The Quality of the Maternity Triage Process: a Qualitative Study

Emergency Service, Hospital, Obstetrics, Qualitative Research, Triage


Introduction: There is no consensus on what the bases and criteria are for the dynamic process of maternity triage. Properly performing the maternity triage process requires reliable data to ensure the correct implementation of this process and the identification of existing deficiencies, and find strategies to modify, improve and enhance the quality of this process. Objective: The present study was conducted to explain the quality of the maternity triage process. Methods: The present qualitative study performed a directed content analysis on 19 maternity triage service providers and key informants selected through purposive sampling. The data were collected through semi-structured interviews in 2018 and analyzed using directed content analysis based on the Donabedian’s model. The accuracy and rigor of the qualitative data were then investigated and confirmed. Results: The participants identified the most important factors affecting the quality of the services provided in maternity triage as two categories of measures and care, and interactions and communication. The category of measures and care included two subcategories of examinations and obtaining a medical history. Conclusion: The present study comprehensively identified different dimensions of the quality of maternity triage services at different levels. The participants identified the quality of the maternity triage process as a multi-dimensional and important concept. Different dimensions of the maternity triage process are recommended that be addressed when designing and implementing maternity triage guidelines and instructions so as to maintain the quality of this process and satisfy their needs.


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1. Lehmann R, Brounts L, Lesperance K, Eckert M, Casey L, Beekley A, et al. A simplified set of trauma triage criteria to safely reduce overtriage: a prospective study. Arch Surg. 2009;144(9):853-8.
2. Cheraghi A, Riazi H, Emamhadi MA, Jambarsang S. A Study on Organizational Factors Affecting Midwifery Errors from the Viewpoint of Midwives in Educational Hospitals and Health Centers of Tehran, 2014. Iran J Forensic Med. 2016;22(2):139-46.
3. Reason J. Human error: models and management. BMJ. 2000;320(7237):768-70.
4. Veit‐Rubin N, Brossard P, Gayet‐Ageron A, Montandon CY, Simon J, Irion O, et al. Validation of an emergency triage scale for obstetrics and gynaecology: a prospective study. BJOG. 2017;124(12):1867-73.
5. Gerber Zimmerman P, McNair R. Triage essence and process. Triage nursing secrets Missouri: Mosby Inc. 2006.
6. Rashidi Fakari F, Simbar M, ZadehModares S, AlaviMajd H. Obstetric triage scales; a narrative review. Arch Acad Emerg Med. 2019;7(1):e13.
7. Wuerz RC, Travers D, Gilboy N, Eitel DR, Rosenau A, Yazhari R. Implementation and refinement of the emergency severity index. Acad Emerg Med. 2001;8(2):170-6.
8. Donabedian A. An introduction to quality assurance in health care: Oxford University Press; 2002.
9. Cohen CC, Shang J. Evaluation of conceptual frameworks applicable to the study of isolation precautions effectiveness. J Adv Nurs. 2015;71(10):2279-92.
10. Polit D, Beck C. Essentials of nursing research: Appraising evidence for nursing research. Baltimore: Lippincott Williams and Wilkins; 2013.
11. Guba EG, Lincoln YS. Competing paradigms in qualitative research. Handbook of Qualitative Research. 1994;2(163-194):105.
12. Lincoln YS, Guba EG. Naturalistic inquiry: Sage; 1985.
13. Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107-15.
14. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-12.
15. Chen HM, Hsieh YH. Key trends of the total reward system in the 21st century. Compens Benefits Rev. 2006;38(6):64-70.
16. Zaboli R, Malmoon Z, Soltani-Zarandi MR, Hassani M. Factors affecting sentinel events in hospital emergency department: a qualitative study. Int J Health Care Qual Assur. 2018;31(6):575-86.
17. Gerdtz MF, Bucknall TK. Triage nurses’ clinical decision making. An observational study of urgency assessment. J Adv Nurs. 2001;35(4):550-61.
18. Andersson AK, Omberg M, Svedlund M. Triage in the emergency department–a qualitative study of the factors which nurses consider when making decisions. Nurs Crit Care. 2006;11(3):136-45.
19. Noon AJ. The cognitive processes underpinning clinical decision in triage assessment: a theoretical conundrum? Int Emerg Nurs. 2014;22(1):40-6.
20. Araújo IMdA, Silva RMd, Bonfim IM, Fernandes AFC. Nursing communication in nursing care to mastectomized women: a grounded theory study. Rev Lat Am Enfermagem. 2010;18(1):54-60.
21. Mahmoudi H, Mohmmadi E, Ebadi A. The Meaning of Emergency Care in the Iranian Nursing Profession. Crit Care Nurs J. 2017;10(1):e10073.
22. Watt D, Wertzler W, Brannan G. Patient expectations of emergency department care:phase I–a focus group study. CJEM. 2005;7(1):12-6.
How to Cite
Rashidi-Fakari F, Simbar M, Safari S, Zadeh-Modares S, Alavi-Majd H. The Quality of the Maternity Triage Process: a Qualitative Study. Adv J Emerg Med. 4(1):e6.
Original article