Evaluating the accuracy of emergency nurses in correct triage using emergency severity index triage in Sina hospital of Tabriz: a cross-sectional analysis

Objective: Triage refers to the evaluation and categorization of patients for better management to deliver services. A good triage system should be able to accurately specify the patients who require urgent care. Thus, this study aimed to evaluate the accuracy of emergency nurses in correct triage using Emergency Severity Index (ESI) triage. Methods: In this descriptive cross-sectional study ۷۵۰ patients, who referred to the emergency department (ED) of Sina teaching hospital, participated from ۲۳ July to ۲۲ August in ۲۰۱۵. Participants were selected using convenience sampling method. The patients’ triage level was determined by physicians and nurses separately and the results were compared. To define the level of agreement between two groups (inter-rater agreement), the kappa index was evaluated. Data were analyzed using SPSS version ۱۷. Results: Among ۷۵۰ patients, ۵۷۷ patients (۷۶.۹%) were classified in correct triage group, ۹۰ patients (۱۲%) in undertriage group and ۸۳ patients (۱۱.۱%) in overtriage group. Kappa agreement coefficient between the ESI triage level of physicians and nurses was ۰.۶۵۹ (۹۵% CI: ۰.۶۴۶-۰.۶۶۷). There was statistically significant difference between the triage level of physicians and nurses (P < ۰.۰۰۱). Conclusion: This study showed that there was moderate agreement between the triages of physicians and nurses. It seems that improving nurses’ skills and knowledge might increase the accuracy of emergency nurses in patients’ correct triage. Therefore, planning programs based on training correct triage for emergency nurses is strongly suggested.

Keywords:

Emergency Department , triage , Nurses , physicians