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Inter-rater agreement of the triage system RETTS-HEV
Louise Nissen1, Hans Kirkegaard, Noel Perez
1Departments of aEmergency bOccupational Medicine, Regional Hospital of Herning, Herning cResearch Center for Emergency Medicine, University of Aarhus, Aarhus, Denmark.
Objective:
The purpose of this study was to evaluate the inter-rater agreement among nurses using the triage system RETTS-HEV (rapid emergency triage and treatment system - hospital unit west) in a Danish emergency department (ED).
Background:
The use of triage systems in Denmark has been implemented recently together with structural changes in hospital organization. Testing and evaluation is therefore needed. The RETTS-HEV is a five-scale triage system being used in the ED of Herning, Denmark, since May 2010. The ED is semilarge, with 29 000 annual visits.
Materials And Methods:
Consecutive patients presenting to the ED were assessed by both a duty and a study nurse using RETTS-HEV. Nurses did not receive training before the study. In all, 146 patients were enroled and a blinded, paired and simultaneous triage was conducted independently to evaluate inter-rater agreement using Fleiss κ.
Results:
A total of 155 patients were triaged over a 10-day period and complete data were available for 146 patients. We found the overall agreement to be good [Fleiss κ 0.60 (95% confidence interval 0.48; 0.72)]. The κ estimate was higher for the group of patients who required immediate attention [0.83 (95% confidence interval 0.18; 1.47)].
Conclusion:
The study found good inter-rater agreement between two independent observers not receiving any new triage training before the study.
