A reliability study of the rapid emergency triage and treatment system for children

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Henrik Døllner²  Stian Lydersen³  Brita Henning¹ 

[1] Department of Pediatrics, St. Olav’s University Hospital, Trondheim, Norway;Department of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology, Trondheim, Norway;Regional Centre for Child and Youth Mental Health and Child Welfare, Trondheim, Norway

关键词: Pediatric emergency care;    Reliability;    RETTS-p;    Triage;   

Others  :  1235876
DOI  :  10.1186/s13049-016-0207-6

 received in 2015-11-14, accepted in 2016-02-02,  发布年份 2016

【 摘 要 】

Background

To evaluate inter- and intrarater reliability of a new Scandinavian triage system for children, the Rapid Emergency Triage and Treatment System-pediatric (RETTS-p).

Methods

Two observational studies were conducted at the Pediatric Emergency Department (PED), St. Olav’s University Hospital, Trondheim, Norway. Using RETTS-p, nurses assign one of five triage priority levels to each patient on the basis of clinical signs and symptoms evaluations and vital parameter measurements.

Study 1: Prior to the introduction of RETTS-p in 2012, all nurses in the PED completed a theoretical and practical training. Four months later, 19 nurses triaged 20 fictive but realistic pediatric cases two times 9 months apart (Waves A and B). Study 2: Nurse pairs consisting of a regular nurse and a research nurse simultaneously and independently triaged 200 pediatric patients who were referred with various common medical and surgical complaints.

Results

Study 1: Kendall’s W for Waves A and B were 0.822 and 0.844, respectively. Using a mixed linear model, we found no difference in triage priority levels between Waves A and B. Compared to a consensus level made by the research group, the nurses rated 85.1 % fictive cases correctly, and 99 % were rated correctly or within one adjacent priority score. Study 2: The interrater correlation coefficient in a linear mixed model was 0.762, confirming a high interrater reliability in real-life triaging.

Discussion

We found a very high degree of agreement between nurses who used RETTS-p to prioritize children, both in a theoretical case scenarios study, but also in real-life triaging.

Conclusions

RETTS-p may be a credible and robust triage system, but it has not been validated yet.

【 授权许可】

   
2016 Henning et al.

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