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Inter-Rater Agreement of Emergency Nurses and Physicians in Emergency Severity Index (ESI) Triage

INTRODUCTION: Triage is one of the most important systems in patients prioritizing at the time of arrival to hospital. Based on the severity of the injury and the need for treatment, this system manages patients in the least time, which could lead to rotation of patients with high reliability and sa...

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Autores principales: Esmailian, Mehrdad, Zamani, Majid, Azadi, Fatemeh, Ghasemi, Faezeh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Shahid Beheshti University of Medical Sciences 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4614563/
https://www.ncbi.nlm.nih.gov/pubmed/26495372
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author Esmailian, Mehrdad
Zamani, Majid
Azadi, Fatemeh
Ghasemi, Faezeh
author_facet Esmailian, Mehrdad
Zamani, Majid
Azadi, Fatemeh
Ghasemi, Faezeh
author_sort Esmailian, Mehrdad
collection PubMed
description INTRODUCTION: Triage is one of the most important systems in patients prioritizing at the time of arrival to hospital. Based on the severity of the injury and the need for treatment, this system manages patients in the least time, which could lead to rotation of patients with high reliability and safety. Currently, the most accepted method for triage is emergency severity index (ESI) system, considered as five-level triage method, too. This method were implemented in Al Zahra Hospital of Isfahan by trained nurses since March to May 2010. This study was aimed to evaluate the accuracy of emergency nursing triage using ESI. METHODS: This prospective cross sectional study was carried out on 601 patients referred to Al-Zahra hospital of Isfahan through May 2010. The patients’ triage level were determined by physicians and nurses separately and the results compared. To define the level of agreement between two groups (inter-rater agreement), the kappa index was evaluated. To specify the association between the time interval of initial triage and patient final status, Chi-Square test was applied using SPSS 18 statistical software. RESULTS: There was no significant difference between results of nurses and physicians triage (P<0/0001). The agreement level (kappa index) between two groups was 94% (95% CI: 0.931-0.957). Of 601 patients, 44.1% ones were hospitalized at the emergency department, 52.6% discharged and 3.3% died. The average of time interval between nursing triage and physician visit was 9.55 minutes at the level one triage, 21.64 minutes at level two, 26.03 minutes at level three, 26.93 minutes at level four, and 11.70 minutes at level five. CONCLUSION: It seems that there is an acceptable inter-rater agreement between emergency nurses and physicians regarding patients’ triage in terms of ESI system.
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spelling pubmed-46145632015-10-22 Inter-Rater Agreement of Emergency Nurses and Physicians in Emergency Severity Index (ESI) Triage Esmailian, Mehrdad Zamani, Majid Azadi, Fatemeh Ghasemi, Faezeh Emerg (Tehran) Original Research INTRODUCTION: Triage is one of the most important systems in patients prioritizing at the time of arrival to hospital. Based on the severity of the injury and the need for treatment, this system manages patients in the least time, which could lead to rotation of patients with high reliability and safety. Currently, the most accepted method for triage is emergency severity index (ESI) system, considered as five-level triage method, too. This method were implemented in Al Zahra Hospital of Isfahan by trained nurses since March to May 2010. This study was aimed to evaluate the accuracy of emergency nursing triage using ESI. METHODS: This prospective cross sectional study was carried out on 601 patients referred to Al-Zahra hospital of Isfahan through May 2010. The patients’ triage level were determined by physicians and nurses separately and the results compared. To define the level of agreement between two groups (inter-rater agreement), the kappa index was evaluated. To specify the association between the time interval of initial triage and patient final status, Chi-Square test was applied using SPSS 18 statistical software. RESULTS: There was no significant difference between results of nurses and physicians triage (P<0/0001). The agreement level (kappa index) between two groups was 94% (95% CI: 0.931-0.957). Of 601 patients, 44.1% ones were hospitalized at the emergency department, 52.6% discharged and 3.3% died. The average of time interval between nursing triage and physician visit was 9.55 minutes at the level one triage, 21.64 minutes at level two, 26.03 minutes at level three, 26.93 minutes at level four, and 11.70 minutes at level five. CONCLUSION: It seems that there is an acceptable inter-rater agreement between emergency nurses and physicians regarding patients’ triage in terms of ESI system. Shahid Beheshti University of Medical Sciences 2014 /pmc/articles/PMC4614563/ /pubmed/26495372 Text en © 2014 Shahid Beheshti University of Medical Sciences. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0), (http://creativecommons.org/licenses/by-nc/3.0/)which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.
spellingShingle Original Research
Esmailian, Mehrdad
Zamani, Majid
Azadi, Fatemeh
Ghasemi, Faezeh
Inter-Rater Agreement of Emergency Nurses and Physicians in Emergency Severity Index (ESI) Triage
title Inter-Rater Agreement of Emergency Nurses and Physicians in Emergency Severity Index (ESI) Triage
title_full Inter-Rater Agreement of Emergency Nurses and Physicians in Emergency Severity Index (ESI) Triage
title_fullStr Inter-Rater Agreement of Emergency Nurses and Physicians in Emergency Severity Index (ESI) Triage
title_full_unstemmed Inter-Rater Agreement of Emergency Nurses and Physicians in Emergency Severity Index (ESI) Triage
title_short Inter-Rater Agreement of Emergency Nurses and Physicians in Emergency Severity Index (ESI) Triage
title_sort inter-rater agreement of emergency nurses and physicians in emergency severity index (esi) triage
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4614563/
https://www.ncbi.nlm.nih.gov/pubmed/26495372
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