Manchester Triage in Sweden – Interrater reliability and accuracy

Olofsson, Patrik; Gellerstedt, Martin; Carlström, Eric

doi:10.1016/j.ienj.2008.11.008

Cited by 70 publications

(64 citation statements)

References 23 publications

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“…It is noted that of the five identified articles that dealt with the reliability of the MTS, two (40%) were performed in the Netherlands (13)(14) , one (20%) in Brazil (12) , one (20%) in Sweden (15) and one (20%) in Australia (16) . Four (80%) studies were conducted with adults (12,(14)(15)(16) and one (20%) with a pediatric population (13) .…”

Section: Resultsmentioning

confidence: 99%

“…Four (80%) studies were conducted with adults (12,(14)(15)(16) and one (20%) with a pediatric population (13) . Of the nine articles on validity of MTS, five (55.5%) were performed in the Netherlands (18)(19)22,(24)(25) , three (33.3%) in Portugal (20)(21)23) and one (11.2%) in Brazil (17) .…”

Section: Resultsmentioning

confidence: 99%

“…This was measured by reference to the following outcomes: evolution of condition/illness severity (17) ; sensitivity and specificity (18,21) ; percentage of overtriage and undertriage (15,18,(24)(25) ; necessity of hospitalization (19,(22)(23) and mortality rate (20,23) . A study (17) that correlated the classification of the patient obtained using the MTS with the same level of severity measured by the Therapeutic Intervention Scoring System (TISS -28) instrument.…”

Section: VImentioning

confidence: 99%

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Scientific Literature on the Reliability and Validity of the Manchester Triage System (MTS) Protocol: A Integrative Literature Review

Souza

Araújo

Chianca

2015

Rev. esc. enferm. USP

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Objective:To analyze the scientific production about the validity and reliability of the Manchester Triage System (MTS) protocol. Method: A descriptive study of an integrative literature review. Articles on the validity and reliability of the MTS developed with children and adults published between 1999 and 2013 were included. Results: 14 articles were selected from a total of 8438, nine of validity and five of reliability. The reliability of the MTS ranged from moderate to almost perfect, with higher intra-evaluation. Regarding validity, the results seem to point to equivalent and satisfactory sensibility and specificity levels of the MTS. The instrument proved to be a good predictor of the need for hospitalization and of hospital mortality. Conclusion: The reliability and validity of the MTS obtained in the studies is varied. It is recommended that new studies indicate necessary modifications to the MTS so that it is more safely used by nurses.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: VImentioning

confidence: 99%

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Scientific Literature on the Reliability and Validity of the Manchester Triage System (MTS) Protocol: A Integrative Literature Review

Souza

Araújo

Chianca

2015

Rev. esc. enferm. USP

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“…[12,13] Increasing queues for treatment, overcrowded emergency departments and slow patient turnover in hospital departments has raised awareness of the need to improve resource allocation, logistics and management techniques to better distribute resources. Therefore, it is important to find methods that meet the patients' needs and improve the efficiency of the health-care system, [14] hence the introduction of personcentred care (PCC), an evidence-based approach that increases patient participation, which has been receiving attention around the world. However, as yet little is known about how to implement research findings in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Changing the ward culture in a clinic during the implementation of person-centred care

Wolf

Ulin

Carlström

2017

JHA

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Objective: The purpose of this study was to explore the impact of an intervention on the organizational culture in five hospital wards in Sweden. The organizational culture was measured at the start of the project and compared with data collected five years later. The intervention was aimed at changing activities towards a new evidenced-based care model called the Gothenburg Person-centred Care model (PCC). Methods: In total, 230 registered nurses and assistant nurses participated in this cross-sectional health-care culture survey during 2009 and 2014. The Organizational Values Questionnaire was used. Results: The results indicated cultural change in all five wards at the clinic. A dominating culture of flexibility decreased and a culture of routines and structure increased. The wards moved towards a higher degree of cultural uniformity. The combination of cultural dimensions also seems to have become more equal during the study period. Conclusions: Few studies have focussed on the development of organizational culture in health-care contexts over time. The results suggest that the implementation of a new model of care has an impact on organizational culture. This implies that health-care managers should have confidence in the outcomes from change projects. It seems that systems of dual logic can develop over time to facilitate change and sustainability. However, if a new working model is to change the culture profoundly, it requires years of zealous implementation.

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“…Previous studies in LMICs have instead attempted to assess the validity of a triage scale by comparing the triage ratings assigned by emergency department (ED) staff for a series of simulated cases against those obtained from an expert panel based on the panel's expert opinion. [12] For the purpose of this study, we will refer to this methodology and use a set of 42 reference vignettes as a reference standard against which accuracy is measured. [13] This study therefore aimed to determine the reliability (inter-and intra-rater) and accuracy of the adult version of the SATS when used by ED nurses in TH, Pakistan.…”

mentioning

confidence: 99%

Reliability and accuracy of the South African Triage Scale when used by nurses in the emergency department of Timergara Hospital, Pakistan

Dalwai

Twomey

Maïkéré³

et al. 2014

S Afr Med J

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Background. Triage is one of the core requirements for the provision of effective emergency care and has been shown to reduce patient mortality. However, in low-and middle-income countries this strategy is underused, under-resourced and poorly researched. Objective. To assess the inter-and intra-rater reliability and accuracy of nurse triage ratings when using the South African Triage Scale (SATS) in an emergency department (ED) in Timergara, Pakistan. Methods. Fifteen ED nurses assigned triage ratings to a set of 42 reference vignettes (written case reports of ED patients) under classroom conditions. Inter-rater reliability was assessed by comparing these triage ratings; intra-rater reliability was assessed by asking the nurses to re-triage 10 random vignettes from the original set of 42 vignettes and comparing these duplicate ratings. Accuracy of the nurse ratings was measured against the reference standard. Results. Inter-rater reliability was substantial (intraclass correlation coefficient 0.77; 95% confidence interval (CI) 0.69 -0.85). The intrarater agreement was also high with 87% exact agreement (95% CI 67 -100) and 100% agreement allowing for a one-level discrepancy in triage ratings. Overall, the SATS had high specificity (97%) and moderate sensitivity (70%). Across all acuity levels the proportion of overtriage did not exceed the acceptable threshold of 30 -50%. Under-triage was acceptable for all except emergency cases (66%). Conclusion. ED nurses in Pakistan can reliably use the SATS to assign triage acuity ratings. While the tool is accurate for 'very urgent' and 'routine' cases, importantly, it may under-triage 'emergency' cases requiring immediate attention. Approaches that will improve accuracy and validity are discussed.

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Manchester Triage in Sweden – Interrater reliability and accuracy

Cited by 70 publications

References 23 publications

Scientific Literature on the Reliability and Validity of the Manchester Triage System (MTS) Protocol: A Integrative Literature Review

Scientific Literature on the Reliability and Validity of the Manchester Triage System (MTS) Protocol: A Integrative Literature Review

Changing the ward culture in a clinic during the implementation of person-centred care

Reliability and accuracy of the South African Triage Scale when used by nurses in the emergency department of Timergara Hospital, Pakistan

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