Do prehospital providers and emergency nurses agree on triage assignment? an efficacy study

Helene Skjøt-Arkil, Louise L Pontoppidan, Jens O Laursen, Matthias Giebner, Jesper D Andersen, Christian B Mogensen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVES: The aim of this study was to investigate the agreement on triage level between prehospital providers and emergency department (ED) nurses in clinical practice when using the same triage system. The objectives were as follows: (a) What is the agreement of triage between prehospital providers and ED nurses, when using Danish Emergency Process Triage (DEPT) correctly? (b) Which part of the triage process yields the highest agreement regarding the final triage?

METHODS: The study was a prospective and observational efficacy study. Patients transported to the ED by ambulances were included. They were triaged by prehospital providers while being transported by ambulance to the ED, and by ED nurses upon arrival. Triage was done using the DEPT - a five-level triage system based on vital signs and a presenting complaint algorithm. An agreement analysis was performed.

RESULTS: DEPT was used correctly by both professions in 292 patients. In 182 (62%) patients the prehospital providers and the ED nurses agreed on the same triage level. This equals to κ=0.47 [95% confidence interval (CI): 0.41-0.56]. When considering the triage based on vital signs the agreement was 72% (κ=0.46; 95% CI: 0.41-0.47), and based on presenting complaint the agreement was 46% (κ=0.41; 95% CI: 0.37-0.44).

CONCLUSION: There was a moderate interrater agreement on triage assignment between ED nurses and prehospital providers. They agreed on final triage more often if they agreed on triage based on vital signs rather than presenting complaints.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Emergency Medicine
Vol/bind26
Udgave nummer1
Sider (fra-til)29-33
ISSN0969-9546
DOI
StatusUdgivet - 1 feb. 2019

Fingeraftryk

Emergencies
Nurses
Hospital Emergency Service
Vital Signs
Confidence Intervals

Emneord

    Citer dette

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    title = "Do prehospital providers and emergency nurses agree on triage assignment?: an efficacy study",
    abstract = "OBJECTIVES: The aim of this study was to investigate the agreement on triage level between prehospital providers and emergency department (ED) nurses in clinical practice when using the same triage system. The objectives were as follows: (a) What is the agreement of triage between prehospital providers and ED nurses, when using Danish Emergency Process Triage (DEPT) correctly? (b) Which part of the triage process yields the highest agreement regarding the final triage?METHODS: The study was a prospective and observational efficacy study. Patients transported to the ED by ambulances were included. They were triaged by prehospital providers while being transported by ambulance to the ED, and by ED nurses upon arrival. Triage was done using the DEPT - a five-level triage system based on vital signs and a presenting complaint algorithm. An agreement analysis was performed.RESULTS: DEPT was used correctly by both professions in 292 patients. In 182 (62{\%}) patients the prehospital providers and the ED nurses agreed on the same triage level. This equals to κ=0.47 [95{\%} confidence interval (CI): 0.41-0.56]. When considering the triage based on vital signs the agreement was 72{\%} (κ=0.46; 95{\%} CI: 0.41-0.47), and based on presenting complaint the agreement was 46{\%} (κ=0.41; 95{\%} CI: 0.37-0.44).CONCLUSION: There was a moderate interrater agreement on triage assignment between ED nurses and prehospital providers. They agreed on final triage more often if they agreed on triage based on vital signs rather than presenting complaints.",
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    Do prehospital providers and emergency nurses agree on triage assignment? an efficacy study. / Skjøt-Arkil, Helene; Pontoppidan, Louise L; Laursen, Jens O; Giebner, Matthias; Andersen, Jesper D; Mogensen, Christian B.

    I: European Journal of Emergency Medicine, Bind 26, Nr. 1, 01.02.2019, s. 29-33.

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    TY - JOUR

    T1 - Do prehospital providers and emergency nurses agree on triage assignment?

    T2 - an efficacy study

    AU - Skjøt-Arkil, Helene

    AU - Pontoppidan, Louise L

    AU - Laursen, Jens O

    AU - Giebner, Matthias

    AU - Andersen, Jesper D

    AU - Mogensen, Christian B

    PY - 2019/2/1

    Y1 - 2019/2/1

    N2 - OBJECTIVES: The aim of this study was to investigate the agreement on triage level between prehospital providers and emergency department (ED) nurses in clinical practice when using the same triage system. The objectives were as follows: (a) What is the agreement of triage between prehospital providers and ED nurses, when using Danish Emergency Process Triage (DEPT) correctly? (b) Which part of the triage process yields the highest agreement regarding the final triage?METHODS: The study was a prospective and observational efficacy study. Patients transported to the ED by ambulances were included. They were triaged by prehospital providers while being transported by ambulance to the ED, and by ED nurses upon arrival. Triage was done using the DEPT - a five-level triage system based on vital signs and a presenting complaint algorithm. An agreement analysis was performed.RESULTS: DEPT was used correctly by both professions in 292 patients. In 182 (62%) patients the prehospital providers and the ED nurses agreed on the same triage level. This equals to κ=0.47 [95% confidence interval (CI): 0.41-0.56]. When considering the triage based on vital signs the agreement was 72% (κ=0.46; 95% CI: 0.41-0.47), and based on presenting complaint the agreement was 46% (κ=0.41; 95% CI: 0.37-0.44).CONCLUSION: There was a moderate interrater agreement on triage assignment between ED nurses and prehospital providers. They agreed on final triage more often if they agreed on triage based on vital signs rather than presenting complaints.

    AB - OBJECTIVES: The aim of this study was to investigate the agreement on triage level between prehospital providers and emergency department (ED) nurses in clinical practice when using the same triage system. The objectives were as follows: (a) What is the agreement of triage between prehospital providers and ED nurses, when using Danish Emergency Process Triage (DEPT) correctly? (b) Which part of the triage process yields the highest agreement regarding the final triage?METHODS: The study was a prospective and observational efficacy study. Patients transported to the ED by ambulances were included. They were triaged by prehospital providers while being transported by ambulance to the ED, and by ED nurses upon arrival. Triage was done using the DEPT - a five-level triage system based on vital signs and a presenting complaint algorithm. An agreement analysis was performed.RESULTS: DEPT was used correctly by both professions in 292 patients. In 182 (62%) patients the prehospital providers and the ED nurses agreed on the same triage level. This equals to κ=0.47 [95% confidence interval (CI): 0.41-0.56]. When considering the triage based on vital signs the agreement was 72% (κ=0.46; 95% CI: 0.41-0.47), and based on presenting complaint the agreement was 46% (κ=0.41; 95% CI: 0.37-0.44).CONCLUSION: There was a moderate interrater agreement on triage assignment between ED nurses and prehospital providers. They agreed on final triage more often if they agreed on triage based on vital signs rather than presenting complaints.

    KW - agreement

    KW - emergency nurse

    KW - prehospital providers

    KW - presenting complaint

    KW - triage

    KW - vital sign

    U2 - 10.1097/MEJ.0000000000000503

    DO - 10.1097/MEJ.0000000000000503

    M3 - Journal article

    VL - 26

    SP - 29

    EP - 33

    JO - European Journal of Emergency Medicine

    JF - European Journal of Emergency Medicine

    SN - 0969-9546

    IS - 1

    ER -