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Related Experiment Videos

Interobserver agreement in emergency department triage.

Joe Nakagawa1, Sripha Ouk, Brad Schwartz

  • 1University of California-Los Angeles Emergency Medicine Center, University of California-Los Angeles School of Medicine, Los Angeles, CA, USA.

Annals of Emergency Medicine
|January 28, 2003
PubMed
Summary
This summary is machine-generated.

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Interobserver agreement among triage nurses is poor, even with vital signs. This suggests telephone triage limitations are not solely due to the communication method, impacting patient care reliability.

Area of Science:

  • Emergency Medicine
  • Nursing
  • Healthcare Quality

Background:

  • Triage is a critical process in emergency departments (EDs) for prioritizing patient care.
  • Previous studies indicated poor agreement between in-person and telephonic triage assessments.
  • Understanding factors influencing triage reliability is essential for improving patient outcomes.

Purpose of the Study:

  • To quantify interobserver reliability in emergency department (ED) triage.
  • To assess the impact of vital signs on triage decision-making.
  • To contextualize prior findings on agreement disparities between in-person and telephonic triage.

Main Methods:

  • Prospective observational study with a randomized crossover design.
  • Two independent, sequential in-person ED intake interviews conducted by experienced triage nurses.

Related Experiment Videos

  • Nurses assigned one of five triage designations before and after receiving vital signs.

    • Main Results:

    • Poor agreement was observed between nurses' initial triage designations (53% agreement, kappa=0.30).
    • Knowledge of vital signs did not enhance agreement (49% agreement, kappa=0.25).
    • The study included 201 patients and 19 experienced triage nurses.

    Conclusions:

    • Significant interobserver variability exists among certified triage nurses using a standardized scale.
    • The study indicates that the communication method (in-person vs. telephone) is not the primary driver of triage unreliability.
    • Findings suggest systemic issues in triage scale design or application contribute to poor agreement.