Cargando…
Validation of the Computerized Pediatric Triage Tool, pediaTRI, in the Pediatric Emergency Department of Lenval Children's Hospital in Nice: A Cross-Sectional Observational Study
INTRODUCTION: A reliable pediatric triage tool is essential for nurses working in pediatric emergency departments to quickly identify children requiring priority care (high-level emergencies) and those who can wait (low-level emergencies). In the absence of a gold standard in France, the objective o...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9113392/ https://www.ncbi.nlm.nih.gov/pubmed/35592843 http://dx.doi.org/10.3389/fped.2022.840181 |
_version_ | 1784709575564328960 |
---|---|
author | Tran, Antoine Valo, Petri Rouvier, Camille Dos Ramos, Emmanuel Freyssinet, Emma Baranton, Emma Haas, Olivier Haas, Hervé Pradier, Christian Gentile, Stéphanie |
author_facet | Tran, Antoine Valo, Petri Rouvier, Camille Dos Ramos, Emmanuel Freyssinet, Emma Baranton, Emma Haas, Olivier Haas, Hervé Pradier, Christian Gentile, Stéphanie |
author_sort | Tran, Antoine |
collection | PubMed |
description | INTRODUCTION: A reliable pediatric triage tool is essential for nurses working in pediatric emergency departments to quickly identify children requiring priority care (high-level emergencies) and those who can wait (low-level emergencies). In the absence of a gold standard in France, the objective of our study was to validate our 5-level pediatric triage tool –pediaTRI– against the reference tool: the Pediatric Early Warning Score (PEWS) System. MATERIALS AND METHODS: We prospectively included 100,506 children who visited the Pediatric Emergency Department at Lenval Children's Hospital (Nice, France) in 2016 and 2017. The performance of pediaTRI to identify high-level emergencies (severity levels 1 and 2) was evaluated in comparison with a PEWS ≥ 4/9. Data from 2018–19 was used as an independent validation cohort. RESULTS: pediaTRI agreed with the PEWS score for 84,896 of the patients (84.5%): 15.0% (14.8–15.2) of the patients were over-triaged and 0.5% (0.5–0.6) under-triaged compared with the PEWS score. pediaTRI had a sensitivity of 76.4% (74.6–78.2), a specificity of 84.7% (84.4–84.9), and positive and negative likelihood ratios of 5.0 (4.8–5.1) and 0.3 (0.3–0.3), respectively, for the identification of high-level emergencies. However, the positive likelihood ratios were lower for patients presenting with a medical complaint [4.1 (4.0–4.2) v 10.4 (7.9–13.7 for trauma), and for younger children [1.2 (1.1–1.2) from 0 to 28 days, and 1.9 (1.8–2.0) from 28 days to 3 months]. CONCLUSION: pediaTRI has a moderate to good validity to triage children in a Pediatric Emergency Department with a tendency to over-triage compared with the PEWS system. Its validity is lower for younger children and for children consulting for a medical complaint. |
format | Online Article Text |
id | pubmed-9113392 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-91133922022-05-18 Validation of the Computerized Pediatric Triage Tool, pediaTRI, in the Pediatric Emergency Department of Lenval Children's Hospital in Nice: A Cross-Sectional Observational Study Tran, Antoine Valo, Petri Rouvier, Camille Dos Ramos, Emmanuel Freyssinet, Emma Baranton, Emma Haas, Olivier Haas, Hervé Pradier, Christian Gentile, Stéphanie Front Pediatr Pediatrics INTRODUCTION: A reliable pediatric triage tool is essential for nurses working in pediatric emergency departments to quickly identify children requiring priority care (high-level emergencies) and those who can wait (low-level emergencies). In the absence of a gold standard in France, the objective of our study was to validate our 5-level pediatric triage tool –pediaTRI– against the reference tool: the Pediatric Early Warning Score (PEWS) System. MATERIALS AND METHODS: We prospectively included 100,506 children who visited the Pediatric Emergency Department at Lenval Children's Hospital (Nice, France) in 2016 and 2017. The performance of pediaTRI to identify high-level emergencies (severity levels 1 and 2) was evaluated in comparison with a PEWS ≥ 4/9. Data from 2018–19 was used as an independent validation cohort. RESULTS: pediaTRI agreed with the PEWS score for 84,896 of the patients (84.5%): 15.0% (14.8–15.2) of the patients were over-triaged and 0.5% (0.5–0.6) under-triaged compared with the PEWS score. pediaTRI had a sensitivity of 76.4% (74.6–78.2), a specificity of 84.7% (84.4–84.9), and positive and negative likelihood ratios of 5.0 (4.8–5.1) and 0.3 (0.3–0.3), respectively, for the identification of high-level emergencies. However, the positive likelihood ratios were lower for patients presenting with a medical complaint [4.1 (4.0–4.2) v 10.4 (7.9–13.7 for trauma), and for younger children [1.2 (1.1–1.2) from 0 to 28 days, and 1.9 (1.8–2.0) from 28 days to 3 months]. CONCLUSION: pediaTRI has a moderate to good validity to triage children in a Pediatric Emergency Department with a tendency to over-triage compared with the PEWS system. Its validity is lower for younger children and for children consulting for a medical complaint. Frontiers Media S.A. 2022-04-26 /pmc/articles/PMC9113392/ /pubmed/35592843 http://dx.doi.org/10.3389/fped.2022.840181 Text en Copyright © 2022 Tran, Valo, Rouvier, Dos Ramos, Freyssinet, Baranton, Haas, Haas, Pradier and Gentile. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Tran, Antoine Valo, Petri Rouvier, Camille Dos Ramos, Emmanuel Freyssinet, Emma Baranton, Emma Haas, Olivier Haas, Hervé Pradier, Christian Gentile, Stéphanie Validation of the Computerized Pediatric Triage Tool, pediaTRI, in the Pediatric Emergency Department of Lenval Children's Hospital in Nice: A Cross-Sectional Observational Study |
title | Validation of the Computerized Pediatric Triage Tool, pediaTRI, in the Pediatric Emergency Department of Lenval Children's Hospital in Nice: A Cross-Sectional Observational Study |
title_full | Validation of the Computerized Pediatric Triage Tool, pediaTRI, in the Pediatric Emergency Department of Lenval Children's Hospital in Nice: A Cross-Sectional Observational Study |
title_fullStr | Validation of the Computerized Pediatric Triage Tool, pediaTRI, in the Pediatric Emergency Department of Lenval Children's Hospital in Nice: A Cross-Sectional Observational Study |
title_full_unstemmed | Validation of the Computerized Pediatric Triage Tool, pediaTRI, in the Pediatric Emergency Department of Lenval Children's Hospital in Nice: A Cross-Sectional Observational Study |
title_short | Validation of the Computerized Pediatric Triage Tool, pediaTRI, in the Pediatric Emergency Department of Lenval Children's Hospital in Nice: A Cross-Sectional Observational Study |
title_sort | validation of the computerized pediatric triage tool, pediatri, in the pediatric emergency department of lenval children's hospital in nice: a cross-sectional observational study |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9113392/ https://www.ncbi.nlm.nih.gov/pubmed/35592843 http://dx.doi.org/10.3389/fped.2022.840181 |
work_keys_str_mv | AT tranantoine validationofthecomputerizedpediatrictriagetoolpediatriinthepediatricemergencydepartmentoflenvalchildrenshospitalinniceacrosssectionalobservationalstudy AT valopetri validationofthecomputerizedpediatrictriagetoolpediatriinthepediatricemergencydepartmentoflenvalchildrenshospitalinniceacrosssectionalobservationalstudy AT rouviercamille validationofthecomputerizedpediatrictriagetoolpediatriinthepediatricemergencydepartmentoflenvalchildrenshospitalinniceacrosssectionalobservationalstudy AT dosramosemmanuel validationofthecomputerizedpediatrictriagetoolpediatriinthepediatricemergencydepartmentoflenvalchildrenshospitalinniceacrosssectionalobservationalstudy AT freyssinetemma validationofthecomputerizedpediatrictriagetoolpediatriinthepediatricemergencydepartmentoflenvalchildrenshospitalinniceacrosssectionalobservationalstudy AT barantonemma validationofthecomputerizedpediatrictriagetoolpediatriinthepediatricemergencydepartmentoflenvalchildrenshospitalinniceacrosssectionalobservationalstudy AT haasolivier validationofthecomputerizedpediatrictriagetoolpediatriinthepediatricemergencydepartmentoflenvalchildrenshospitalinniceacrosssectionalobservationalstudy AT haasherve validationofthecomputerizedpediatrictriagetoolpediatriinthepediatricemergencydepartmentoflenvalchildrenshospitalinniceacrosssectionalobservationalstudy AT pradierchristian validationofthecomputerizedpediatrictriagetoolpediatriinthepediatricemergencydepartmentoflenvalchildrenshospitalinniceacrosssectionalobservationalstudy AT gentilestephanie validationofthecomputerizedpediatrictriagetoolpediatriinthepediatricemergencydepartmentoflenvalchildrenshospitalinniceacrosssectionalobservationalstudy |