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Assessment of the triage system in a pediatric emergency department. A pilot study on critical codes
E Piccotti1, M Magnani, B Tubino
1Pediatric Emergency Department, "G. Gaslini" Children's Hospital, Genoa, Italy. emanuelapiccotti@ospedale-gaslini.ge.it
Insights
This study assessed the emergency department triage system in an Italian children's hospital, finding that while vital signs and symptoms were well-documented, adherence to guidelines for assigning yellow codes needs improvement.
Area of Science:
- Pediatric Emergency Medicine
- Healthcare Quality Improvement
Background:
- Hospital Emergency Departments (EDs) in Italy utilize a color-coded triage system to prioritize patient care.
- Triage codes range from red (very critical) to white (not critical).
Purpose of the Study:
- To evaluate the accuracy and adherence to guidelines of the triage system at "Giannina Gaslini" Children's Hospital in Genoa, Italy.
- Specifically assess the correct application of the yellow triage code.
Main Methods:
- Retrospective review of 130 triage forms from 2003 assigned a yellow code.
- Analysis focused on the recording of vital parameters, identification of main symptoms, and appropriateness of the assigned color code.
Main Results:
- Vital signs were recorded in 94% of cases; main symptoms identified in 97%.
- The yellow code was assigned correctly according to hospital guidelines in 84% of reviewed forms.
- The rate of underestimation (3.2%) was higher than previously reported literature values (2%).
Conclusions:
- The findings highlight a need for enhanced compliance with established triage guidelines.
- Further evaluation of the triage system, particularly for green and white codes, is recommended to ensure optimal patient prioritization.
Introduction:
In Italy, triage involves assigning a priority color code to patients arriving at the hospital Emergency Department: red (very critical), yellow (moderately critical), green (not very critical), and white (not critical).
Methods:
This study was aimed at assessing the triage system in the Emergency Department of "Giannina Gaslini" Children's Hospital in Genoa, Italy. The authors examined 130 triage forms assigning a yellow code in 2003, in order to determine whether they had been correctly filled in with regard to the detection of vital parameters, identification of main symptoms and color code assignment.
Results:
Results showed that vital signs were recorded in 94% of patients, main symptoms were identified in 97%, and a yellow code was assigned according to hospital guidelines in 84%. The percentage of underestimation (3.2%) was higher than that reported in the literature (2%).
Conclusions:
The study shows the need to improve compliance with the guidelines and to evaluate green and white codes.
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