To ascertain the awareness among Triage Staff about Clinical Conditions treated in the department of Hand Surgery from their Referral Pattern: A Cross Sectional Observational Study in a Tertiary Care Center

Author(s): Maithreyi Sethu and Srinivasan Rajappa

Objectives

• To ascertain the referral pattern and the awareness about clinical conditions treated in the Department of Hand Surgery among the triage staff.

• To determine if is there a difference between the triaging by the doctors and by the junior (less than 5 years in service) and the senior nurses (more than 5 years in service) with reference to clinical conditions which are treated in the Hand surgery Department.

Materials and methods
This was a cross-sectional observational study which was conducted in a tertiary care center in India. The study involved a total of 115 participants with junior nurses, senior nurses and doctors working in the triage service of the hospital. All participants were shown a semi-structured tool with clinical scenarios which had photographs and clinical information in text, on a computer screen using Microsoft PowerPoint. The clinical scenario was also narrated to them. The referral pattern was noted down and tabulated.

Results
It is interesting to note that, • Only in 1 out of the 20 scenarios, hand surgery was the most frequently referred department. • Most of the Bony injuries of the hand and the forearm were mainly referred to orthopaedics. • Burns and raw areas of the forearm were frequently referred to plastic surgery. • Hand deformities were commonly referred to either plastic surgery or orthopaedics. • Nerve injuries were referred to neurology and orthopaedics typically. • Orthopaedics was the most referred department. • The average reference percentage of the junior nurse was 3.91%, senior nurse was 21.9% and doctors was 23.95%. Junior nurses performed exceedingly poor in referring cases to the department of hand surgery as compared to the other two subgroups.

Conclusion
This study shows us the drawbacks in our present triaging system emphasizing the need for training our staff on new departments referral pattern, the advancements, and updated protocols.