{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T02:22:55Z","timestamp":1768443775939,"version":"3.49.0"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,29]],"date-time":"2024-12-29T00:00:00Z","timestamp":1735430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Japan Journal Nursing Sci"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study aimed to grasp the third delay using an observational method of actual nurses\/midwives' practice overtime during care provision to emergency obstetric patients in a tertiary referral national hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective quantitative design was employed to observe the 24\u2010h obstetric triage process from February 4 to March 7, 2023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study involved observations of 120 obstetric patients with mean maternal age of 29.1\u2009years (SD\u2009=\u20095.5); 81.6% were between 20 and 35\u2009years, 14.2% were over 35\u2009years, and 4.2% were under 20\u2009years. There were 99 (82.5%) pregnant women: 67.7% were preterm, 29.3% term, and 3% postdate, and there were 21 (17.5%) postpartum women. Initial diagnoses were postpartum hemorrhage, 9 (7.5%), antepartum hemorrhage, 15 (12.5%), eclampsia, 13 (10.8), severe preeclampsia, 19 (15.9), preeclampsia, 12 (10%), obstructed labor, 3 (2.5%), previous scar, 13 (10.8%), and others, 36 (30%). Waiting time was within 15\u2009minutes for 30.8% of the observations. Median waiting time from registration to consultation was 9\u2009min. Interquartile range (IQR) for postpartum hemorrhage was 3.5\u201323.5\u2009min, and IQR for eclampsia was 11.5\u2013117.5. There were no maternal deaths during the 24\u2010h observation of each obstetric patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The obstetric triage process requires additional training for triaging time\u2010sensitive obstetric complications; the wide IQR of waiting time indicated management misalignments thus causing the third delay. The clinical priority of obstetric patients with leading risk factors for morbidity and mortality, such as hypertensive disorders of pregnancy and hemorrhage, needs to be approached within a continuum of care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jjns.12639","type":"journal-article","created":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T03:09:18Z","timestamp":1735528158000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Observational study of the third delay in emergency obstetric triage at the referral national hospital in Tanzania: Baseline survey"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9209-0968","authenticated-orcid":false,"given":"Mugara Joseph","family":"Mahungururo","sequence":"first","affiliation":[{"name":"Department of Maternal and Reproductive Health Muhimbili National Hospital  Dar es Salaam Tanzania"},{"name":"St. Luke's International University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7412-3941","authenticated-orcid":false,"given":"Shigeko","family":"Horiuchi","sequence":"additional","affiliation":[{"name":"St. Luke's International University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1519-2845","authenticated-orcid":false,"given":"Eri","family":"Shishido","sequence":"additional","affiliation":[{"name":"St. Luke's International University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1891\/9780826133939"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogn.2017.09.002"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0009.2005.00397.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.4314\/mmj.v31i3.8"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-016-1098-2"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-017-1407-4"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2019.04.004"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.21.285945"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-018-1763-8"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-017-1503-5"},{"key":"e_1_2_10_12_1","unstructured":"Ministry of Health (MoH) [Tanzania Mainland] Ministry of Health (MoH) [Zanzibar] National Bureau of Statistics (NBS) Office of the Chief Government Statistician (OCGS) and ICF. (2022).2023 Tanzania demographic and health survey and malaria indicator survey 2022 key indicators report. 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(2021).The state of the world's midwifery 2021 UNFPA WHO & ICM. 2021.www.unfpa.org\/sowmy+ supplement.https:\/\/\\www.unfpa.org\/sites\/default\/files\/resourcepdf\/SoWMy_2021_supplements_final_v2.pdf"},{"key":"e_1_2_10_22_1","volume-title":"Making pregnancy safer: the critical role of the skilled attendant: a joint statement by WHO, ICM and FIGO","year":"2004"}],"container-title":["Japan Journal of Nursing Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jjns.12639","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T08:11:06Z","timestamp":1740557466000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jjns.12639"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,29]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1111\/jjns.12639"],"URL":"https:\/\/doi.org\/10.1111\/jjns.12639","archive":["Portico"],"relation":{},"ISSN":["1742-7932","1742-7924"],"issn-type":[{"value":"1742-7932","type":"print"},{"value":"1742-7924","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,29]]},"assertion":[{"value":"2024-05-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e12639"}}