EFFECTIVENESS OF NURSE-INITIATED SONO TRIAGE TRAINING ON KNOWLEDGE, SKILL ACQUISITION AND LEARNING CURVE AMONG EMERGENCY NURSES: A QUASI EXPERIMENTAL STUDY

Abstract

Background: Timely trauma triage is essential for improving patient outcomes in emergency departments. Nurse-Initiated Sono Triage (NISt), integrating the Trauma Triage Protocol (TTP) with point-of-care ultrasound using the extended Focused Assessment with Sonography for Trauma (e-FAST), has the potential to enhance nurses' competency in early trauma assessment. Objective: To evaluate the effectiveness of a Nurse-Initiated Sono Triage educational programme on emergency nurses' knowledge, skill acquisition, and learning curve. Methods: A quasi-experimental one-group pre-test–post-test study was conducted among 30 emergency nurses at a tertiary care hospital in New Delhi between April and July 2024. Participants received a structured educational programme followed by simulation-based and supervised clinical training in NISt. Knowledge was assessed using a structured questionnaire, while competency was evaluated using standardized observation checklists. Each nurse performed 20 supervised Sono Triage assessments. Pre- and post-intervention scores were compared using paired t-tests, and competency progression was analysed using Linear Mixed Models. Results: Significant improvements were observed in both knowledge and practical competency following the intervention. The mean Sono Triage knowledge score increased from 10.60 ± 3.21 to 18.53 ± 1.42 (p < 0.001). Trauma Triage Protocol skill scores improved significantly (4.966 ± 0.034 vs. 4.992 ± 0.010; p < 0.001). All Sono Triage skill domains, including probe handling, cardiac, right upper quadrant, left upper quadrant, pelvic, and e-FAST assessment, demonstrated statistically significant improvements (p < 0.001). The time required to complete Sono Triage assessments decreased significantly across repeated patient encounters, demonstrating progressive competency acquisition and an improved learning curve. Conclusion: The Nurse-Initiated Sono Triage educational programme significantly enhanced emergency nurses' knowledge, technical skills, and efficiency in performing trauma ultrasound assessments. The findings support the integration of competency-based Sono Triage training into emergency nursing practice to strengthen early trauma assessment, facilitate timely clinical decision-making, and improve the quality of emergency care.