Effectiveness of a Training Course on Accuracy of Triaging of Pediatric Patients

Abstract

BACKGROUND:In the context of a new but busy Pediatric Emergency Department, the risk of missing patients who need more emergent care can be reduced by timely and accurate triaging. In the emergency department of King Fahad Armed Forces Hospital, the Canadian Triage and Acuity Scale had already been implemented, including the pediatric version (PaedCTAS). However, a common observation remained that critical patients did not always receive priority with subsequent delays in management. To improve this accuracy, a training course was administered to health care professionals responsible for triaging of pediatric patients.AIM:To determine the effectiveness of a training course on accuracy of triaging of Pediatric Patients.METHODS:A triage training course was conducted over two months, with patient encounter sheets reviewed before the course for 6 months and after the course for 12 months. Accuracy was calculated by comparing it to level as determined by two pediatric emergency physicians. Also, admission rates were used as a surrogate marker to also determine accuracy.RESULTS:A total of 31 053 patient sheets were reviewed. There was a considerable improvement in the correct determination of all triage levels, with accuracy ranging from 56.5% to 78.3% before the course, and reaching from 79.1% to 90.8% after the course with a statistically significant difference. Triaging errors still present were mainly in the form of down-triage.CONCLUSION:Our training course in triage has a significant impact on the accuracy of triaging of ill pediatric patients. Further improvement can be obtained by repeated courses and direct feedback with debriefing sessions on challenges to triage level determination.

Reliability and Accuracy of the Pediatric Swiss Emergency Triage Scale—the SETSped Study

“…Recently, in a study based on 15 pediatric scenarios, Alshaibi 18 showed a mistriage rate of more than 50% among nurses using CTAS. Using the CTAS on more than 31,000 pediatric patients, Azzam et al 19 showed an accuracy of approximately 57% before training, with an improvement to 78% after training. Finally, a Swedish team reported a correct triage rate of 57.6% based on 7614 triage decisions with the CTAS (423 nurses and 18 scenarios).…”