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Accuracy and interrater reliability of paediatric emergency department triage
Author(s) -
Allen Amy R,
Spittal Matthew J,
Nicolas Caroline,
Oakley Ed,
Freed Gary L
Publication year - 2015
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12455
Subject(s) - triage , inter rater reliability , medicine , emergency department , reliability (semiconductor) , medical emergency , emergency medicine , nursing , rating scale , psychology , developmental psychology , power (physics) , physics , quantum mechanics
Objective To determine the accuracy and reliability of triage of children in public hospital EDs using the A ustralasian T riage S cale ( ATS ). This is the first study to examine these issues in paediatric triage following the 2007 development of the E mergency T riage E ducation K it ( ETEK ) to foster accurate and consistent application of the ATS . Methods A convenience sample of 167 triage nurses working at three general hospitals and one speciality paediatric hospital in greater metropolitan M elbourne assigned triage ratings for nine paediatric clinical scenarios using the ATS . Scenarios were derived from the ETEK or from other published sources. Kappa was used to assess interrater reliability within and between hospitals. Results Triage nurses correctly assigned triage scores to an average of 5.3 of nine paediatric clinical scenarios. Accuracy in specific hospitals ranged from a low of 15% on one scenario, to 100% accuracy on a different scenario at a different hospital. Interrater reliability within and across the EDs studied was found to be kappa = 0.27. Both accuracy and interrater reliability were marginally higher at the speciality paediatric hospital. Conclusions Our findings demonstrate inconsistencies in the accuracy and reliability in which sick children presenting to EDs receive triage scores both within and across hospitals. These results suggest the need for improvements either in current triage nurse training or training resources. Use of the ETEK alone has not resulted in high levels of paediatric triage accuracy or reliability.