Pediatric triage variations among nurses, pediatric and emergency residents using the Canadian triage and acuity scale

Abstract Background Emergency care continues to be a challenge, since patients’ arrival is unscheduled and could occur at the same time which may fill the Emergency Department with non-urgent patients. Triaging is an integral part of every busy ED. The Canadian Triage and Acuity Scale (CTAS) is cons...

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Autores principales:	Saleh Alshaibi, Tala AlBassri, Suliman AlQeuflie, Winnie Philip, Nesrin Alharthy
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	CTAS Triaging system Pediatrics Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/3e5c057a4a514720988e2509e19d9191
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spelling	oai:doaj.org-article:3e5c057a4a514720988e2509e19d91912021-11-28T12:14:13ZPediatric triage variations among nurses, pediatric and emergency residents using the Canadian triage and acuity scale10.1186/s12873-021-00541-01471-227Xhttps://doaj.org/article/3e5c057a4a514720988e2509e19d91912021-11-01T00:00:00Zhttps://doi.org/10.1186/s12873-021-00541-0https://doaj.org/toc/1471-227XAbstract Background Emergency care continues to be a challenge, since patients’ arrival is unscheduled and could occur at the same time which may fill the Emergency Department with non-urgent patients. Triaging is an integral part of every busy ED. The Canadian Triage and Acuity Scale (CTAS) is considered an accurate tool to be used outside Canada. This study aims to identify the chosen triage level and compare the variation between registered nurses, pediatric and adult emergency residents by using CTAS cases. Method This study was conducted at King Abdulaziz Medical City,Saudi Arabia. A cross-sectional self-administered questionnaire was used, and which contains 15 case scenarios with different triage levels. All cases were adopted from a Canadian triage course after receiving permission. Each case provides the patient’s symptoms, clinical signs and mode of arrival to the ED. The participants were instructed to assign a triage level using the following scale. A non-random sampling technique was used for this study. The rates of agreement between residents were calculated using kappa statistics (weighted-kappa) (95%CI). Result A total of 151 participants completed the study questionnaire which include 15 case scenarios. 73 were nurses and 78 were residents. The results showed 51.3, 56.6, and 59.9% mis-triaged the cases among the nurses, emergency residents, and pediatric residents respectively. Triage scores were compared using the Kruskal Wallis test and were statistically significant with a p value of 0.006. The mean ranks for nurses, emergency residents and pediatric residents were 86.41, 73.6 and 59.96, respectively. The Kruskal Wallis Post-Hoc test was performed to see which groups were statistically significant, and it was found that there was a significant difference between nurses and pediatrics residents (P value = 0.005). Moreover, there were no significant differences found between nurses and ER residents (P value> 0.05). Conclusion The triaging system was found to be a very important tool to prioritize patients based on their complaints. The results showed that nurses had the greatest experience in implementing patients on the right triage level. On the other hand, ER and pediatric residents need to develop more knowledge about CTAS and become exposed more to the triaging system during their training.Saleh AlshaibiTala AlBassriSuliman AlQeuflieWinnie PhilipNesrin AlharthyBMCarticleCTASTriaging systemPediatricsSpecial situations and conditionsRC952-1245Medical emergencies. Critical care. Intensive care. First aidRC86-88.9ENBMC Emergency Medicine, Vol 21, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	CTAS Triaging system Pediatrics Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	CTAS Triaging system Pediatrics Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Saleh Alshaibi Tala AlBassri Suliman AlQeuflie Winnie Philip Nesrin Alharthy Pediatric triage variations among nurses, pediatric and emergency residents using the Canadian triage and acuity scale
description	Abstract Background Emergency care continues to be a challenge, since patients’ arrival is unscheduled and could occur at the same time which may fill the Emergency Department with non-urgent patients. Triaging is an integral part of every busy ED. The Canadian Triage and Acuity Scale (CTAS) is considered an accurate tool to be used outside Canada. This study aims to identify the chosen triage level and compare the variation between registered nurses, pediatric and adult emergency residents by using CTAS cases. Method This study was conducted at King Abdulaziz Medical City,Saudi Arabia. A cross-sectional self-administered questionnaire was used, and which contains 15 case scenarios with different triage levels. All cases were adopted from a Canadian triage course after receiving permission. Each case provides the patient’s symptoms, clinical signs and mode of arrival to the ED. The participants were instructed to assign a triage level using the following scale. A non-random sampling technique was used for this study. The rates of agreement between residents were calculated using kappa statistics (weighted-kappa) (95%CI). Result A total of 151 participants completed the study questionnaire which include 15 case scenarios. 73 were nurses and 78 were residents. The results showed 51.3, 56.6, and 59.9% mis-triaged the cases among the nurses, emergency residents, and pediatric residents respectively. Triage scores were compared using the Kruskal Wallis test and were statistically significant with a p value of 0.006. The mean ranks for nurses, emergency residents and pediatric residents were 86.41, 73.6 and 59.96, respectively. The Kruskal Wallis Post-Hoc test was performed to see which groups were statistically significant, and it was found that there was a significant difference between nurses and pediatrics residents (P value = 0.005). Moreover, there were no significant differences found between nurses and ER residents (P value> 0.05). Conclusion The triaging system was found to be a very important tool to prioritize patients based on their complaints. The results showed that nurses had the greatest experience in implementing patients on the right triage level. On the other hand, ER and pediatric residents need to develop more knowledge about CTAS and become exposed more to the triaging system during their training.
format	article
author	Saleh Alshaibi Tala AlBassri Suliman AlQeuflie Winnie Philip Nesrin Alharthy
author_facet	Saleh Alshaibi Tala AlBassri Suliman AlQeuflie Winnie Philip Nesrin Alharthy
author_sort	Saleh Alshaibi
title	Pediatric triage variations among nurses, pediatric and emergency residents using the Canadian triage and acuity scale
title_short	Pediatric triage variations among nurses, pediatric and emergency residents using the Canadian triage and acuity scale
title_full	Pediatric triage variations among nurses, pediatric and emergency residents using the Canadian triage and acuity scale
title_fullStr	Pediatric triage variations among nurses, pediatric and emergency residents using the Canadian triage and acuity scale
title_full_unstemmed	Pediatric triage variations among nurses, pediatric and emergency residents using the Canadian triage and acuity scale
title_sort	pediatric triage variations among nurses, pediatric and emergency residents using the canadian triage and acuity scale
publisher	BMC
publishDate	2021
url	https://doaj.org/article/3e5c057a4a514720988e2509e19d9191
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Pediatric triage variations among nurses, pediatric and emergency residents using the Canadian triage and acuity scale

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