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Predicting patient disposition in a paediatric emergency department
Author(s) -
Bradman Kate,
Borland Meredith,
Pascoe Elaine
Publication year - 2014
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12011
Subject(s) - medicine , triage , early warning score , emergency department , observational study , emergency medicine , attendance , population , prospective cohort study , pediatrics , environmental health , psychiatry , economics , economic growth
Aim The aim of this study is to directly compare published prediction tools with triage nurse ( TN ) predictions within a defined paediatric population. Method A prospective observational study carried out over a week in M ay 2010 in the Emergency Department ( ED ) at Princess Margaret Hospital for Children in Perth, Western A ustralia. TN predicted which patients would be admitted to hospital at the time of ED presentation. Data required for the other prediction tools (paediatric early warning score ( PEWS ); triage category and the Pediatric Risk of Admission Score ( PRISA ) and PRISA II were obtained from the notes following the patient's ED attendance. Results A total of 1223 patients presented during the study week, 91 patients were excluded and a total of 946 patients (83.6%) had TN predictions and were included in the analysis. TN predictions were compared against a PEWS ≥ 4, triage category 1, 2 and 3, PRISA ≥ 9 and PRISA II ≥ 2. TN s had the highest prediction accuracy (87.7%), followed by an elevated PEWS (82.9%), triage category of 1, 2, or 3 (82.9%). The PRISA and PRISA II score had an accuracy of 80.1% and 79.7%, respectively. Conclusion When compared with validated prediction tools, the TN is the most accurate predictor of need to admit. This study provides valuable information in planning efficient flow of patients through the ED .