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Scoping Review on Challenges and Barriers in Triage Education for Emergency Nurses
Abstract
Introduction/Objective
Triage effectiveness, especially the application of the Canadian Triage and Acuity Scale (CTAS), is vital to patient safety in emergency departments (EDs). The aim of this scoping review was to conduct a systematic literature mapping of knowledge about barriers to triage education among emergency nurses, focusing on the use of CTAS in resource-constrained settings, including Saudi Arabia.
Methods
Based on the Joanna Briggs Institute (JBI) approach to scoping reviews, a comprehensive search using PubMed, Embase, CINAHL, Google Scholar, and OpenGrey to find peer-reviewed literature (2015–2025) was conducted. Eligibility was defined using the Population-Concept-Context (PCC) framework. Thematic synthesis, data extraction, and study selection were performed.
Results
A total of twelve studies met the inclusion criteria. The major obstacles were divided into the following groups: professional (e.g., lack of expertise, error rates of 20–38%), environmental (e.g., noise, overcrowding), and systemic (e.g., absence of standardized training, staffing shortages). Subgroup analysis showed that emerging and inexperienced nurses faced increased challenges, particularly in non-Canadian settings implementing CTAS.
Discussion
Multifaceted interventions are needed due to the interplay of barriers. There is promise in simulation-based learning and standardized curricula. Cultural and infrastructural aspects of certain regions, such as the Qassim region of Saudi Arabia, require customized models such as the Qassim Comprehensive Triage Model (QCTM-CTAS).
Conclusion
Targeted, evidence-based strategies are urgently required to overcome triage education barriers, enhance CTAS proficiency, and improve patient outcomes globally.
