The reliability of the Australasian Triage Scale: a meta-analysis

Ebrahimi, Mohsen; Heydari, Abbas; Mazlom, Reza; Mirhaghi, Amir

doi:10.5847/wjem.j.1920-8642.2015.02.002

Cited by 68 publications

(49 citation statements)

References 25 publications

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“…Data collection includes referral source (self-referred, general practice, specialist, nursing home), mode of arrival (self-referral, ambulance), hospital facility, triage category (Australasian triage category),6 7 presenting problem, mode of separation (admitted to hospital, discharged or died). Presenting problems allocated by triage nurses at the point of patient arrival to ED were categorised into broad clinical groups by the investigating team (see table 1).…”

Section: Methodsmentioning

confidence: 99%

Statewide retrospective study of low acuity emergency presentations in New South Wales, Australia: who, what, where and why?

et al. 2016

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ObjectiveThe present study aims to use a statewide population-based registry to assess the prevalence of low acuity emergency department (ED) presentations, describe the trend in presentation rates and to determine whether they were associated with various presentation characteristics such as the type of hospital as well as clinical and demographic variables.Design and settingThis was a retrospective analysis of a population-based registry of ED presentations in New South Wales (NSW). Generalised estimating equations with log links were used to determine factors associated with low acuity presentations to account for repeat presentations and the possibility of clustering of outcomes.ParticipantsPatients were included in this analysis if they presented to an ED between January 2010 and December 2014. The outcomes of interest were low acuity presentation, defined as those who self-presented (were not transported by ambulance), were assigned a triage category of 4 or 5 (semiurgent or non-urgent) and discharged back to usual residence from ED.ResultsThere were 10.7 million ED presentations analysed. Of these, 45% were classified as a low acuity presentation. There was no discernible increase in the rate of low acuity presentations across NSW between 2010 and 2014. The strongest predictors of low acuity ED presentation were age <40 years of age (OR 1.77); injury or musculoskeletal administrative and non-urgent procedures (OR 2.96); ear, nose and throat, eye or oral (OR 5.53); skin or allergy-type presenting problems (OR 2.84).ConclusionsLow acuity ED presentations comprise almost half of all ED presentations. Alternative emergency models of care may help meet the needs of these patients.

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Section: Methodsmentioning

confidence: 99%

Statewide retrospective study of low acuity emergency presentations in New South Wales, Australia: who, what, where and why?

et al. 2016

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“…[7,8] The organization of out-of-hour services in primary care has changed, with new models such as large GP cooperatives (GPCs) and primary care centres integrated into EDs. [9][10][11] In the Netherlands, the proportion of self-referrals at EDs is approximately 30%. [12] Almost all Dutch citizens have a GP and basic health insurance.…”

Section: Introductionmentioning

confidence: 99%

Effects of a general practitioner cooperative co-located with an emergency department on patient throughput

Veelen

Brand

Reijnen

et al. 2016

World Journal of Emergency Medicine

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BACKGROUND:In 2013 a General Practitioner Cooperative (GPC) was introduced at the Emergency Department (ED) of our hospital. One of the aims of this co-located GPC was to improve throughput of the remaining patients at the ED. To determine the change in patient fl ow, we assessed the number of self-referrals, redirection of self-referrals to the GPC and back to the ED, as well as ward and ICU admission rates and length of stay of the remaining ED population. METHODS:We conducted a four months' pre-post comparison before and after the implementation of a co-located GPC with an urban ED in the Netherlands. RESULTS:More than half of our ED patients were self-referrals. At triage, 54.5% of these selfreferrals were redirected to the GPC. After assessment at the GPC, 8.5% of them were referred back to the ED. The number of patients treated at the ED declined with 20

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“…5 7 9 10 In addition, two meta-analyses including studies of 'live' triage and the triage of paper case scenarios reported correlation coefficients of 0.60 and 0.77 for the CTAS and ESI, respectively, whereas a meta-analysis including only studies applying the triage of paper case scenarios reported a correlation coefficient of 0.40 for the ATS. [13][14][15] One factor that may contribute to errors in triage is that triage decisions are based to a large extent on informed but subjective estimates of the patient's presenting condition, such as estimates of pain and future resource utilisation in the ATS and ESI, respectively. 16 17 Another negative factor may be the complexities of triage systems with large numbers of different presenting complaints.…”

Section: Introductionmentioning

confidence: 99%

Inter-rater reliability between nurses for a new paediatric triage system based primarily on vital parameters: the Paediatric Triage Instrument (PETI)

Karjala

Eriksson

2017

BMJ Open

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IntroductionThe major paediatric triage systems are primarily based on flow charts involving signs and symptoms for orientation and subjective estimates of the patient's condition. In contrast, the 4-level Paediatric Triage Instrument (PETI) is primarily based on vital parameters and was developed exclusively for paediatric triage in patients with medical symptoms. The aim of this study was to assess the inter-rater reliability of this triage system in children when used by nurses.MethodsA design was employed in which triage was performed simultaneously and independently by a research nurse and an emergency department (ED) nurse using the PETI. All patients aged ≤12 years who presented at the ED with a medical symptom were considered eligible for participation.ResultsThe 89 participants exhibited a median age of 2 years and were triaged by 28 different nurses. The inter-rater reliability between nurses calculated with the quadratic-weighted κ was 0.78 (95% CI 0.67 to 0.89); the linear-weighted κ was 0.67 (95% CI 0.56 to 0.80) and the unweighted κ was 0.59 (95% CI 0.44 to 0.73). For the patients aged <1, 1–3 and >3 years, the quadratic-weighted κ values were 0.67 (95% CI 0.39 to 0.94), 0.86 (95% CI 0.75 to 0.97) and 0.73 (95% CI 0.49 to 0.97), respectively. The median triage duration was 6 min.ConclusionsThe PETI exhibited substantial reliability when used in children aged ≤12 years and almost perfect reliability among children aged 1–3 years. Moreover, rapid application of the PETI was demonstrated. This study has some limitations, including sample size and generalisability, but the PETI exhibited promise regarding reliability, and the next step could be either a larger reliability study or a validation study.

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The reliability of the Australasian Triage Scale: a meta-analysis

Cited by 68 publications

References 25 publications

Statewide retrospective study of low acuity emergency presentations in New South Wales, Australia: who, what, where and why?

Statewide retrospective study of low acuity emergency presentations in New South Wales, Australia: who, what, where and why?

Effects of a general practitioner cooperative co-located with an emergency department on patient throughput

Inter-rater reliability between nurses for a new paediatric triage system based primarily on vital parameters: the Paediatric Triage Instrument (PETI)

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