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Reproducibility of the TRIPED-GM paediatric triage system

M Concepción Míguez-Navarro1, Gloria Guerrero-Márquez1, Carmen Ignacio Cerro2

  • 1Servicio de Urgencias de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.

Enfermeria Clinica
|April 27, 2025
PubMed

Insights

The TRIPED-GM pediatric triage system demonstrates high reliability in emergency settings, with nurses showing strong agreement when classifying patient urgency. This ensures consistent and effective care for children in critical situations.

Area of Science:

  • Emergency Medicine
  • Pediatric Nursing
  • Healthcare Quality Improvement

Background:

  • Effective patient triage is crucial for reducing morbidity and mortality in emergency departments.
  • The TRIPED-GM system is a five-level pediatric triage classification designed for ease of use and reliability.
  • Key mandatory components of the TRIPED-GM system include the Pediatric Assessment Triangle (PAT), chief complaint, and priority rectifiers.

Purpose of the Study:

  • To evaluate the reproducibility of the TRIPED-GM pediatric triage system.
  • To assess the consistency of patient urgency classification when applied by multiple nurses.

Main Methods:

  • An observational, descriptive, cross-sectional study was conducted with 237 pediatric patients (under 16 years).
  • Two research nurses and sixteen experienced pediatric emergency nurses evaluated patients consecutively and blindly.
  • Reliability was quantified using Kappa (κ), linear Kappa (κp), and quadratic Kappa (κp²) indices.

Main Results:

  • High overall agreement was observed, with 93.2% of patients showing concordance between nurses (κ = 0.84).
  • Excellent concordance was found for mandatory triage components: PAT (κ = 0.82), chief complaint (κ = 0.76), and rectifiers (κ = 0.94).
  • Slightly higher concordance was noted for illness-related cases (κ = 0.84) compared to trauma/accidents (κ = 0.79).

Conclusions:

  • The TRIPED-GM pediatric triage system exhibits strong reliability when utilized in emergency services.
  • The system's consistency supports its effective application in classifying pediatric patient urgency.
  • Findings indicate the TRIPED-GM system is a dependable tool for pediatric emergency triage.
Abstract

Keywords:
ChildClasificaciónClassificationEmergency medical servicesNiñosReproducibilidad de los resultadosReproducibility of resultsServicios de urgenciaTriageTriaje

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