Table 3 Main theme, categories and subcategories emerged from data analysis

limitation on admission due to improper referral of patients to COVID-19 centers

Not knowing how to deal with patient admission at the beginning of COVID-19 pandemic

unpreparedness to deal with the COVID-19 results in disorganized triage

Increased referral of patients in COVID-19 pandemic

Obligatory regulation on admission of COVID-19 patients in COVID-19 or non-COVID-19 centers

Improper distribution of patients in non-COVID-19 centers

Patients’ stress due to improper conditions caused by crowds

Challenge of patient admission and care due to lack of a clear structure

Delay in investigation of COVID-19 patients due to lack of a specific structure

Not knowing how to deal with patient admission at the beginning of COVID-19 pandemic

Waste of time following the confusion of referrals to triage ward

Concern about transmitting the disease to others, especially the family members

Fear of being infected, the cause of social and family isolation

Threats to the physical and mental health of personnel during COVID-19 pandemic

Social isolation because people thought the medical staff were the carrier of COVID-19

Concerns about contracting COVID-19

Challenges of triage personnel infected with COVID-19

heavy workload due to COVID-19 pandemic

Physical, psychological, and social consequences of COVID-19

Physical exhaustion due to COVID-19 pandemic

Mental exhaustion due to COVID-19 pandemic

Increase in the number of COVID-19 patients due to improper patient admission

Physical and mental exhaustion of patients and staff at the peak of COVID-19

High-risk pregnancy due to COVID-19 contraction of mother

Clinical errors at the peak of COVID-19

Physical exhaustion of personnel at the peak of COVID-19

Long-term hospitalization of patients suspected to be infected by COVID-19

Reluctance of patients to refer to COVID-19 centers

Fear of being hospitalized in COVID-19 centers is a factor of hiding the truth

Fear of being hospitalized in COVID-19 centers is a factor of hiding the truth

An increase in the number of infection patient due to fear of stigma of COVID-19

Quality of care which is neglected at the time of COVID-19

Neglect of inpatient care due to unnecessary registration system

Increase in clinical errors due to the crowd in triage ward

Neglect of inpatient care due to the crowd in triage ward during COVID-19 pandemic

Degrading the quality of care due to fear of contracting COVID-19

Problems or challenges of not having a fixed resident in triage ward

Fast diagnosis due to the presence of a fixed obstetric resident in triage ward

Reduction in the quality of service due to improper triage structure in COVID-19 pandemic

Benefits of having a fixed gynecologist resident in triage ward

Negligence in following health protocols

Necessity of and personnel cooperation in systematically observing COVID-19 conditions in triage section

The need for regulations of following the health protocols

Adequate care in proper triage ward

The requirement for a purposeful structure of tasks division in the triage ward

Dissatisfaction due to not following the compliance plan

Dissatisfaction with lack of proper triage infrastructure in COVID-19 conditions

Patient’s unreasonable expectations of triage services during COVID-19 pandemic

Lack of space due to high patient referrals

Challenges of triage equipment shortage

The benefits of creating an outpatient room which is monitored regularly in triage ward

Challenges of not having an isolation room prepared for COVID-19 patients

An increase in the cost of treatment despite of being a public hospital

Deficiency in purposeful and efficient triage management in COVID-19 conditions

The need to combine clinical education with treatment in triage training centers

Imposing a cost on the health system due to COVID-19 pandemic

Low level of job satisfaction due to not receiving the payment assigned for health care staff in COVID-19 pandemic

Lack of enough motivation to work due to unfair payment assigned for health care staff in COVID-19 pandemic

Patient’s comfort following empathetic communication

Empathetic communication: giving care compassionately in triage ward

Communicating with patients which is neglected at the time of COVID-19

The obligation for effective communication between the service provider and the recipient

Improper communication with family of the patient

Fear of being infected, the cause of poor communication between patients and staff

Improper relationship due to fear of disease transmission

Commitment and effort of the staff in the difficult conditions of COVID-19 pandemic

Commitment to work in difficult COVID-19 conditions

Accountability required to improve the provision of services during the COVID-19 pandemic

Patient’s satisfaction with the responsibility of personnel

Effective care as the result of team work

Effective care requirements

Feeling of power as a result of experience and skill in performance