Application of the national triage scale is not uniform

Reliability and validity of the Toowoomba adult trauma triage tool: a Queensland, Australia study

“…Three of the five simulations showed close to 50:50 spreads across two triage categories and one simulation had results spread across 3 triage categories. These results are consistent with those of other studies on the NTS (Considine, Ung, Thomas, 2000;Dilley and Standen, 1998;Doherty, 1996). In comparison, data from the TATTT coding of the other nine written scenarios showed five of the nine simulations recorded full agreement across all 15 coders and none varied across more than two triage codes.…”

“…A number of studies have identified experimentally that this is unlikely to occur. Doherty (1996) conducted a study into the uniformity of triage between medical and nursing staff and between four different hospitals utilising the NTS. The study comprised 12 written patient scenarios.…”

“…The study comprised 12 written patient scenarios. He found that no one scenario was triaged the same by all participants and 10 of the 12 scenarios received triage scores encompassing three or more categories (Doherty, 1996). Dilley and Standen (1998) assessed the level of uniformity among Victorian public hospital triage nurses in utilizing the NTS.…”

“…If triage nurses fail to categorise patients appropriately then medical attention may be unacceptably delayed or unnecessarily expedited (Goodacre, Gillet, Harris, et al 1999). As a consequence there will be inequity in patient access to ED services, potential risks to patient safety, inefficiencies in the management of patient workload and difficulty in making meaningful comparisons between institutions based on triage categorisation data (Considine, Ung, Thomas, 2000;Goodacre, Gillet, Harris, et al 1999;Doherty, 1996;Monash Institute of Health Services Research, 2001). …”

Triage nurse perceptions of the use, reliability and acceptability of the Toowoomba Adult Triage Trauma Tool (TATTT)

“…Since the inception of the ATS and its predecessor, the national triage scale (NTS), more than 10 years ago, there have been a number of experimental studies suggesting a lack of standardisation in the application of the scale. For example, Doherty (1996) conducted a study into the uniformity of triage between medical and nursing staff between four different hospitals using written scenarios. The results showed that no one scenario was triaged the same by all participants and 10 of the 12 scenarios received triage scores that encompassed three or more categories.…”