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The new emergency department "Tuscan triage System". Validation study.
Stefano Bambi1, Giovanni Becattini2, Marco Ruggeri3
1Health Sciences Department, University of Florence - Italy, Viale Morgagni 48 - 50134 Firenze, Italy.
International Emergency Nursing
|June 20, 2021
Summary
The new Tuscan Triage System (TTS) for emergency departments demonstrates high validity and reliability in assigning patient priority levels. This validated triage system appears safe for clinical use.
Area of Science:
- Emergency Medicine
- Healthcare Systems Management
- Clinical Triage
Background:
- Tuscan Emergency Departments (EDs) implemented a new organizational framework with low-priority streaming.
- The Tuscan Triage System (TTS) was developed to support this reorganization.
Purpose of the Study:
- To validate the Tuscan Triage System (TTS) for content, face, and criterion validity, and inter-rater reliability.
- To compare triage level assignments between the previous Regional Triage System (RTS) and the new TTS.
Main Methods:
- A validation study involved 24 nurses trained on the TTS.
- Nurses assigned TTS priority levels to 100 clinical case vignettes (reference standard).
- Content Validity Index - Scale/Average (S-CVI/Ave) and Krippendorff's alpha were calculated.
Main Results:
- TTS achieved high content (S-CVI/Ave=0.98) and face validity (S-CVI/Ave=1).
- Inter-rater reliability was good (Krippendorff α=0.808).
- The TTS showed a shift towards lower priority levels compared to the RTS, with undertriage at 10.45% and overtriage at 14.29%.
Conclusions:
- The Tuscan Triage System (TTS) demonstrates strong validity and reliability.
- The TTS appears safe, though further validation in real clinical settings is recommended.
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