Knowledge and Practice of Triage Among Accident and Emergency Nurses in Selected Tertiary Hospitals in Ekiti State, Nigeria

Background and objectives: Triage is a critical function in emergency departments that determines the prioritization of patients based on clinical urgency. Inaccurate triage decisions can lead to adverse patient outcomes and increased morbidity and mortality. Despite the global recognition of triage importance, limited evidence exists regarding triage knowledge and practice among emergency nurses in South-Western Nigeria. This study aimed to assess the knowledge and practice of triage, identify associated factors, and determine predictors of triage knowledge and practice among Accident and Emergency nurses in selected tertiary hospitals in Ekiti State, Nigeria. Methods: A cross-sectional study was conducted among 120 nurses working in the emergency departments of three tertiary hospitals: Ekiti State University Teaching Hospital (EKSUTH), Federal Teaching Hospital Ido-Ekiti (FETHI), and Afe Babalola University Teaching Hospital (ABUAD). Participants were selected using simple random sampling. Data were collected using a self-structured, validated questionnaire with four sections assessing socio-demographics, knowledge, practice, and determinants of triage. Knowledge and practice scores were graded using mean score analysis. Data were analyzed using SPSS version 22, employing descriptive statistics, Chi-square tests, likelihood ratio tests, and binary logistic regression at a significance level of p<0.05. Results: The majority of respondents were female (76.7%), aged 21-35 years (77.5%), and held RN/RM/BNSC qualifications (45.0%). Mean age was 30.5±7.3 years, and mean emergency department experience was 3.8±3.5 years. Overall, 91.7% demonstrated good knowledge of triage, and 82.5% demonstrated good self-reported practice. However, specific knowledge deficits were identified: only 56.7% correctly identified the number of triage categories, and only 33.3% practiced triage at the recommended location. Factors significantly associated with triage knowledge were age group (p=0.014), marital status (p=0.008), and years of emergency experience (p=0.004). Educational qualification was significantly associated with triage practice (p=0.004). Logistic regression revealed that married nurses were 10.41 times more likely to have good triage knowledge compared to single nurses (OR=10.41, 95% CI: 1.275-84.998, p=0.029). No significant association was found between triage knowledge and practice (p=0.831). Conclusion: While emergency nurses in Ekiti State demonstrate high overall knowledge and self-reported practice of triage, significant gaps exist in specific knowledge domains and correct triage location practices. The dissociation between knowledge and practice suggests that factors beyond cognitive knowledge influence clinical triage performance. Educational qualification and clinical experience are critical determinants of triage competence. These findings underscore the urgent need for standardized triage protocols, continuous professional development programs, and system-level interventions to enhance triage accuracy and patient safety in Nigerian emergency departments.