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Do emergency nurses and doctors agree in their triage assessment of dyspneic patients?
Lim, Beng Leong; Liew, Xing Mei; Vasu, Alicia; Chan, Kim Chai.
Afiliação
  • Lim BL; Tan Tock Seng Hospital, Emergency Department, Singapore. Electronic address: Beng_Leong_Lim@ttsh.com.sg.
  • Liew XM; Tan Tock Seng Hospital, Emergency Department, Singapore.
  • Vasu A; Tan Tock Seng Hospital, Emergency Department, Singapore.
  • Chan KC; Tan Tock Seng Hospital, Emergency Department, Singapore.
Int Emerg Nurs ; 22(4): 208-13, 2014 Oct.
Article em En | MEDLINE | ID: mdl-24631277
OBJECTIVES: This study investigated the inter-observer agreement (IOA) between doctors and nurses on triaging adult ED dyspneic patients. METHODS: This was a prospective observational study comparing eight trained ED nurses with doctors. Each patient was assessed by a nurse and two doctors (1 and 2) who decided on four-point Patient Acuity Category (PAC) and triage management steps. The primary outcome was the proportion of resuscitation room escalations from consult. Secondary outcomes included proportions and IOA of assigned PAC and steps in triage management. The investigators reported IOA as the k statistic (95% CIs) and percent agreement. DATA/RESULTS: There were 22/302 (7.3%) escalations; one from clinical deterioration. Proportions of assigned PAC status by nurses, Drs 1 and 2 were: PAC 1: 20.2-24.2%; PAC 2: 71.5-72.8%; PAC 3: 4.3-7.0%; PAC 4: 0.0-0.7%. The IOA was at least fair to moderate [k: 0.33 (0.22-0.43) to 1.00] in all steps of management except for electrocardiogram [k: 0.19 (0.10-0.27) to 0.45 (0.35-0.55)] ordering. The percent agreement ranged from 81 to 100% for all management steps except for chest Xray (66-73%) and electrocardiogram (61-71%) ordering. CONCLUSION: Trained ED nurses were safe and managed adult dyspneic patients as well as doctors at triage.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Médicos / Triagem / Competência Clínica / Dispneia / Serviço Hospitalar de Emergência / Enfermeiros Clínicos Idioma: En Ano de publicação: 2014 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Médicos / Triagem / Competência Clínica / Dispneia / Serviço Hospitalar de Emergência / Enfermeiros Clínicos Idioma: En Ano de publicação: 2014 Tipo de documento: Article