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首页> 外文期刊>Canadian Journal of Emergency Medicine >Reliability of the Canadian Triage and Acuity Scale: interrater and intrarater agreement from a community and an academic emergency department
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Reliability of the Canadian Triage and Acuity Scale: interrater and intrarater agreement from a community and an academic emergency department

机译：加拿大分流和敏锐度量表的可靠性：社区和学术急诊部门之间的互助和评估者协议

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Objectives:The Canadian Triage and Acuity Scale (CTAS) is a five-level triage tool that is used to help prioritize the order in which emergency department (ED) patients should be seen. The objectives of this study were to determine the interrater and intrarater agreement of the 2008 CTAS guideline revisions by triage nurses and to compare agreement between triage nurses working in a small community ED and an academic ED.Methods:Seventy-eight triage nurses assigned CTAS scores and free-text presenting complaints for 10 paper-based case scenarios. For five scenarios, the CTAS score should have remained unchanged from previous guidelines, whereas the other five scenarios should have been triaged differently based on the 2008 CTAS first-order modifiers. Thirty-three participants repeated the questionnaire 90 days later, and intrarater agreement was measured.Results:There was a higher level of agreement (κ = 0.73; 95% CI 0.68–0.79) for the five case scenarios, which relied on the older 2004 guidelines compared to the scenarios where the 2008 guidelines would have suggested a different triage level (κ = 0.50; 95% CI 0.42–0.59). For the 10 case scenarios analyzed, the free-text presenting complaints matched the Canadian Emergency Department Information System (CEDIS) list 90.1% of the time (κ = 0.80; 95% CI 0.76–0.84).Conclusion:The reliability of CTAS scoring by academic and community ED nurses was relatively good; however, the application of the 2008 CTAS revisions appears less reliable than the 2004 CTAS guidelines. These results may be useful to develop educational materials to strengthen reliability and validity for triage scoring using the 2008 CTAS guideline revisions.
机译：目标：加拿大分诊和敏锐度量表（CTAS）是一种五级分流工具，用于帮助确定急诊科（ED）患者的诊治顺序。这项研究的目的是确定分诊护士对2008 CTAS指南修订的内和分内协议，并比较在小社区ED和学术ED中工作的分诊护士之间的协议。方法：为88名分诊护士分配了CTAS评分以及针对10种纸质案例的自由文本投诉。对于五种情况，CTAS得分应与以前的指南保持不变，而其他五种情况应根据2008 CTAS一阶修正量进行不同的分类。 33名参与者在90天后重复了调查表，并评估了评定者内部的同意。结果：在5个案例中，有较高的同意水平（κ= 0.73; 95％CI 0.68–0.79），这取决于2004年的老年人。与2008年指南建议采用不同分类标准的方案相比（κ= 0.50; 95％CI 0.42-0.59）。对于所分析的10种情况，自由文本陈述投诉与加拿大急诊信息系统（CEDIS）列表匹配的时间为90.1％（κ= 0.80; 95％CI为0.76-0.84）。结论：CTAS评分的可靠性通过学术和社区教育署的护士相对较好;但是，2008 CTAS修订版的应用似乎不如2004 CTAS指南可靠。这些结果可能有助于开发教育材料，以增强使用2008 CTAS指南修订版进行的分流计分的可靠性和有效性。

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