Validity of the Canadian Paediatric Triage and Acuity Scale in a tertiary care hospital

Gravel, Jocelyn; Manzano, Sergio; Arsenault, Michael

doi:10.1017/s1481803500010885

Cited by 72 publications

(62 citation statements)

References 17 publications

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“…(14) 67 (10) *Based on the Canadian Pediatric Triage and Acuity Scale, where 1 = resuscitation, 2 = emergent, 3 = urgent, 4 = semiurgent, and 5 = non-urgent. 14 †Based on International Statistical Classification of Diseases and Related Health Problems, 10th Revision. 16 Some visits were coded with more than one diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Medication Records in the Emergency Department: Agreement Between Paper-Based Charts and Automated Dispensing Device

Wing

Hill-Taylor²,

Sketris³

et al. 2012

CJHP

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Section: Discussionmentioning

confidence: 99%

“…This validated scale indicates the severity of a patient's presenting illness on a 5-point scale, where 1 is for the most seriously ill patients (those requiring resuscitation), 2 = emergent, 3 = urgent, 4 = semiurgent, and 5 = non-urgent. 14 Ethics approval was obtained from the Research Ethics Board of the IWK Health Centre.…”

Section: Methodsmentioning

confidence: 99%

Medication Records in the Emergency Department: Agreement Between Paper-Based Charts and Automated Dispensing Device

Wing

Hill-Taylor²,

Sketris³

et al. 2012

CJHP

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“…This tool has good interrater agreement, has been validated, and has been found to correlate with markers of severity, patient outcome, and PED resource use such as ED LOS, admission to the hospital, and admission to the pediatric intensive care unit. [15][16][17] Our secondary objectives were to assess if the change in PED use was accompanied with changes in system performance outcomes, such as mean and median total LOS in the PED and the LWBS rate. These outcomes were assessed within the level of acuity as determined by the CTAS score.…”

Section: Objectives and Outcome Measuresmentioning

confidence: 99%

Trends in use in a Canadian pediatric emergency department

Doan¹,

Genuis²,

2014

CJEM

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Introduction: Emergency department (ED) crowding is a significant problem in Canada and has been associated with decreased quality of care in general and pediatric emergency departments (PEDs). Although boarding of admitted patients in the ED is the main contributor to adult ED overcrowding, factors involved in PED crowding may be different. The objective of this study was to report the trend in PED services use and to document the degree of overcrowding experienced in a Canadian PED. Methods: A retrospective cohort study was conducted using administrative data from a tertiary care PED from 2002 to 2011. The primary outcome was PED use (total volume of visits and case severity per triage levels using the Canadian Triage and Acuity Scale [CTAS] score and admissions). Secondary outcomes included measures of PED overcrowding, such as rates of patients leaving without being seen (LWBS) and length of stay (LOS).Results: Total volumes increased by 30% over the 10-year study period, whereas hospitalizations remained stable at approximately 10%. Trends in CTAS levels did not indicate meaningful changes in the severity of cases treated at our PED. LWBS proportions among CTAS 3, CTAS 4, and CTAS 5 groups and LOS for all CTAS groups progressively and statistically increased from year to year. Conclusions: Over the course of the study period, there was a substantial increase in PED visits, which likely contributed to the worsening markers of PED flow outcomes. Further study into the effects of PED crowding on patient outcomes is warranted.

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“…[3][4][5][6] Recent publications report proportions of LWBS varying between 1 and 17%, with a mean of approximately 5%. 4,[6][7][8][9] As these patients may have important clinical outcomes, the rate of patients who LWBS has been considered one of the most important performance indicators for pediatric EDs. 10,11 There is very little information regarding the outcome of patients who LWBS and the morbidity engendered by the problem.…”

Section: Ré Sumémentioning

confidence: 99%

Unfavourable outcome for children leaving the emergency department without being seen by a physician

Gravel

Gouin

Carrière

et al. 2013

CJEM

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Objective: To assess the prevalence of an unfavourable outcome among children leaving without being seen by a physician in the emergency department (ED).Method: This was a prospective cohort study conducted over a complete year in a pediatric tertiary care ED. A random sample of all children younger than 19 years of age who left without being seen by a physician was contacted by phone 4 to 6 days following the ED visit. The primary outcome was the occurrence of an unfavourable outcome prospectively defined using a Delphi method among 15 pediatric emergency physicians. An unfavourable outcome was defined as hospitalization, the need for an invasive procedure (intravenous or intramuscular medication, fracture reduction, bone casting, or surgical intervention), suicide attempt, or death in the 72 hours following leaving without being seen by a physician. As a secondary outcome, multiple potential predictors were evaluated. The first analysis evaluated the proportion of unfavourable outcomes among children who left without being seen by a physician. Then logistic regression identified predictors of unfavourable outcomes. Results: During the study period, 61,909 children presented to the ED, 7,592 (12%) left without being seen by a physician, and 1,579 were recruited. Thirty-eight (2.4%; 95% CI 1.7-3.2) patients fulfilled the criteria for an unfavourable outcome. On multiple logistic regression, chief complaints related to trauma and absence of nurse counseling had higher risks of unfavourable outcome.Conclusions: Approximately 2% of children who left without being seen by a physician at a tertiary care pediatric ED had an unfavourable outcome. RÉ SUMÉObjectif: L'é tude visait à é valuer la pré valence des é vé nements dé favorables survenus chez les enfants qui quittent le service d'urgence (SU) sans avoir é té vus par un mé decin. Mé thode: Il s'agit d'une é tude de cohortes prospective, d'une duré e de 1 an, mené e dans un SU de soins tertiaires en pé diatrie. Un certain nombre d'enfants choisis au hasard, parmi tous ceux qui avaient moins de 19 ans et qui avaient quitté le SU sans avoir é té vus par un mé decin, ont é té joints par té lé phone, de 4 à 6 jours aprè s la demande de consultation. Le principal critè re d'é valuation consistait en la survenue d'é vé nements dé favorables, dé finis de maniè re prospective, à l'aide de la mé thode Delphi, par 15 pé diatres urgentologues. Les é vé nements dé favorables ont é té dé finis comme l'hospitalisation, la né cessité d'une intervention effractive (administration intraveineuse ou intramusculaire de mé dicaments, ré duction de fractures, pose d'un appareil plâ tré , intervention chirurgicale), une tentative de suicide, ou la mort dans les 72 heures suivant le dé part du SU sans examen pré alable par un mé decin. Quant au critè re d'é valuation secondaire, plusieurs facteurs pré visionnels possibles d'é vé nement dé favorable ont fait l'objet d'é valuation. La premiè re analyse visait à é valuer la proportion d'é vé nements dé favorables chez les enfants qui...

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Validity of the Canadian Paediatric Triage and Acuity Scale in a tertiary care hospital

Cited by 72 publications

References 17 publications

Medication Records in the Emergency Department: Agreement Between Paper-Based Charts and Automated Dispensing Device

Medication Records in the Emergency Department: Agreement Between Paper-Based Charts and Automated Dispensing Device

Trends in use in a Canadian pediatric emergency department

Unfavourable outcome for children leaving the emergency department without being seen by a physician

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