An evaluation of the use of the South African Triage Scale in an urban district hospital in Durban, South Africa

Abstract

Background: Emergency centres in South Africa are among the busiest in the world and serve as entry points for hospital care for most of the population. The South African Triage Scale (SATS) is a validated tool introduced nationally in 2006 and intended to increase the efficiency of emergency centres through a process of prioritisation of the severely ill patient. The objective of this study was to evaluate the use of the SATS in a busy urban district hospital in Durban, South Africa.

Methods: A chart review of triaged patients was performed. The hospital uses a one-page SATS sheet and manages both medical and surgical patients. The triage history, physiological parameters, application of discriminator lists, final triage code and outcome was audited and compared with findings from the patients’ clinical records.

Results: The mean triage early warning score was 1.50 (95% CI 1–2) and average time to treatment was 59 min (95% CI 51– 67). Essential bedside investigations were missing on some very ill patients, there was poor documentation in many fields and confirmed time to treatment was within recommended timescales for only 48% of patients. Use of the discriminator list resulted in over-triage of 66.7% and an under-triage of 14%. Some 76% of patients were discharged from the emergency centre, 15% were admitted and 5.5% were transferred out.

Conclusion: Nurse-led triage has been successfully implemented at the emergency centre of this hospital using SATS but some notable gaps were identified.

Keywords: audit, emergency centre, South African Triage Scale