Outcomes for Emergency Severity Index Triage Implementation in the Emergency Department
Introduction: Hospital triage scale in emergency departments needs to be valid and reliable. Lack of sufficient data exists on triage scale rigor in emergency departments of Iran. This study aimed to determine the impact of the emergency severity index (ESI) triage scale in the emergency departm...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2015-04-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/5737/11791_CE(Ra1)_F(GH)_PF1(PAK)_PFA(AK)_PF2(PAG).pdf |
| _version_ | 1818655397382193152 |
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| author | Amir Mirhaghi Hadi Kooshiar Habibollah Esmaeili Mohsen Ebrahimi |
| author_facet | Amir Mirhaghi Hadi Kooshiar Habibollah Esmaeili Mohsen Ebrahimi |
| author_sort | Amir Mirhaghi |
| collection | DOAJ |
| description | Introduction: Hospital triage scale in emergency departments
needs to be valid and reliable. Lack of sufficient data exists on
triage scale rigor in emergency departments of Iran. This study
aimed to determine the impact of the emergency severity index
(ESI) triage scale in the emergency department.
Materials and Methods: A single-center study was conducted.
Proportion of triage categories allocated to high-risk patients
admitted to high-acuity departments was examined in observational period in June 2012 and May 2013. True triage score
was reported based on patients` paper- based scenario questionnaire. Interrater reliability was assessed using unweighted
kappa. Concordance among experts, nurses and physicians
was examined. The Chi-square test and Kappa statistics was
used for statistical analysis.
Results: Triage decisions regarding high-risk patients before and
after implementation period are independent from each other
(χ2
= 22.254; df=1; p<0.05) and more high-risk patients were
recognized after implementation of the ESI. Overall agreement
and concordance were (79%) and (κ=0.54) among nurses; (71%)
and (κ=0.45) among physicians, (85%) and (κ=0.81) among
experts, respectively. Correct triage decisions among clinicians
were increased after implementation of the ESI.
Conclusion: The ESI as valid and reliable tool improving
desirable outcomes` in the emergency department has been
recommended but it may not reveal optimal outcomes in
developing countries comparing to what have been achieved in
the developed countries. In addition, patient influx in ESI level II
could create considerable controversy with clinicians. |
| first_indexed | 2024-12-17T03:09:02Z |
| format | Article |
| id | doaj.art-a692336a25a7497e8c0eb1c5c69e6949 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-17T03:09:02Z |
| publishDate | 2015-04-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-a692336a25a7497e8c0eb1c5c69e69492022-12-21T22:05:53ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2015-04-0194OC04OC0710.7860/JCDR/2015/11791.5737Outcomes for Emergency Severity Index Triage Implementation in the Emergency DepartmentAmir Mirhaghi0Hadi Kooshiar1Habibollah Esmaeili2Mohsen Ebrahimi3PhD Candidate, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran. Assistant Professor, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran. Associate Professor, Department of Biostatistics, Mashhad University of Medical Sciences, Mashhad, Iran.Assistant Professor, Department of Emergency Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.Introduction: Hospital triage scale in emergency departments needs to be valid and reliable. Lack of sufficient data exists on triage scale rigor in emergency departments of Iran. This study aimed to determine the impact of the emergency severity index (ESI) triage scale in the emergency department. Materials and Methods: A single-center study was conducted. Proportion of triage categories allocated to high-risk patients admitted to high-acuity departments was examined in observational period in June 2012 and May 2013. True triage score was reported based on patients` paper- based scenario questionnaire. Interrater reliability was assessed using unweighted kappa. Concordance among experts, nurses and physicians was examined. The Chi-square test and Kappa statistics was used for statistical analysis. Results: Triage decisions regarding high-risk patients before and after implementation period are independent from each other (χ2 = 22.254; df=1; p<0.05) and more high-risk patients were recognized after implementation of the ESI. Overall agreement and concordance were (79%) and (κ=0.54) among nurses; (71%) and (κ=0.45) among physicians, (85%) and (κ=0.81) among experts, respectively. Correct triage decisions among clinicians were increased after implementation of the ESI. Conclusion: The ESI as valid and reliable tool improving desirable outcomes` in the emergency department has been recommended but it may not reveal optimal outcomes in developing countries comparing to what have been achieved in the developed countries. In addition, patient influx in ESI level II could create considerable controversy with clinicians.https://jcdr.net/articles/PDF/5737/11791_CE(Ra1)_F(GH)_PF1(PAK)_PFA(AK)_PF2(PAG).pdfalgorithmesireliability |
| spellingShingle | Amir Mirhaghi Hadi Kooshiar Habibollah Esmaeili Mohsen Ebrahimi Outcomes for Emergency Severity Index Triage Implementation in the Emergency Department Journal of Clinical and Diagnostic Research algorithm esi reliability |
| title | Outcomes for Emergency Severity Index Triage Implementation in the Emergency Department |
| title_full | Outcomes for Emergency Severity Index Triage Implementation in the Emergency Department |
| title_fullStr | Outcomes for Emergency Severity Index Triage Implementation in the Emergency Department |
| title_full_unstemmed | Outcomes for Emergency Severity Index Triage Implementation in the Emergency Department |
| title_short | Outcomes for Emergency Severity Index Triage Implementation in the Emergency Department |
| title_sort | outcomes for emergency severity index triage implementation in the emergency department |
| topic | algorithm esi reliability |
| url | https://jcdr.net/articles/PDF/5737/11791_CE(Ra1)_F(GH)_PF1(PAK)_PFA(AK)_PF2(PAG).pdf |
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