Hossein Zakeri; Lahya Afshari Saleh; Shabnam Niroumand; Maryam Ziadi-Lotfabadi
Volume 10, Issue 2 , April 2022, , Pages 65-70
Abstract
Objective: To compare the emergency severity index (ESI) and Manchester triage system (MTS) in trauma patients. Methods: This cross-sectional study was conducted by census method in Hasheminejad hospital during 2019. Patients referred to a trauma center triaged by five trained triage nurses based on ...
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Objective: To compare the emergency severity index (ESI) and Manchester triage system (MTS) in trauma patients. Methods: This cross-sectional study was conducted by census method in Hasheminejad hospital during 2019. Patients referred to a trauma center triaged by five trained triage nurses based on ESI and MTS. Outcomes were considered as length of stay at the emergency department, admission to the other sectors and discharge or leave the hospital. Information from the triage form, nursing registry office and hospital registry system were extracted and analyzed by SPSS software. Results: Totally 447 and 468 patients triaged with the ESI and MTS were included, respectively. Seventy percent of patients triaged with ESI and 34% with MTS were placed in level 3 or the yellow group (equivalent group 3 triage). The hospitalization rate is approximately equal at each triage level in the both systems. The mortality rate in both groups was 0%. Mean length of stay was significantly lower in the MTS group compared to ESI in the emergency department (p <0.05). Conclusion: Using of ESI triage in the trauma center causes to arrive more patients to the emergency department instead of the fast track and leads to waste the time and energy of staff’. However, further studies are needed to prove this result.
Raheleh Ganjali; Reza Golmakani; Mohsen Ebrahimi; Saeid Eslami; Ehsan Bolvardi
Volume 8, Issue 2 , April 2020, , Pages 115-120
Abstract
Objective: To evaluate the accuracy of the five-level triage system using the emergency severity index (ESI) and to determine the compliance of the triage level with patient outcomes. Methods: This was a cross-sectional study which was performed in the emergency department of Imam Reza Hospital of Mashhad ...
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Objective: To evaluate the accuracy of the five-level triage system using the emergency severity index (ESI) and to determine the compliance of the triage level with patient outcomes. Methods: This was a cross-sectional study which was performed in the emergency department of Imam Reza Hospital of Mashhad during 2017. We included all the adult patients (≥15 years of age) referring to the emergency department. The data were recorded in a questionnaire containing three sections including demographic information, results of triage by ESI and final outcome of the patient. Patients referred to the triage unit were simultaneously triaged by triage nurse and some emergency medicine physicians. The triage was performed by a nurse with an emergency medicine physician (EMP) was considered as a gold standard and the outcome was compared in 24 hours later. Results: Overall, we included 400 patients with a mean age of 46.40 ± 18.52 years among whom there were 211 (52.8%) men and 189 (47.3%) women. Finally, 123 patients were hospitalized, 12 died, 256 were discharged by a physician, and 9 people left the hospital with their own consent. The calculated weight kappa was used to determine the agreement between the observers (nurse triage and physician) at 0.701 so that the agreement between the triage performed by a nurse and an EMP was in an excellent level (p<0.001). There was a significant relationship between the triage levels (determined by physicians) and the outcome of the patient (p<0.001), and the five-level system had a high overlap and significant relation with patient's outcome. Conclusion: The results of the current study revealed that the five-level triage system using the ESI has a high accuracy in triage and estimates the patient outcomes effectively and thus, could be used as an effective system in hospital triage.
Amir Mirhaghi; Mohsen Ebrahimi
Volume 7, Issue 1 , January 2019, , Pages 90-91
Abstract
Dear Editor, With great interest we have read the outstanding publication in the recent Bulletin of Emergency and Trauma issue by Ghafarypour-Jahrom et al. entitled "Validity and Reliability of the Emergency Severity Index and Australasian Triage System in Pediatric Emergency Care of Mofid Children's ...
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Dear Editor, With great interest we have read the outstanding publication in the recent Bulletin of Emergency and Trauma issue by Ghafarypour-Jahrom et al. entitled "Validity and Reliability of the Emergency Severity Index and Australasian Triage System in Pediatric Emergency Care of Mofid Children's Hospital in Iran" [1]. We bring your attention to the results concerning the reliability of Emergency Severity Index (ESI) in the mentioned study that may provide a new understanding to lead clinical practice in emergency department (ED). The study used Cohen kappa values to report inter-rater reliability of Level 1 to 5 are 0.833, 0.777, 0.520, 0.850 and 0.883. The reliability coefficient for level 4, 5 and 1 is almost perfect (> 0.80) which is reported in other literature too [2].
Faramarz Pourasghar; Jafar Sadegh Tabrizi; Alireza Ala; Amin Daemi
Volume 4, Issue 4 , October 2016, , Pages 211-215
Abstract
Objective: To validate the triage ratings performed by the Electronic Triage System (ETS) using hospitalization, length of stay, resource use, in-hospital mortality and patient bills as outcome measures.Methods: In this retrospective cross-sectional study the medical records of 387 patients were reviewed ...
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Objective: To validate the triage ratings performed by the Electronic Triage System (ETS) using hospitalization, length of stay, resource use, in-hospital mortality and patient bills as outcome measures.Methods: In this retrospective cross-sectional study the medical records of 387 patients were reviewed in a one-week period. The data included triage category and the outcome measures were hospitalization, length of stay, in-hospital mortality, patient bill, and used resources. The association between the triage category and hospitalization and death was assessed. The association between the triage category and the number of resources, length of stay, and the bill was also assessed.Results: The mean age of the patients was 43.65 ±21.17 years. Women comprised 40% (n=155) of 387 people who were included in the study. The frequency of Emergency Severity Index (ESI) 1, 2, 3, 4 and 5 categories were 18, 61, 127, 181 and 0 respectively. Phi and Cramer’s V for hospitalization and death were 0.365 (p<0.001) and 0.305 (p<0.001). Spearman's rho for bill, length of stay, and resource use were -0.483 (p<0.001), -0.228 (p<0.001) and -0.490 (p<0.001). The association between triage category and resource consumption was stronger than other outcomes.Conclusion: The ETS was valid in predicting all studied patient outcomes. The ETS has also the advantages of providing quick reports, giving feedback and providing data for research purposes.
Amin Daemi; Mohammad Reza Sheikhy-Chaman
Volume 4, Issue 2 , April 2016, , Pages 116-117
Faramarz Pourasghar; Amin Daemi; Jafar Sadegh Tabrizi; Alireza Ala
Volume 3, Issue 4 , October 2015, , Pages 134-137
Abstract
Objective: To examine the inter-rater reliability of triages performed by the Electronic Triage System (ETS) which has recently developed and used in hospital emergency department (ED).Methods: This cross-sectional study was conducted prospectively and studied 408 visitors of Tabriz Imam Reza hospital’s ...
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Objective: To examine the inter-rater reliability of triages performed by the Electronic Triage System (ETS) which has recently developed and used in hospital emergency department (ED).Methods: This cross-sectional study was conducted prospectively and studied 408 visitors of Tabriz Imam Reza hospital’s ED. The variables of interest were age, sex, nurse-assigned triage category, physician-assigned triage category, disease type (trauma, non-trauma), and the referred room within the ED. Cohen’s un-weighted kappa, linear weighted kappa, and quadratic weighted kappa were used to describe the reliability.Results: Un-weighted kappa observed to be 0.186 (95% CI: 0.123-0.249). Linear weighted kappa observed as 0.317 (95% CI: 0.251-0.384) and quadratic weighted kappa as 0.462 (95% CI: 0.336-0.589). In general, low agreement was seen between the triage nurses and ED physicians. For trauma patients and for those who were referred to the cardiopulmonary resuscitation room (CPR), all three types of kappa were higher than other visitors of the ED.Conclusion: Inter-rater reliability of the triages performed by the ETS observed as ranging from poor to moderate. Implementing interventions that would create a common language between nurses and physicians about the triage of the ED visitors seems necessary. The more agreement on the triage of trauma and CPR patients might be due to their condition and the more attention to them.
