Background: Emergency department triage accuracy is fundamental to patient safety, resource allocation, and clinical outcomes. The Canadian Triage and Acuity Scale (CTAS) provides a standardised five-level framework, yet its effectiveness depends critically on comprehensive, contextually adapted training. The Qassim Comprehensive Training Model (QCTM-CTAS) represents a localised intervention designed to address region-specific challenges in Saudi Arabian emergency departments. Aim: This systematic review and meta-analysis synthesizes the evidence base for QCTM-CTAS, examining its impact on emergency nurses' triage competence, clinical decision-making, and patient assignment accuracy. Methods: This systematic review and meta-analysis synthesised evidence from a mixed-methods study evaluating the QCTM-CTAS intervention across 196 emergency nurses in Qassim Region hospitals. Quantitative outcomes were analysed using nonparametric methods (Mann-Whitney U, Wilcoxon signed-rank tests) with effect sizes calculated as r = |Z|/√N. Qualitative data from 17 interviews underwent thematic analysis following Braun and Clarke's framework. Delphi methodology with seven experts established content validity. Results: The intervention group demonstrated statistically significant improvements across all measured domains compared to controls. CTAS knowledge and understanding showed large between-group effects (U = 0.000, Z = -12.515, p 0.60), suggesting equitable training effects. Conclusions: The QCTM-CTAS intervention produced large to very large effects on emergency nurses' triage competence across multiple domains. The comprehensive, context-adapted approach effectively bridged the gap between standardized CTAS guidelines and region-specific practice realities in Qassim, Saudi Arabia.
Alharbi et al. (Thu,) studied this question.