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Poor agreement in application of the Australasian Triage Scale to paediatric emergency department presentations
Dianne J Crellin
Master of Nursing Candidate, School of Nursing, University of Melbourne; Clinical Nurse Educator, Department of Emergency Medicine, Royal Children's Hospital, Melbourne VIC
Linda Johnston
Associate Professor of Evidence Based Infant, Child and Adolescent Nursing, Royal Children's Hospital; University of Melbourne, VIC
Abstract
Background. The Australasian Triage Scale (ATS) is used in Australian emergency departments (ED) to describe patient priority on arrival. This study aimed to determine the level of inter-rater consistency with which the scale is applied to paediatric presentations. Additionally, it sought to document the level of certainty with which nurses apply the scale. Method: An anonymous survey of emergency nurses responsible for paediatric triage decisions using written patient profiles. Results. The level of agreement between nurses applying the ATS to paediatric presentations can be described as poor and appears lower than the consistency with which it is applied to adult presentations. Conclusion. Inconsistent allocation of ATS category implies variable patient waiting times, which may have detrimental effects on patient condition. Hence, efforts must be made to address the inconsistency that exists in paediatric triage decision-making.
Keywords
triage, emergency nursing, paediatrics, interrater reliability
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