Nurses at primary healthcare centres across Bahrain should receive structured triage education and standardised protocols to enhance patient care, according to a recently published academic study.
The cross-sectional study, titled ‘Knowledge, Attitude, and Practice of Triage among Nurses in Primary Healthcare Centres of Bahrain’, also found that only 1.4 per cent of surveyed participants held certifications in triage and emergency response.
The study was conducted by Dhabya Al Sada, Eman Al Salman, Fatima Al Nooh, Mooza Al Thawadi and Nawal Habib from primary healthcare centres in Bahrain and was published in the peer-reviewed Journal of the Bahrain Medical Society.
“Primary healthcare is the cornerstone of health services in Bahrain and serves as the first point of contact for patients with urgent and non-urgent conditions,” the authors noted in the study.
“This study aimed to assess nurses’ knowledge, attitudes, and practices regarding triage in primary healthcare centres (PHCs) in Bahrain and to explore factors associated with triage competence.”
Triage is the process of quickly assessing and prioritising patients to ensure that those with the most urgent or severe conditions are treated first. It ensures that limited medical resources are used to maximise survival and optimise effectiveness and efficiency.
The results are based on a cross-sectional study conducted in July 2021 across 27 government health centres, through an online self-administered questionnaire targeting nurses in treatment rooms, including diabetic nurses, mother and child health nurses and nursing supervisors.
In total, 555 staff nurses completed the survey, of whom 90.8pc were female. The questionnaire consisted of 18 items, including 10 questions covering participant demographics and professional characteristics, including training background, and eight triage-related questions structured into three domains.
Four questions focused on knowledge, while three addressed attitude and one focused on practice.
“Only 5.2pc of respondents attended a triage training course, and only 1.4pc successfully completed it with an official certificate,” the researchers explained.
However, 96.9pc of nurses were aware of triage protocols.
Although 74.2pc of nurses found the triage manual easy-to-use, only 25.8pc reported being confident in their ability to apply it.
“Confidence was significantly associated with years of experience and prior triage training, highlighting a gap between knowledge and practical competence,” researchers explained.
The study also found that a dedicated triage nurse was absent in 40.5pc of shifts and more than one-third of centres lacked a triage room.
Triage was mainly performed for urgent complaints (91pc) and for cases without appointments (90.6pc).
Although triage has been studied in emergency departments, this study focused on primary healthcare settings, where research is limited.
Primary care triage involves mixed urgent and non-urgent demand, variable walk-in volumes, and constrained space and staffing, which may contribute to inconsistent implementation even when protocols exist.
The study highlighted the need for structured, ongoing triage training, including simulation-based exercises, alongside institutional support to enhance consistency, confidence and patient safety.
These standardised protocols should be reinforced through continuous professional development, monitoring, and evaluation of triage practices, according to the researchers.
naman@gdnmedia.bh
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