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Development of a clinical triage readiness and practice assessment tool for midwives in the maternity units of South Africa

BMC Nurs. 2026 Feb 26. doi: 10.1186/s12912-026-04470-w. Online ahead of print.

ABSTRACT

INTRODUCTION: The triage system is a process that is used to prioritise patient-care based on the urgency of their medical need. The triage system helps to expedite the delivery of time-critical treatment for patients with life-threatening conditions, to ensure that all patients are appropriately prioritised according to their medical urgency, improve patient flow, and improve patient satisfaction. However, based on our knowledge there’s no developed tool that assesses Clinical Triage Readiness and Practice among midwives, particularly in our context.

AIM: This study aims to primarily develop the clinical triage readiness and practice assessment tool for midwives, and second, to use the scale to identify and describe factors influencing clinical triage readiness and practices among midwives in resource-constrained district hospitals in Mpumalanga Province.

METHODS: A quantitative, cross-sectional, and descriptive research design underpinned this study. A stratified random sampling approach was used to select participants from a population of 300 midwives working in the maternity units. Data were collected using a self-developed questionnaire, and only 150 questionnaires were returned filled. The data were organised and analysed using the Statistical Package for Social Sciences (SPSS) version 29.0 computer software. Exploratory factor analysis using principal component analysis was conducted to determine the underlying dimensional structure of the instrument, followed by Cronbach’s alpha to assess the internal consistency of each extracted dimension. Logistic regression analysis was used to identify factors influencing triage practices.

RESULTS: The factor analysis illuminates that clinical triage readiness and practices can be assessed by six factors. Among the factors are knowledge and usefulness, organisational and policy readiness for triage, midwives’ skills and teamwork, patient-related challenges, and resource and infrastructure constraints. The study further yields that knowledge and usefulness, and organizational support/staff well-being are positively associated with good practice.

CONLUSION: This study developed the clinical triage readiness and practice assessment tool to assess factors influencing clinical triage readiness and practices among midwives in maternity units. The tool demonstrated acceptable reliability and a clear multidimensional structure, capturing individual, organisational, patient-related, and health system influences on triage. The study underscored that knowledge and usefulness, organisational support and staff well-being is positively associated with good practice. Therefore, theses findings advocates for an clinical environment that supports the psychological well-being of midwives to enhance quality triage practice.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41749222 | DOI:10.1186/s12912-026-04470-w

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