TY - JOUR
T1 - Assessing triage efficiency in Italy
T2 - a comparative study using simulated cases among nurses
AU - Zaboli, Arian
AU - Brigo, Francesco
AU - Cipriano, Alessandro
AU - Sibilio, Serena
AU - Magnarelli, Gabriele
AU - Pfeifer, Norbert
AU - Fratti, Michele
AU - Malalan, Fabio
AU - Massar, Magdalena
AU - Mian, Michael
AU - Pagnucci, Nicola
AU - Brigiari, Gloria
AU - Ghiadoni, Lorenzo
AU - Turcato, Gianni
N1 - Lehr-KH (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), via A. Volta, 13°, Bolzano, Italy und Hospital of Merano-Meran (SABES-ASDAA), Merano-Meran, Italy Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, Salzburg, Austria
PY - 2024/8/6
Y1 - 2024/8/6
N2 - BackgroundEmergency Departments (EDs) across Italy use different triage systems, which vary from region to region. This study aimed to assess whether nurses working in different EDs assign triage codes in a similar and standardized manner.MethodsA multicenter observational simulation study involved the EDs of Bolzano Hospital, Merano Hospital, Pisa University Hospital, and Rovereto Hospital. All participating nurses were given 30 simulated clinical cases (vignettes) and asked to assign triage codes according to the triage systems used in their EDs. Subsequently, we assessed inter-rater agreement and evaluated if code assignment had different performance among hospitals in relation to different clinical outcomes.ResultsEighty-seven nurses participated in this study. There was marked variation in assigned triage codes both across hospitals and among individual operators. The kappa values for inter-rater agreement were 0.632 for Bolzano Hospital, 0.589 for Merano Hospital, 0.464 for Pisa University Hospital, and 0.574 for Rovereto Hospital. Sensitivity and specificity levels varied considerably for the same outcomes when comparing different hospitals.ConclusionThere is a high degree of subjectivity in triage code assignment by ED nurses. In the interest of equitable care for patients, this variability within the same country is hardly acceptable.
AB - BackgroundEmergency Departments (EDs) across Italy use different triage systems, which vary from region to region. This study aimed to assess whether nurses working in different EDs assign triage codes in a similar and standardized manner.MethodsA multicenter observational simulation study involved the EDs of Bolzano Hospital, Merano Hospital, Pisa University Hospital, and Rovereto Hospital. All participating nurses were given 30 simulated clinical cases (vignettes) and asked to assign triage codes according to the triage systems used in their EDs. Subsequently, we assessed inter-rater agreement and evaluated if code assignment had different performance among hospitals in relation to different clinical outcomes.ResultsEighty-seven nurses participated in this study. There was marked variation in assigned triage codes both across hospitals and among individual operators. The kappa values for inter-rater agreement were 0.632 for Bolzano Hospital, 0.589 for Merano Hospital, 0.464 for Pisa University Hospital, and 0.574 for Rovereto Hospital. Sensitivity and specificity levels varied considerably for the same outcomes when comparing different hospitals.ConclusionThere is a high degree of subjectivity in triage code assignment by ED nurses. In the interest of equitable care for patients, this variability within the same country is hardly acceptable.
KW - Emergency Department
KW - Emergency nursing
KW - Italian triage
KW - Italy
KW - Nurse
KW - Nurse triage
KW - Triage
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pmu_pure&SrcAuth=WosAPI&KeyUT=WOS:001286310200003&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1007/s11739-024-03735-z
DO - 10.1007/s11739-024-03735-z
M3 - Original Article
C2 - 39105967
SN - 1828-0447
JO - INTERNAL AND EMERGENCY MEDICINE
JF - INTERNAL AND EMERGENCY MEDICINE
ER -