted by a person who has no interest in the study. Hospitals (with participants who obtained low score of skill) were stratified to specialist and non specialist hospital. then randomized into intervention and control group
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Parallel
Other design features
The Intervention in a form of educational program only provided to intervention group. Control group did not received any intervention.
Phase
Not Applicable
Type of endpoint/s
Efficacy
Statistical methods / analysis
The study involves 2 phases: Phase 1 is basedline survey. Phase 2 is to identify effectiveness of educational program on skill and accuracy of triage decisions among registered nurses and medical officer assistants in the 10 ED hospitals in North Penisular of Malaysia,
The ten hospitals with participants (n=143) who obtained low score were stratified to specialist (n=4) non specialist hospitals (n=6). The hospitals randomized to intervention (n=69) and control group (n-74) in ratio 1:1.using balloting method by a person who has no interest in the study. Intervention was provided to intervention group, while control group did not received any intervention. Measurement of the score were conducted after intervention group received intervention at post test (two weeks and follow-up (four weeks).
Data analyzed using descriptive Descriptive statistics were used for examining the frequency distribution of demographic characteristic and items of the questionnaire, including mean score of TDMI and PSBQs, t-test Chi square and Fisher exact tests, RM ANCOVA applied as appropriate.

Recruitment
Recruitment status
Completed
Date of first participant enrolment
Anticipated
Actual
1/03/2015
Date of last participant enrolment
Anticipated
Actual
14/04/2016
Date of last data collection
Anticipated
Actual
28/04/2016
Sample size
Target
202
Accrual to date
Final
143
Recruitment outside Australia
Country [1] 21519 0
Malaysia
State/province [1] 21519 0
North Penisular Malaysia

Funding & Sponsors
Funding source category [1] 295671 0
University
Name [1] 295671 0
Universiti Malaya
Country [1] 295671 0
Malaysia
Primary sponsor type
University
Name
University of Malaya
Address
Unit of Research Grant Management
Universiti Malaya
50603 Lembah Pantai,
Kuala Lumpur,
Malaysia
Country
Malaysia
Secondary sponsor category [1] 302978 0
None
Name [1] 302978 0
Address [1] 302978 0
Country [1] 302978 0

Ethics approval
Ethics application status
Approved
Ethics committee name [1] 296985 0
Ethics Committee (Human) Universiti Sains Malaysia, Health Campus (JEPeM USM code: USM/JEPeM/[282.3(7)]
Ethics committee address [1] 296985 0
Ethics Committee (Human)
Universiti Sains Malaysia,Health Campus
16150 Kubang Kerian
Kelantan, Malaysia
Ethics committee country [1] 296985 0
Malaysia
Date submitted for ethics approval [1] 296985 0
23/04/2014
Approval date [1] 296985 0
22/07/2014
Ethics approval number [1] 296985 0
Ethics committee name [2] 303442 0
National Malaysia Medical Research (NMRR)
Ethics committee address [2] 303442 0
Medical Research & Ethics Committee
Ministry of Health Malaysia
a/a Institut Pengurusan Kesihatan
Jalan Rumah Sakit, Bangsar
59000 Kuala Lumpur,
Ethics committee country [2] 303442 0
Malaysia
Date submitted for ethics approval [2] 303442 0
01/09/2014
Approval date [2] 303442 0
04/11/2014
Ethics approval number [2] 303442 0

Summary
Brief summary
Intervention was an educational program. It was conducted in 140 minutes by trained personnel. The purpose is to identify skills and accuracy triage decision-making before and after intervention.
Trial website

Trial related presentations / publications
Public notes
Level of skills and accuracy of triage decision making improved after educational education

Contacts
Principal investigator
Name 72626 0
Dr Siti Aishah Ghazali
Address 72626 0
School of Health Sciences
Universiti Sains Malaysia, Health campus,
16150 Kubang Kerian
Kelantan,Malaysia.
Country 72626 0
Malaysia
Phone 72626 0
+60129644232
Fax 72626 0
+609 7677515
Email 72626 0
schah@usm.my
Contact person for public queries
Name 72627 0
Dr Siti Aishah Ghazali
Address 72627 0
School of Health Sciences
Universiti Sains Malaysia, Health campus,
16150 Kubang Kerian
Kelantan,Malaysia.
Country 72627 0
Malaysia
Phone 72627 0
+60129644232
Fax 72627 0
+609 7677515
Email 72627 0
schah@usm.my
Contact person for scientific queries
Name 72628 0
Prof Khatijah Lim Abdullah
Address 72628 0
Department of Nursing Science, Department of Nursing Science,
Faculty of Medicine, University of Malaya,
50603 Kuala Lumpur, Malaysia
Country 72628 0
Malaysia
Phone 72628 0
+603-7967 3732.
Fax 72628 0
: +603-7949 4636
Email 72628 0
katlim@um.edu.my

Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
No/undecided IPD sharing reason/comment
It confidential and to respect participant's and institution's right not to reveal individuall data in details.


What supporting documents are/will be available?

Doc. No.TypeCitationLinkEmailOther DetailsAttachment
2148Informed consent form    The document can be obtain through me (email) for ... [More Details] 372392-(Uploaded-30-06-2019-01-23-06)-Study-related document.pdf



Results publications and other study-related documents

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No documents have been uploaded by study researchers.

Documents added automatically
No additional documents have been identified.