Inter-rater reliability of the South African Triage Scale: Assessing two different cadres of health care workers in a real time environment

Twomey, Michèle; Sá, Angela De; Wallis, Lee; Myers, Jonathan E.

doi:10.1016/j.afjem.2011.08.003

Cited by 14 publications

(11 citation statements)

References 5 publications

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“…Detailed results of included studies are presented in appendix 1. They assess reliability of CTAS [6][7][8][9][10][11], ESI [12][13][14][15][16][17][18][19], Adaptive process triage (ADAPT) [20], South African Triage Scale (SATS) [21,22], MTS [19,23,24], ATS [25,26], Italian fourlevel triage system (I-4L) [27,28] Some of these studies (8 studies) were excluded from metaanalysis due to lack of standard error for kappa measures. Results of Cochran's Q tests showed a low p-value (p-value <.001) which means a significant heterogeneous results among different studies.…”

Section: Resultsmentioning

confidence: 99%

“…With regard to the fact that the use of information technology is growing in healthcare system and with respect to spread of computerized triage in EDs [9,[34][35][36][37][38][39][40][41], it is suggested that another review could be performed on validity and reliability of electronic/ computerized triage. Another point is that some of triage systems [20,21,[28][29][30] are newly invented and are not used and studied enough. This could be assumed that if more studies were performed on them, they might show greater reliability.…”

Section: Resultsmentioning

confidence: 99%

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Kappa Agreement of Emergency Department Triage Scales; A Systematic Review and Meta-Analysis

et al. 2014

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The aim of this review was to compare the reliability of existing triage scales. The research question was that, using kappa value as reliability measure, in adult ED patients to what extent did clinicians' triage ratings agree with eachother or with a gold standard? Methods: The search was limited to studies on adult patients (≥15 years) visiting EDs for somatic reasons and to English and Persian studies that have reported kappa. Studies solely on geriatric patients, computerized triage, telephone triage, and specialty triages were excluded. PubMed, Scopus, ISI web of knowledge, Mosby's Nursing Index, Magiran and SID, were systematically searched through August 2013. 13 articles for kappa (n=38829), 11 articles for linear weighted kappa (LWK) (n= 22697) and 12 articles for quadratic weighted kappa (QWK) (n=10915) met our inclusion criteria. Heterogeneity among studies and publication bias were checked. All pooled analyses of kappa scores for each triage scale were calculated based on random-effects model and then the scales were compared. Results: Findings suggest that five-level scales are more reliable in triaging patients in the emergency department than others (pooled kappa: 0.53, 95% CI (0.48, 0.57), LWK= 0.76, 95% CI (0.72, 0.81) and QWK = 0.74, 95% CI (0.69, 0.79)). The Canadian Triage and Acuity Scale (CTAS) and the Emergency Severity Index (ESI) have been studied more than the other scales. Conclusion: It seems necessary to set a consensus method to assess and compare the reliability of triage scales. This review suggests more specific studies on reliability of triage scales, especially on intra-rater agreement.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Kappa Agreement of Emergency Department Triage Scales; A Systematic Review and Meta-Analysis

et al. 2014

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“…The third part of the SATS allows for an experienced senior healthcare professional to provide oversight of the process. 9,10 The SATS is specially designed for use in low-resource clinical settings. It is also simple, easy to use and can be used effectively by nursing assistants in emergency centres providing care to both medical and surgical patients.…”

Section: Introductionmentioning

confidence: 99%

“…2,8 It improves the efficiency of emergency centres, reduces patients' waiting times, improves patient flow and improves job satisfaction among staff. 1,9,11 However, these benefits are dependent on the correct implementation of the tool.…”

Section: Introductionmentioning

confidence: 99%

An evaluation of the use of the South African Triage Scale in an urban district hospital in Durban, South Africa

Soogun

Naidoo

2017

South African Family Practice

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Background: Emergency centres in South Africa are among the busiest in the world and serve as entry points for hospital care for most of the population. The South African Triage Scale (SATS) is a validated tool introduced nationally in 2006 and intended to increase the efficiency of emergency centres through a process of prioritisation of the severely ill patient. The objective of this study was to evaluate the use of the SATS in a busy urban district hospital in Durban, South Africa. Methods: A chart review of triaged patients was performed. The hospital uses a one-page SATS sheet and manages both medical and surgical patients. The triage history, physiological parameters, application of discriminator lists, final triage code and outcome was audited and compared with findings from the patients' clinical records. Results: The mean triage early warning score was 1.50 (95% CI 1-2) and average time to treatment was 59 min (95% CI 51-67). Essential bedside investigations were missing on some very ill patients, there was poor documentation in many fields and confirmed time to treatment was within recommended timescales for only 48% of patients. Use of the discriminator list resulted in over-triage of 66.7% and an under-triage of 14%. Some 76% of patients were discharged from the emergency centre, 15% were admitted and 5.5% were transferred out. Conclusion: Nurse-led triage has been successfully implemented at the emergency centre of this hospital using SATS but some notable gaps were identified.

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“…In resource-poor settings, there is a need for a triage system that does not require extensive training, can handle a large number of severely injured patients, and is applicable in situations with medical staff shortages and limited resources [52]. The South African Triage Score (SATS) was developed in 2006 in South Africa and has been proposed for urban and rural hospitals in developing countries [53]. SATS uses a scoring system based on physiologic parameters, the Triage Early Warning Score (TEWS), and a list of identifiable clinical conditions (table 2).…”

Section: Rr = Respiratory Rate (Breaths/min) Pox = Pulse Oximetry Hmentioning

confidence: 99%

TRIAGE : Management of the trauma patient

Lampi¹

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Triage, derived from the French word for sorting, aims to assess and prioritize injured patients, regardless of whether the injuries are sustained from everyday road traffic accident with few injured or a mass casualty incident. Triage seeks to provide the greatest benefit to the largest number of casualties in order to minimize morbidity and mortality. Triage in a pre-hospital setting entails management and sorting of patients according to an assessment of medical need, prioritization, and evacuation. In-hospital triage aims to rapidly identify the most injured and ensure timely and appropriate treatment according to the patient's clinical urgency. A number of different systems for performing triage have been established and implemented globally. The methodology is recognized and utilized but there is still a need for an evidence-based strategy to optimize training and the efficacy of the different systems.The main aim of this thesis was to determine triage performance among prehospital personnel and investigate the potential advantage of a triage system for trauma patients. The papers included in this thesis evaluated the triage skills of physicians, pre-hospital personnel, and rescue services personnel by testing their performance before and after an educational intervention. The last paper evaluated potential benefits of using a triage system for trauma patients admitted to the emergency department at MOI Teaching and Referral Hospital in Eldoret, Kenya.The results presented in this thesis illustrate that triage skills are lacking among physicians. Experienced pre-hospital personnel are more skilled in performing triage than physicians. The triage skills of the rescue services personnel improved significantly after the educational intervention. Moreover, the potential benefit to trauma patients of implementing an in-hospital triage system in a resource-poor environment was shown. In conclusion, health care personnel, especially physicians without experience but highly involved in trauma patient management, seem to be in need of triage training. How to train, how to implement, and how to evaluate triage skills must be considered in order to develop effective training. POPULÄRVETENSKAPLIG SAMMANFATTNINGOrdet triage kommer från franskans "sortera" och är ett av det första stegen i omhändertagandet av skadade när det råder resursbrist. Från 1800-talets blodiga slagfält, till dagens skadeplats och akutmottagningar har sättet att triagera patienter utvecklats. Men då, som nu, är grundtanken den samma, att sortera och prioritera de skadade utifrån tillgängliga resurser och patienternas vårdbehov. Följaktligen har begreppet kommit att bli centralt inom ämnet katastrofmedicin. Att avlida till följd av skador i samband med allvarliga händelser men också skador i till exempel vardagstrafiken är ett globalt hälsoproblem. Tiden från olycka till sjukhusbehandling är en viktig och ofta avgörande överlevnadsfaktor för en patient. I det här sammanhanget talas det om "den gyllene timmen", som påvisar vikten av att få ...

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Inter-rater reliability of the South African Triage Scale: Assessing two different cadres of health care workers in a real time environment

Cited by 14 publications

References 5 publications

Kappa Agreement of Emergency Department Triage Scales; A Systematic Review and Meta-Analysis

Kappa Agreement of Emergency Department Triage Scales; A Systematic Review and Meta-Analysis

An evaluation of the use of the South African Triage Scale in an urban district hospital in Durban, South Africa

TRIAGE : Management of the trauma patient

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