Evaluation of the Emergency Severity Index (version 3) Triage Algorithm in Pediatric Patients

Baumann, Michael R.; Strout, Tania D.

doi:10.1111/j.1553-2712.2005.tb00872.x

Cited by 69 publications

(79 citation statements)

References 24 publications

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“…In the present study, hospitalization rate was found to increase with higher triage acuity ( Table 1), which is in line with the findings of previous studies on pediatric, adult, geriatric and self-referred patient populations (3,10,(15)(16)(17)(18)(19). However, evaluation of self-referred patients was indicative of a lower hospitalization rate in all ESI triage levels, which could be due to the low acuity of patient conditions (19).…”

Section: Discussionsupporting

confidence: 81%

Validity of the emergency severity index in predicting patient outcomes in a major emergency department

Pourasghar

Tabrizi

Ala

et al. 2016

J Nurs Midwifery Sci

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Background and Purpose: The emergency severity index (ESI) triage system has been recommended by the Ministry of Health to classify patients at emergency departments. This study aimed to assess the validity of ESI system (version 4) in the emergency department of a teaching hospital. Outcome measures were hospitalization, emergency department (ED) length of stay, resource consumption, in-hospital mortality, and patient service costs. Methods:In this retrospective cross-sectional study, medical records of 562 ED patients were reviewed to determine the ESI level and outcome measures in April 2013. Possible correlations were assessed using Phi and Cramer's V and Spearman's Rho. Data analysis was performed in SPSS V.16, and P value of 0.05 was considered significant. Results:In this study, frequency of five ESI levels (1-5) was 24, 14, 365, 158 and 0, respectively. In addition, Phi and Cramer's V for hospitalization and mortality were 0.350 (P<0.001) and 0.345 (P<0.001), respectively. Spearman's Rho for patient service costs, ED length of stay, and resource consumption were -0.434 (P<0.001), -0.015 (P=0.362), and -0.411 (P<0.001), respectively. According to our findings, the association between triage levels and resource consumption was more significant compared to other outcome measures. Conclusion:According to the results of this study, ESI triage ratings could successfully predict patient outcomes in terms of hospitalization, in-hospital mortality, resource consumption, and patient service costs. Therefore, use of this valid triage system is recommended for the arrangement of human and physical resources at emergency departments.

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Section: Discussionsupporting

confidence: 81%

Validity of the emergency severity index in predicting patient outcomes in a major emergency department

Pourasghar

Tabrizi

Ala

et al. 2016

J Nurs Midwifery Sci

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“…The Manchester staging system can efficiently and safely identify and support the assistance of patients with less urgent conditions (35) . Paediatric screening through risk classification and severity indexes often used in emergency units by trained nurses makes paediatric patients feel more confident (33) . In order to provide quality care, it is essential to review work processes, and train and qualify health workers.…”

Section: Discussionmentioning

confidence: 99%

“…Two other studies report the implementation of measures to improve the quality of patient care for children, such as the creation of an electronic form for skin evaluations, with records of placement and removal of elec- trodes for EEG and a more standardised method of skin cleansing performed in neonatal and paediatric intensive care units (29) , and the use of instruments to classify the risk of falls (30) . Another frequently addressed subject in the analysed papers was the acquisition of new knowledge in the training and education of professionals to ensure safe care during paediatric hospitalisations (19,25,(31)(32)(33)(34)(35)(36)(37)(38) . One study addressed the reduction of hospital-acquired infections by using strict aseptic techniques to perform invasive procedures, and intensifying hand washing and changing of gloves between each activity.…”

Section: Discussionmentioning

confidence: 99%

Segurança do paciente no cuidado à criança hospitalizada: evidências para enfermagem pediátrica

Wegner

Silva

Peres

et al. 2017

Rev. Gaúcha Enferm.

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Objectives: To describe evidence of international literature on the safe care of the hospitalised child after the World Alliance for Patient Safety and list contributions of the general theoretical framework of patient safety for paediatric nursing. Results: Thirty-two articles were analysed, most of which were from North American, with a descriptive approach. The quality of the recorded information in the medical records, the use of checklists, and the training of health workers contribute to safe care in paediatric nursing and improve the medication process and partnerships with parents. Conclusion:General information available on patient safety should be incorporated in paediatric nursing care. Keywords: Patient safety. Child, hospitalised. Nursing care. Paediatric nursing. RESUMO Objetivos: Descrever evidências na literatura internacional para o cuidado seguro da criança hospitalizada após a criação da Aliança Mundial para a Segurança do Paciente e elencar contribuições do referencial teórico geral da segurança do paciente para a enfermagem pediátrica. Resultados: Foram analisados 32 artigos, a maioria norte-americanos, com delineamento descritivo. A qualidade do registro das informações no prontuário, o emprego de checklists e a formação profissional contribuem para o cuidado seguro na enfermagem pediátrica, bem como para melhorias no processo medicamentoso e na parceria com os pais. Método Conclusão:As informações gerais disponíveis sobre a segurança do paciente devem ser incorporadas no cuidado de enfermagem pediátrica. Palavras-chave: Segurança do paciente. Criança hospitalizada. Cuidados de enfermagem. Enfermagem pediátrica. RESUMEN Objetivos: Describir la evidencia de la literatura internacional para el cuidado seguro de los niños hospitalizados después de la creación de la Alianza Mundial para la Seguridad del Paciente y listar las contribuciones del marco teórico general de la seguridad del paciente para la enfermería pediátrica. Resultados: Se analizaron 32 artículos, la mayoría de América, con diseño descriptivo. La calidad de los registros de la información en la historia clínica, el uso de listas de control y la formación profesional contribuyen a la atención segura en enfermería pediátrica, así como mejoras en el proceso de la medicación y la asociación con los padres. Conclusión:La información general disponible sobre la seguridad del paciente debe ser incorporada en la atención de enfermería pediátrica. Palabras clave: Seguridad del paciente. Niño hospitalizado. Atención de enfermería. Enfermería pediátrica.

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“…Triage category was used because previous studies have suggested that ED triage status predicts severity of illness. 17,18 This method has been used in other studies using NHAMCS data to define the immediacy with which the patient should be seen. 19 We added bronchodilator therapy as a second predictor variable because short-acting b-agonists are recommended first-line treatment of moderate to severe asthma exacerbations in the ED.…”

Section: Study Populationmentioning

confidence: 99%

Variation and Trends in ED Use of Radiographs for Asthma, Bronchiolitis, and Croup in Children

2013

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WHAT'S KNOWN ON THIS SUBJECT: Variation in the emergency department (ED) use of radiographs for asthma, bronchiolitis, and croup exists. Unnecessary radiographs contribute to higher costs of care, decreased ED efficiency, and increased radiation in children.WHAT THIS STUDY ADDS: Despite no changes in guidelines to support routine use, there is a significant upward trend in the use of radiographs for children with emergency department visits for asthma. Pediatric-focused EDs use significantly fewer radiographs for asthma, bronchiolitis, and croup. abstract OBJECTIVES: The objectives were (1) to determine trends in radiograph use in emergency department (ED) care of children with asthma, bronchiolitis, and croup; and (2) to examine the association of patient and hospital factors with variation in radiograph use.METHODS: A retrospective, cross-sectional study of National Hospital Ambulatory Medical Care Survey data between 1995 and 2009 on radiograph use at ED visits in children aged 2 to 18 years with asthma, aged 3 months to 1 year with bronchiolitis, and aged 3 months to 6 years with croup. Odds ratios (ORs) were calculated and adjusted for all factors studied. RESULTS:The use of radiographs for asthma increased significantly over time (OR: 1.06; 95% confidence interval [CI]: 1.03-1.09; P , .001 for trend) but were unchanged for bronchiolitis and croup. Pediatric-focused EDs had lower use for asthma (OR: 0.44; 95% CI: 0.29-0.68), bronchiolitis (OR: 0.37; 95% CI: 0.23-0.59), and croup (OR: 0.34; 95% CI: 0.17-0.68). Compared with the Northeast region, the Midwest and South had statistically higher use of radiographs for all 3 conditions. The Western region had higher use only for asthma (OR: 1.67; 95% CI: 1.07-2.60), and bronchiolitis (OR: 2.94; 95% CI: 1. 48-5.87). No associations were seen for metropolitan statistical area or hospital ownership status. CONCLUSIONS:The ED use of radiographs for children with asthma increased significantly from 1995 to 2009. Reversing this trend could result in substantial cost savings and reduced radiation. Pediatricfocused EDs used significantly fewer radiographs for asthma, bronchiolitis, and croup. The translation of practices from pediatricfocused EDs to all EDs could improve performance. Pediatrics 2013;132:245-252 AUTHORS:

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Evaluation of the Emergency Severity Index (version 3) Triage Algorithm in Pediatric Patients

Abstract: The ESI triage algorithm demonstrated reliability and validity between triage assignment and resource use in this group of ED pediatric patients.

Cited by 69 publications

References 24 publications

Validity of the emergency severity index in predicting patient outcomes in a major emergency department

Validity of the emergency severity index in predicting patient outcomes in a major emergency department

Segurança do paciente no cuidado à criança hospitalizada: evidências para enfermagem pediátrica

Variation and Trends in ED Use of Radiographs for Asthma, Bronchiolitis, and Croup in Children

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