Reliability of the revised Swiss Emergency Triage Scale: a computer simulation study.
Details
State: Public
Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_687A01F16FD3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Reliability of the revised Swiss Emergency Triage Scale: a computer simulation study.
Journal
European journal of emergency medicine
ISSN
1473-5695 (Electronic)
ISSN-L
0969-9546
Publication state
Published
Issued date
08/2018
Peer-reviewed
Oui
Volume
25
Number
4
Pages
264-269
Language
english
Notes
Publication types: Evaluation Studies ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
The Swiss Emergency Triage Scale (SETS) is a four-level emergency scale that previously showed moderate reliability and high rates of undertriage due to a lack of standardization. It was revised to better standardize the measurement and interpretation of vital signs during the triage process.
The aim of this study was to explore the inter-rater and test-retest reliability, and the rate of correct triage of the revised SETS.
Thirty clinical scenarios were evaluated twice at a 3-month interval using an interactive computerized triage simulator by 58 triage nurses at an urban teaching emergency department admitting 60 000 patients a year. Inter-rater and test-retest reliabilities were determined using κ statistics. Triage decisions were compared with a gold standard attributed by an expert panel. Rates of correct triage, undertriage, and overtriage were computed. A logistic regression model was used to identify the predictors of correct triage.
A total of 3387 triage situations were analyzed. Inter-rater reliability showed substantial agreement [mean κ: 0.68; 95% confidence interval (CI): 0.60-0.78] and test-retest almost perfect agreement (mean κ: 0.86; 95% CI: 0.84-0.88). The rate of correct triage was 84.1%, and rates of undertriage and overtriage were 7.2 and 8.7%, respectively. Vital sign measurement was an independent predictor of correct triage (odds ratios for correct triage: 1.29 for each additional vital sign measured, 95% CI: 1.20-1.39).
The revised SETS incorporating standardized vital sign measurement and interpretation during the triage process resulted in high reliability and low rates of mistriage.
The aim of this study was to explore the inter-rater and test-retest reliability, and the rate of correct triage of the revised SETS.
Thirty clinical scenarios were evaluated twice at a 3-month interval using an interactive computerized triage simulator by 58 triage nurses at an urban teaching emergency department admitting 60 000 patients a year. Inter-rater and test-retest reliabilities were determined using κ statistics. Triage decisions were compared with a gold standard attributed by an expert panel. Rates of correct triage, undertriage, and overtriage were computed. A logistic regression model was used to identify the predictors of correct triage.
A total of 3387 triage situations were analyzed. Inter-rater reliability showed substantial agreement [mean κ: 0.68; 95% confidence interval (CI): 0.60-0.78] and test-retest almost perfect agreement (mean κ: 0.86; 95% CI: 0.84-0.88). The rate of correct triage was 84.1%, and rates of undertriage and overtriage were 7.2 and 8.7%, respectively. Vital sign measurement was an independent predictor of correct triage (odds ratios for correct triage: 1.29 for each additional vital sign measured, 95% CI: 1.20-1.39).
The revised SETS incorporating standardized vital sign measurement and interpretation during the triage process resulted in high reliability and low rates of mistriage.
Keywords
Clinical Competence, Computer Simulation, Critical Illness/therapy, Emergency Nursing/methods, Emergency Service, Hospital/statistics & numerical data, Female, Hospitals, Teaching, Humans, Logistic Models, Male, Observer Variation, Prospective Studies, Switzerland, Triage/methods, Vital Signs
Pubmed
Web of science
Create date
24/01/2017 18:53
Last modification date
20/08/2019 15:23