The Manchester Triage System provides good reliability in an Australian emergency department

Abstract

The MTS is a reliable system of triage in the emergency department.

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

“…In two other studies, one in Sweden and one in Australia, the MTS showed good reliability between observers, with Kappa indices of 0.80 and 0.81, respectively (15)(16) . The agreement between the MTS and two other protocols for risk classification was also evaluated.…”

“…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) .…”

“…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) .…”

“…The same result was observed in a study performed in an Medical Academic Center in Amsterdam when comparing the correlation in both protocols, where the value of the MTS Kappa varied from 0.68 to 0.83, while the ESI ranged from 0.37 to 0.55 (14) . Another study also showed that the MTS is a reliable triage for the emergency department, especially when evaluated for extreme errors, where the range of Kappa was 0.40 to 0.80, an average of 0.63 (16) . Thus, it was realized that the reliability of the MTS ranged from moderate to almost perfect, being greater when the intra-observer agreement was evaluated.…”

“…The Kappa coefficient can range from 0 to 1, where 0 means no correlation and 1 is perfect agreement (27) . In this study, there were only five articles (12)(13)(14)(15)(16) found that addressed the reliability assessment of the MTS, and all used the Kappa statistic to measure the reliability of the scale. These findings suggest that further studies on the reliability of this protocol must be designed, since knowing the reproducibility of the MTS ensures safer practice for the nurse, and the assignment of the patient's severity level reflects his real health condition.…”