Quality and Effectiveness of a Pediatric Triage Training Program in a Guatemalan Public Hospital. Issue 8 (August 2016)

• Record Type: Journal Article
• Authors: Crouse, Heather L.; Vaides, Henry; Torres, Francisco; Ishigami, Elise M.; Walsh, Michael T.; Soto, Miguel A.; Torrey, Susan B.
• Is Part Of: Pediatric emergency care. Volume 32:Issue 8(2016)
• Publication Date: 2016-08
• Subjects: triage training -- international emergency medicine -- global health -- Emergency Triage Assessment and Treatment (ETAT) -- Clasificación, Evaluación y Tratamiento de Emergencias Pediátricas (CETEP); Pediatric emergencies -- Periodicals; 618.92002505
• DOI: 10.1097/PEC.0000000000000277
• Languages: English
• ISSNs: 0749-5161

Abstract

Abstract : Objectives: This study aimed to develop and implement an Emergency Triage Assessment and Treatment (ETAT) training program at a Guatemalan public hospital. Collaborators included Baylor College of Medicine/Texas Children's Hospital, the Guatemalan Ministry of Health, and the Pan American Health Organization. Methods: The ETAT is a World Health Organization program to teach pediatric assessment, triage, and initial management to health care workers in resource-limited settings. The Baylor College of Medicine/Texas Children's Hospital created ETAT training materials in Spanish (Clasificación, Evaluación y Tratamiento de Emergencias Pediátricas [CETEP]) and conducted a train-the-trainer course for Hospital Nacional Pedro Bethancourt (HNPB) health care leadership. The HNPB subsequently conducted local trainings using a modified curriculum. Midcourse modifications based on evaluations and focus groups included distribution of manuals before training and an adding a day to the course. Course quality was assessed using participant evaluations and comparing pretest and posttest scores. Effectiveness was defined as 90% concordance between triage levels assigned by participants and facilitators. Results: A total of 249 health care workers were trained by 24 HNPB facilitators. Mean pretest and posttest scores were 55 and 70, respectively ( P < 0.001). On a 4-point scale, participants rated overall course quality and effectiveness as 3.6. Mean pretest (49 vs 58, P = 0.002) and posttest scores (68 vs 72, P = 0.01) improved for groups trained after modifications, as did evaluations for course quality (3.4 vs 3.7, P < 0.001) and effectiveness (3.4 vs 3.8, P < 0.001). Triage levels were assigned with 95% concordance (confidence interval, 91.9–97.3) between participants and facilitators. Conclusions: Hospital Nacional Pedro Bethancourt experts conducted high-quality trainings with locally relevant CETEP (ETAT) material. Trainings were effective and well received. The pediatric emergency department at HNPB now uses a triage system based on CETEP (ETAT).