Knowledge and Practices of Postgraduate Student Nurses in UK Universities Regarding Triage System in Hospital Emergency Departments

This research proposal aims to investigate the knowledge and practices of postgraduate student nurses in UK universities regarding the triage system in hospital emergency departments. The proposal includes the background of the study, problem statement, research objectives, research questions, significance of the study, and limitations. The proposal also outlines the literature review, methodology, and data analysis methods.

KNOWLEDGE AND PRACTICES OF
POSTGRADUATE STUDENT NURSES IN UK
UNIVERSITIES REGARDING TRIAGING
SYSTEM IN HOSPITAL EMERGENCY
DEPARTMENTS
A research proposal submitted by
Student Name
Faculty of Health Sciences and Wellbeing

Table of Contents
Table of Contents........................................................................................................................................2
CHAPTER ONE: INTRODUCTION......................................................................................................3
1.1 Introduction.......................................................................................................................................3
1.2 Background of the Study...................................................................................................................3
1.2. Problem Statement............................................................................................................................6
1.4 Research Objectives...........................................................................................................................9
1.4.1 Aim.................................................................................................................................................9
1.4.2 Specific Objectives.........................................................................................................................9
1.5 Research Questions............................................................................................................................9
1.6 Significance of the Study...................................................................................................................9
1.7 Limitation of the study.....................................................................................................................10
CHAPTER TWO: LITERATURE REVIEW.......................................................................................10
CHAPTER THREE: MATERIAL AND METHODOLOGY..............................................................12
Research methodology:.........................................................................................................................12
Aims & objectives:................................................................................................................................12
Method:.................................................................................................................................................12
Rationale for the methodology:.............................................................................................................12
3.1 Research Study Design....................................................................................................................13
3.2 The Population and Sampling..........................................................................................................13
3.3 Sampling design and Sampling frame..............................................................................................14
3.5 Sampling technique.........................................................................................................................14
3.7 Research approach...........................................................................................................................14
3.8 Data collection methods: The questionnaire....................................................................................14
3.10 Validity and Reliability..................................................................................................................16
3.11 Ethical Considerations...................................................................................................................16
3.12 Pilot Study.....................................................................................................................................16
3.13 Data Analysis Methods..................................................................................................................16
3.14 Gantt Chart....................................................................................................................................17
REFERENCES........................................................................................................................................20

CHAPTER ONE: INTRODUCTION
1.1 Introduction
The triage system is characterized as a beneficial technique in the Emergency Department
(ED) that involves prioritizing patients based on the severity of their conditions (Wolf et al.,
2018), hence lowering the amount of time patients must wait before obtaining medical treatment
and enhancing the quality of patient care (Fathoni, et al., 2016), (Gilboy, et al., 2019) and
(Considine, et al., 2017) as well as healthcare in general. When a patient is triaged, they are
placed in the proper area at the appropriate time in order to get the appropriate degree of care and
the relevant resources are allocated in order to satisfy the patient's medical requirements. This
area of the hospital makes it possible for the caretaker to be assigned to an appropriate evaluation
and treatment location (Jenson et al., 2018) and (Weber, 2019). However, triage is a widespread
issue in ED worldwide.
1.2 Background of the Study
There are 25.0 million people that present themselves to emergency rooms in the United
Kingdom every time, and triage must be used to prioritize these patients based on the acuity, or
severity, of their conditions (The KingFunds, 2022). In the discourse of an ED, the term "triage"
known to the first step of the initial patient interaction, which is also the stage that is often
considered to be the most formal. Nevertheless, the rising amount of duties needed by triage
personnel as imposed by regulatory authorities (for example, prescription reconciliation and
suicide screening) makes it take longer to evaluate each patient, which in turn slows down the
flow of patients. Higher percentages of patients departing without being seen have been related
to bottlenecks that occur during the intake process and to lengthy wait periods in waiting rooms
(Wolf et al., 2018) and (Carter, Pouch & Larson, 2014). The approach that has been used in
many emergency rooms is to gather less information during the triage process or to use a "instant
bedding" or "pull till full" system. "Instant bedding" or "pull till full" system occurs when the
sick people is transferred immediately to a bed that is available; this procedure is repeated until
no more beds are left. ED.
In the ED, the step that is most critical is called triage. The purpose of triage is to
guarantee that each and every patient receives treatment that is prompt, precise, supportive, and
accurate according to their situation relying on ABCDE (Airway, Breathing, Circulation,

Disability, and Environment) preferences. Triage is useful because it helps ensure that every
patient receives treatment (Fadli and Sastria, 2017). The evaluation of emergency casualties by
urgent care nurses consists of a general examination, the taking of a patient history, and the
measurement of vital signs. In UK, the victims are then labelled per the emergency situation that
accompany them, with Priority 1 (P1) denoting emergent patients, Priority 2 (P2) denoting
urgent patients, Priority 3 (P3) denoting non-urgent patients, and Priority 4 (P4) denoting
patients who have passed away (Mersh, Vassallo and Royal College of Emergency Medicine,
2020), whilst with red denoting emergent patients, yellow denoting urgent patients, green
denoting non-urgent patients, and black denoting patients who have passed away are used
globally (Fadli and Sastria, 2017).
Emergency nurses are in the front of the hospital care delivery system; they are always
the introductory to engage critically sick or wounded patients and provide them with medical
attention. In addition to this, they focus on the primary anchors that are used for triage in health
facilities (Dulandas & Brysiewicz, 2018). Thus triage student nurses ought to be taught to always
have quick access to, or should have a clear view of, the areas designated for registration and
waiting.
In order to achieve the goal of the triage system and get assistance from the triage nurse
in determining the appropriate level, the student triage nurses should learn to follow a series of
stages. These steps including from danger environmental for all healthcare units and patients,
optical signs, major concerns, centered appraisal, presumption building, acuity dedication and
reassessment (Culley and Svendsen, 2014) and (AlMarzooq, 2020) and acuity determination and
reassessment involved triage. The expertise and cognitive content of triage nurses have been
mentioned as crucial variables in the decision-making process during triage. This is mirrored in
the allocation of triage categories, which indicate which victims need to be examined first (Kerie,
Tilahun & Mandesh 2018). Being a competent decision maker is essential for a triage nurse since
the decisions they make will determine the result of the triage.
The overestimation or underestimation of the triage level may have a negative impact on
the quality of treatment provided, can waste resources, can extend the duration of a patient's stay,
and may even alter the death rate. The right triage choice, on the other hand, demonstrates a high

quality of care, proper patient allocation, and enough time for treatment provided by the
emergency triage nurse (Mohammed, 2017) and (Dulandas & Brysiewicz, 2018,).
The quantity of patients who present themselves to emergency departments (EDs) has
grown over the last several years in industrialised high income nations as well as in low income
countries, in part due of self-referrals; this has led to EDs being congested (Afaya, Azongo and
Yakong, 2017). This gave rise to the issue that there should be a system that prioritises patients
in the order of urgency in the treatment that they need. In emergency departments of many
hospitals in low-income nations, there is no structured triage procedure. When compared to rich
nations, emergency treatment, including triage, is often one of the weakest links in the health
systems of low-income countries; yet, if it is well-organized, it has the potential to save lives and
save healthcare costs (Afaya, Azongo and Yakong, 2017).
When it comes to seeing patients, student nurses will often operate on a "first-come, first-
served" basis just like other clinician nurses. Frequently, there is no emergency department, and
patients who arrive at the hospital are examined either in the wards or in the outpatient clinic
(Lindskou et al., 2019). Because of this approach, there is no space for urgent and life-
threatening situations to be handled quickly. At this time, the majority of hospitals have EDs that
are consistently at capacity. This large volume of patients attending the ED may have an effect
on the quality of healthcare provided since the resources that are allocated for emergency
situations may be diverted to persons who have requirements that are possibly less urgent. As a
result, there is widespread agreement that triage is an essential component of the ED that cuts
down on patients' total wait times while ensuring that each and every patient receives the
appropriate care (Afaya, Azongo and Yakong, 2017).
The most important responsibilities of a nurse who is in charge of triage are to ensure that
patients are assessed by observing their overall appearance, collecting a focused history in order
to identify the issues that are now being presented, and evaluating the clinical risk (Lewis et al.,
2016). This same research reveals that nurses are responsible for ensuring the gathering and
analysis of physiological data using a primary survey technique, as well as the prompt
implementation of first aid procedures whenever they are required to do so.
In a similar vein, the use of speedy first aid measures may often avert an increase in the
fatality rate. In addition, the primary domain of a triage nurse is to do a speedy evaluation of

each patient within five to ten minutes. If there is sufficient space in the waiting area, the nurse
may perform further evaluations of patients at his or her own discretion (Rahmatullah et al.,
2017).
The student nurse doing triage has to have sufficient professional education and expertise
in emergency triage, as well as decision making and the provision of emergency nursing care.
Hence, engaging qualified and experienced nursing personnel for the triage process in the ED
and educating them how to correctly do triage may avert a significant number of fatalities,
impairments, and extra expenditures associated with treatment. Therefore, formal education
basically implementing the pedagogical strategies in triage enhances the efficacy of triage
student nurses, and with improved confidence, they will be better equipped to function more
effectively (Wu et al., 2018). Additionally, professional education in triage improves patient
safety (Torres, 2016).
1.2. Problem Statement
The UK universities follow Nursing and Midwifery Council (NMC) guideline that
enforced through the following standards: “The Standards framework for Nursing and Midwifery
Education, Standards for Student Supervision and Assessment, and Programmed Standards
Specific to each approved programmer” (NMC, 2018). Students studying nursing may attain
programme objectives and proficiency levels in recognition of these criteria. All nursing and
midwifery personnel must conduct their work in accordance with the Code’s criteria, as well as
the conduct that nurses, midwives, and certified nursing assistants are supposed to maintain
(NMC, 2018). The Code outlines the competency standards for nurses, midwives, and nursing
associates to be licensed to practice in the United Kingdom. All nursing students in their final
year are now eligible to participate in extended practicum for up to 100% of their programme
thanks to the emergency standards. If these criteria are implemented locally, learners may choose
to participate in a paid clinical placement while the emergency standard is in effect, depending
on necessity. As usual, the Approved Educational Institutions’ (AEIs) responsibility is to ensure
that students have satisfied all of their instructional objectives and programme criteria in order to
graduate from their programme and register with the NMC (NMC, 2021).
Since its inception, the Evidence-Based Practice (EBP) movement has been tasked with
the mission of bridging the gap that has existed between scientific research and clinical

application (Wu et al., 2018). This was in line with the Institute of Medicine's (IOM) aim that by
the year 2020, which was for 90 percent of clinical choices were to be evidence-based in order to
enhance the overall quality of health care in China (Wu et al., 2018) and (Brooke & Mallion,
2016). In UK, evidence-based practice tries to evaluate the quality of evidence about the risks
and benefits of therapies (including non-treatment) that may have a direct bearing on clinical
choices made by NHS experts and patient care. Data-based practice has many advantages that is
treatment is clinically and economically effective, that high standards are maintained, that care is
offered based on the best available evidence, and that the best results for individuals are attained.
In the UK, qualified nurse mentors who are part of the healthcare team provide help to
student nurses throughout their clinical rotations. Placements are a crucial component of nursing
education because they provide future nurses the chance to practice their clinical skills and see
how EBP is used. Unfortunately, there is little information available about the tactics used by
community nurse mentors to implement EBP and assist nursing students in understanding how
EBP is applied in a variety of unique community settings (Brooke & Mallion, 2016) and (NMC,
2008). Student nurses are on the frontline of the future health care system, and they are in a vital
position to challenge practice and apply the most up-to-date research findings in health care
decision making. (Niesche and Haase, 2012). In this, a good triage system must be able to
accurately determine the patients in requirement of an emergency care, mainly guiding them to
the right path with having the fast access towards the diagnostic as well as a therapeutic care
treatment. Within this, the triage system generally has five levels as well as the triage care nurses
can classify the patients mainly based over the criteria of an illness severity and the needed
facility.
The EDs of hospitals globally struggle with triage on a regular basis. The system is
described as a helpful procedure that is carried out in the ED and involves prioritizing patients in
accordance with the severity of their conditions (Wolf, et al., 2018). As a result, the amount of
time that patients have to wait before acquiring medical tending is decreased, which ultimately
results in an improvement in both the quality of patient care (Fathoni, et al., 2016) and
(Considine, et al., 2017). According to the findings of Afaya et al. (2017), worsened result for
patients occur whenever there is a biased distribution of patients in the triage rooms.

These consequences are instantly associated to impaired health and patients' treatment, as
well as an indefinite quantity on the mortality rates in ED, it is pointed out (World Health
Organization, 2019). The results may be affected by a number of variables, including the kind of
triage system used, how well it works, and the level of knowledge and skill possessed by
emergency student nurses on practice in the emergency department (ED). The nursing education
programme in the UK lasts three years and is at the BSc level (Bachelor of Science). Previously,
the Nurse and Midwifery Council opened a consultation on student nursing education
programme requirements in July, 2022. The purpose of this 10-week consultation is to ascertain
what knowledge and abilities nursing students need in order to provide safe and efficient patient
care. One of the suggestions is to provide nurses more freedom when it comes to modelled
learning, which is crucial for nurses learning triaging algorithms in emergency rooms (NMC,
2022).
The "Standards framework for nursing and midwifery education" (2018) explicitly states
in standard 5.1 that "Curricula and assessments are created, produced, delivered, and assessed to
make sure that students attain the proficiencies and objectives for their approved course."
Research has shown that inadequate training in this field of triaging system does not adequately
educate nurses to utilize triage (Mahmoudi et al, 2017) and (Delnavaz et al., 2018,). The design,
development, delivery, and evaluation of curricula and assessments of NMC to student
nurses are all done with the goal of ensuring that students complete their authorized programme
with the requisite competencies and objectives (Mahmoudi et al, 2017). Among patient’s triage,
an internal elements consisting the care nurse’s experiences, skills, personal characteristics,
knowledge, enhanced work, working environment as well as the assessment of the patient is
quite important. It is effectively analyzed by the study that undertrained among older people was
still an issue. If the care nurses do not observe the specific principles of the triage within the
categorization of the vulnerable patients, a mistake as over triage can occur that can be quite
dangerous for the people who are at greater risk as well as can need a life saving measures.
Finally examining nurses' triage methods and understanding will go a long way toward
improving how education surrounding triage methods is taught in UK universities, leading to an
improvement in the quality of patient treatment in the emergency department. In light of this

context, the aim is to evaluate the current knowledge and practices of triage among nurse’s
students in UK universities.
1.4 Research Objectives
1.4.1 Aim
The aim of this study is assess and evaluate the current knowledge and practices of
student nurses in UK universities regarding triaging system in hospitals.
1.4.2 Specific Objectives
 To evaluate how the postgraduate student nurses’ knowledge affects the quality of
emergency care practice in triaging practice.
 To examine how postgraduate student nurses may respond to emergency situations in
triaging system.
1.5 Research Questions
 What knowledge do postgraduate student nurses have in order to respond to emergency
situations in triaging system?
 How does the knowledge of postgraduate student nurses’ practices impact on the quality
of emergency care in triaging practice?
 What knowledge do postgraduate student nurses need in order to respond to emergency
situations in triaging system?
1.6 Significance of the Study
When a client in need of urgent medical assistance arrives at the ED, the emergency
department triage nurse is the first person they speak with. It has been proposed that the
knowledge and experience of student nurses are crucial components of the triage decision-
making process (Stanfield, 2015). Numerous triage educational courses are predicated on the
premise that improving one's level of knowledge can enhance the quality of triage decisions. In
order to deliver safe and effective emergency care, student nurses must be able to make accurate
clinical judgments on the urgency of a patient's condition and the level of intervention required
(Aloyce et al., 2014).

Such an understanding bolsters the relevance of this research study, as the results will elucidate
the essential of the requirement for nurses to acquire information via professional trainings in
order to provide high-quality emergency care in the ED or while providing emergency treatment.
The research may potentially highlight the gaps in nurse education regarding triaging system that
may impede the improvement of student nurse’s emergency care knowledge and practices
1.7 Limitation of the study
There may be limitations time wise or in recruitment of large sample sizes of nurse
participants for this study, however, a large number of universities will be approached where
there are postgraduate nursing courses in order to increase the sample size.
CHAPTER TWO: LITERATURE REVIEW
Triage is the duty of the nurse, who must be trained and equipped for this duty
(Mahmoudi et al., 2017). Without sufficient and effective training, they will not be able to
employ triage effectively (Mirhaghi and Roudbari, 2011). For this reason, nursing colleges must
be able to expose students to urgent circumstances in order to prepare them for triage. Viewing
emergency situations and working in a difficult environment may help students learn;
consequently, the majority of institutions across the globe seek out student-centered instructional
techniques that can enhance students' clinical management (Mollahadi, 2010). For triage
instruction in healthcare systems, a range of approaches are used, including lectures, small-group
discussions, role-playing, demonstrations, film viewings, and direct observation. The
conventional form of teaching (lecture) is mostly verbal and widely employed owing to its ease
of implementation (Golafrooz, Shahri and Khaghanizade, 2010).
Numerous research has studied nurses' triage expertise; some of these studies have
demonstrated that nurses lack sufficient triage understanding. A research done in Sweden (Lee et
al., 2005) revealed that emergency department triage nurses do not get enough training. Another
Iranian research (Mirhaghi and Roudbari, 2011) found that nurses lacked enough understanding
of triage and had not been adequately taught. A research conducted in Australia revealed that
42% of the nurses had not received triage training, and 14% of those who had attended triage
education sessions were not adequately prepared to perform triage (Fry and Burr, 2001). In Iran,
nursing students are only trained on triage during a two-hour course (Khatiban et al., 2014).

Consequently, the absence of triage education is the cause of nurses' limited triage expertise
(Mirhaghi and Roudbari, 2011).
According to the research study, understanding of triage is an essential aspect in triage
decision-making (Dadashzadeh et al., 2013). Therefore, effective teaching approaches should be
devised and made available to enhance the nurses' decision-making abilities. In this respect, the
majority of healthcare systems and colleges are searching for instructional techniques that might
enhance medical decision among healthcare practitioners (Magnussen et al., 2000).
Collaboration is essential for fostering a responsive and inventive student experience.
People are aware that students must be exposed to real-world patient care and that there is a
severe dearth of placement opportunities in many regions of the world (Roxburgh and Beattie,
2018).
Roxburgh has spent the past decade doing research and analysing practise placement
strategies that improve the student experience (Roxburgh, 2014) and (Holland et al., 2010).
Student experience-related National Student Survey scores are where the United Kingdom falls
short. Constantly, UK students complain about the injustice of student allocations, the lack of
transparency in how requests for placement adjustments are handled, and the inadequacy of
advance warning to prepare for their assigned placement (Roxburgh, 2014). Students will often
approach the staff person they feel would be the most 'accommodating' of their request. When
clinical regions are unable to handle the amount of students identified in their practice placement
audits, placement distribution is further complicated. This necessitates extensive rework on the
part of higher education institutions as they search for an alternate placement. Students and
clinical areas may get fewer than six weeks' notice before to the beginning of their placement,
which is a significant consideration (Roxburgh and Beattie, 2018).
Students must actively participate in co-creating their experience. This offers a lot of
advantages, including a better student experience and students take responsibility for their
programme rather than passively accepting it. Nurse education at university level must mimic
changes in the patient experience in which students' participation is proactive and not only
symbolic or as observers.

CHAPTER THREE: MATERIAL AND METHODOLOGY
Research methodology:
The research methodology is generally a pathway of illustrating how the researchers
mainly intended to carry out the study effectively. It is generally a logical as well as a systematic
plan in order to resolve the research questions. A methodology can detail an approach to
researcher towards a research in order to ensure the reliable, valid outcomes which can
effectively address their aims and objectives as well.
Aims & objectives:
The aim of this study is to investigate the knowledge and clinical practice of postgraduate
student nurses regarding triaging in Emergency departments. This will be done as a cross
sectional study using a questionnaire which will be disseminated via an online survey tool such
as Qualtrics. The postgraduate nurses will be recruited via approaching heads of nursing schools
at UK universities who are enrolled for postgraduate studies. The objectives are to evaluate how
the postgraduate student nurses’ knowledge affects the quality of emergency care practice in
triaging practice and to examine how postgraduate student nurses may respond to emergency
situations in triaging system.
Method:
A questionnaire will be developed from reading published literature on triage in
emergency departments and clinical skills required by nurses to practice triaging. The questions
will be outlined to explore nurse’s knowledge and how this impacts on their clinical practice of
triage. An online survey tool such as Qualtrics will be used to disseminate the questionnaire. All
nurse participants will be anonymized and data collected will be analyzed statistically using the
Statistical Package for the Social Sciences (SPSS) software.
Rationale for the methodology:
For doing research over the specific topic, it is essential to use a questionnaire as it is
mainly a popular study approaches, it is because it can offer an efficient and fast as well as an
inexpensive means of collecting the huge amount of data from a sizeable sample volume. These
such tools are generally effective for measuring the subject behavior, its intentions, the attitudes
and opinions, its preferences as well. While talking about the study of qualitative and
quantitative analysis, the quantitative research methods can specifically deal with statistics and

numerical values in order to prove the wide general information of the study more effectively. It
can attain a higher understanding as well as knowledge of the world around. The research
approach is quite easier and can enable the researchers to systematically determine the variables
as well as can test hypothesis as well. In addition to this, the researchers can use the quantitative
approach to observe the events or situations which can make influence over people.
3.1 Research Study Design
A cross-sectional survey across UK universities will be conducted to assess and evaluate
the knowledge and practices of postgraduate student nurses in UK universities via an online
survey using Qualtrics.
3.2 The Population and Sampling
The study population will be student nurses from UK universities. Universities that offer
nurse training courses will be purposively selected in order to target the participants. Such
universities will be identified by consulting the Universities and Colleges Admissions Service
(UCAS) website.
Nurse student participants will be recruited via sending out an online survey to the heads
of nursing schools with relevant information such as the participant information sheet, consent
form and the Gatekeepers letter so they will then cascade this information to their nurse students
to enable them to participate.
Sample size:
According to Blumberg, Cooper and Schindler (2003), the sample size is a smaller subset of a
larger population.
The sample size required is calculated for 40% accuracy in study population triage at 80%
confidence interval level to be 51 nurse participants. This was calculated using this website for
power calculation: https://clincalc.com/stats/samplesize.aspx. When an accuracy of 65% was
used a sample size of 573 participants was required. Due to time constraints, a 40% accuracy was
anticipated in sample population of triaging knowledge and hence a power calculation with an
80% confidence interval level was used to reduce the number of sample size.

3.3 Sampling design and Sampling frame
This research will use descriptive and quantitative methods. Ball (2019) says descriptive
research involves collecting quantitative data for statistical inferences about a specific audience.
It is a successful, cost-effective strategy that accurately portrays the issue. This is true for
extensive samples. Ball (2019) says this survey method is the finest for getting original data
because it is accurate. This technique will collect qualitative and quantitative data using
descriptive and inferential statistics.
A sampling frame is a list of goods, persons, or establishments from which to draw observations.
A sample frame's selection is crucial because it represents the complete population. This survey
will sample different universities. This frame will help the researcher acquire accurate data.
3.5 Sampling technique
Sampling technique is generally the name or the other identification of the specific
procedures by which the significant entities of the sample mainly have been chosen. For the
study there have been selected about 51 nursing student and where the accuracy of 65% was
mainly used a sample size of about 573 participants was needed.
3.7 Research approach
This study used an inductive technique. This method begins with specific observations,
eventually applied to generalized ideas and study findings. Inductive research is best for small
samples since it includes context. Despite being acceptable for the research, the approach has a
fundamental problem that provides broad hypotheses and a conclusion based on small-number
observations, putting doubts on the validity of the robust findings.
3.8 Data collection methods: The questionnaire
Within this research process the questionnaire is used that is evaluated to extract more
data for topic. Participants will be surveyed online. This study will manually collect
questionnaire data from randomly selected participants. Send the URL via WhatsApp or email.
This validates the questionnaire. The online survey will feature closed-ended questions and five-
point agreement scale questions. The questionnaire will be sent via WhatsApp, email, and social
media, increasing the response rate. This study uses Google Forms, a free online survey
software. These are convenient because of the epidemic.

Questionnaire:
Question 1: Is time taken in triage system to book is shorter?
A: Yes B: No
C: Unidentified D: In process
Question 2: Is time taken in triage system see doctor was shorter?
A: Yes B: No
C: Unidentified D: In process
Question 3: Is information received from triage system of healthcare department is shorter?
A: Yes B: No
C: Unidentified D: In process
Question 4: Is anxiety is experience due to triage system of emergency department in healthcare setting?
A: Yes B: No
C: Unidentified D: In process
Question 5: Is convenience is suffered by patient due to triage system of emergency department in
healthcare setting is shorter?
A: Yes B: No
C: Unidentified D: In process
3.9 Data collection procedures
Pretesting will occur before the primary survey. The pretest is for 5. This verifies the
questionnaire's validity and structure. Pretest comments will improve problematic questions,
resulting in a logical, relevant, easy-to-fill-out, and brief research instrument. The investigation
includes questionnaires. The questionnaire determines age and gender first. The second portion
asks about knowledge and practices of student nurses’ in UK universities regarding triaging
system in hospital emergency departments. The questionnaires will include a research and

researcher introduction. The letter also says the study's data will be kept private and used
academically.
3.10 Validity and Reliability
The use of well-structured research methods (standard tools) as well as sampling to
ensure randomization and representation helped to assure validity. The questionnaire will be
tested for both validity and reliability during the pilot study which will be conducted using 5
student nurses for feedback. Any ambiguous or irrelevant questions will be removed or modified
as per feedback.
3.11 Ethical Considerations
An ethics application will be submitted to the University’s ethics committee. All aspects
of patient confidentiality and how collected data will be collected, managed, used and stored
will be observed according to the requirements of the University’s ethics regulations. All the
ethical considerations were effectively met within the study and the data of all the patients were
remained confidential.
3.12 Pilot Study
A total of 5 nurse students will be recruited to provide feedback on the questionnaire.
This will involve time taken to complete the feedback, quality of questions, relevancy of the
questions and ambiguity regarding the wording of the questions. All feedback received will be
used to amend the questionnaire accordingly.
3.13 Data Analysis Methods
An analysis is needed for research. Data hinders qualitative research (2021). This basic study
will assess responder output. The researcher looks for incomplete questionnaires and missing
data after gathering data. Examine portion sizes. Data analysis compiles and adjusts statistics.
After cleansing and summarizing data, researchers can conclude completeness and
understanding. SPSS analyses coded and tabular data. SPSS 19 is a user-friendly statistics
program. Statistics describe samples and data. Mean, frequency, and SD are descriptive statistics.
Tabular and graphical data display. Frequencies, percentages, averages, and standard deviations
will be used to evaluate quantitative data and identify patterns and trends. This analysis will
entail interviewee content analysis and correlation.

3.14 Gantt Chart
The work plan and schedule for the study has been presented using a Gantt Chart as follows:

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Evaluating the accuracy of emergency nurses in correct triage using emergency severity index
triage in Sina hospital of Tabriz, 2018 [Online] Available through:
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