The Soterion Rapid Triage System: Evaluation of inter-rater reliability and validity

Maningas, Peter A; Hime, Derek A.; Parker, Donald E.; McMurry, Ted A.

doi:10.1016/j.jemermed.2005.05.037

Cited by 31 publications

(32 citation statements)

References 14 publications

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“…15 The Soterion Rapid Triage System is another five-level computerized triage system that has been evaluated in two studies. 16,18 The studies reported excellent interrater agreement when the system was applied to 422 adult patients (weighted k, 0.87; 95% CI = 0.84 to 0.91) and to 117 pediatric patients (weighted k, 0.90; 95% CI = 0.83 to 0.96). The tool that has been the most commonly studied is the e-TRIAGE.…”

Section: Discussionmentioning

confidence: 97%

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Reliability of a Computerized Version of the Pediatric Canadian Triage and Acuity Scale

et al. 2007

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Section: Discussionmentioning

confidence: 97%

“…[15][16][17] Among them, the Soterion Rapid Triage system is a five-level triage tool initially developed for adults but also applicable to children. Studies revealed a high agreement between nurses for triage of adults (weighted k, 0.87) 16 and pediatric patients (weighted k, 0.90). 18 The other computerized triage tool previously evaluated is the e-TRIAGE.…”

mentioning

confidence: 99%

Reliability of a Computerized Version of the Pediatric Canadian Triage and Acuity Scale

et al. 2007

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“…18 Other triage tools have been evaluated in different settings; among them, was the Soterion Rapid Triage System, a five-level computerized triage tool. 20 In this study by Maningas et al, 21 a research nurse performed a second triage blinded to the first evaluation on patients younger than 13 years. The study reported an impressive weighted kappa score of 0.90 (95% CI = 0.83 to 0.96) for the 117 patients evaluated by two nurses.…”

Section: Discussionmentioning

confidence: 99%

Interrater Agreement between Nurses for the Pediatric Canadian Triage and Acuity Scale in a Tertiary Care Center

Gravel¹,

Gouin²,

Manzano³

et al. 2008

Academic Emergency Medicine

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Objectives: The objective was to measure the interrater agreement between nurses assigning triage levels to children visiting a pediatric emergency departments (EDs) assisted by a computerized version of the Pediatric Canadian Triage and Acuity Scale (PedCTAS).Methods: This was a prospective cohort study evaluating children triaged from Level 2 (emergent) to Level 5 (nonurgent). A convenience sample of patients triaged during 38 shifts from April to September 2007 in a tertiary care pediatric ED was evaluated. All patients were initially triaged by regular triage nurses using a computerized version of the PedCTAS. Research nurses performed a second evaluation blinded to the first evaluation using the same triage tool. These research nurses were regular ED nurses performing extra hours for research purposes exclusively. The primary outcome measure was the interrater agreement between the two nurses as measured by the linear weighted kappa score. Secondary outcomes included the proportion of patient for which nurses did not apply the triage level suggested by Staturg (override) and agreement for these overrides.Results: A total of 499 patients were recruited. The overall interrater agreement was moderate (linear weighted kappa score of 0.55 [95% confidence interval {CI} = 0.48 to 0.61] and quadratic weighted kappa score of 0.61 [95% CI = 0.42 to 0.80]). There was a discrepancy of more than one level in only 10 patients (2% of the study population). Overrides occurred in 23.2 and 21.8% for regular and research triage nurses, respectively. These overrides were equally distributed between increase and decrease in triage level.Conclusions: Nurses using Staturg, which is a computerized version of the PedCTAS, demonstrated moderate interrater agreement for assignment of triage level to children presenting to a pediatric ED.ACADEMIC EMERGENCY MEDICINE 2008; 15:1262-1267

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“…More recently, Grafstein and colleagues found high reliability with PC-linked triage, in which each presenting complaint was linked to one or more specific CTAS levels, thus directing the triage nurse toward the preferred triage levels for each complaint type. 8,26 Using this approach, the study nurse performed the second triage while observing the duty nurse's triage assessment; they independently input their determination of the triage score into a computer. Although blinded to the duty nurse's triage score, the study nurse did not perform an independent assessment.…”

Section: Discussionmentioning

confidence: 99%

“…Maningas and colleagues found excellent reliability among independent users of the Soterion Rapid Triage System, a complaint-driven, algorithm-based computerized triage system. 26 Currently, clinical applications of all major nationally recognized triage systems, including CTAS, the Australasian Triage Scale, 27 the Emergency Severity Index in the United States 19,20 and the Manchester Triage Scale in the United Kingdom, 28 are based on training, memory and experience. In the current ED environment, triage nurses cannot be expected to refer to the paper version during actual clinical shifts or to accurately recall the entire contents from memory.…”

Section: Discussionmentioning

confidence: 99%

The effect of training on nurse agreement using an electronic triage system

Dong

Bullard

Meurer

et al. 2007

CJEM

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Objectives: Emergency department (ED) triage prioritizes patients based on urgency of care, and the Canadian Triage and Acuity Scale (CTAS) is the national standard. We describe the inter-rater agreement and manual overrides of nurses using a CTAS-compliant web-based triage tool (eTRIAGE) for 2 different intensities of staff training. Methods: This prospective study was conducted in an urban tertiary care ED. In phase 1, eTRIAGE was deployed after a 3-hour training course for 24 triage nurses who were asked to share this knowledge during regular triage shifts with colleagues who had not received training (n = 77). In phase 2, a targeted group of 8 triage nurses underwent further training with eTRIAGE. In each phase, patients were assessed first by the duty triage nurse and then by a blinded independent study nurse, both using eTRIAGE. Inter-rater agreement was calculated using kappa (weighted κ) statistics. Results: In phase 1, 569 patients were enrolled with 513 (90.2%) complete records; 577 patients were enrolled in phase 2 with 555 (96.2%) complete records. Inter-rater agreement during phase 1 was moderate (weighted κ = 0.55; 95% confidence interval [CI] 0.49-0.62); agreement improved in phase 2 (weighted κ = 0.65; 95% CI 0.60-0.70). Manual overrides of eTRIAGE scores were infrequent (approximately 10%) during both periods. Conclusions: Agreement between study nurses and duty triage nurses, both using eTRIAGE, was moderate to good, with a trend toward improvement with additional training. Triage overrides were infrequent. Continued attempts to refine the triage process and training appear warranted. RÉSUMÉObjectifs : Le triage à l'urgence attribue aux patients une priorité fondée sur l'urgence des soins nécessaires et l'Échelle canadienne de triage et de gravité (ECTG) constitue à cette fin la norme nationale. Nous décrivons la concordance entre évaluateurs et les dérogations manuelles des infirmières qui utilisent un outil de triage électronique conforme à l'ECTG (eTRIAGE) pour deux degrés différents de formation du personnel. Méthodes : Cette étude prospective a été réalisée au service d'urgence d'un établissement de soins tertiaires en milieu urbain. Au cours de la phase 1, on a déployé le système eTRIAGE après ORIGINAL RESEARCH • RECHERCHE ORIGINALE ADVANCES

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The Soterion Rapid Triage System: Evaluation of inter-rater reliability and validity

Cited by 31 publications

References 14 publications

Reliability of a Computerized Version of the Pediatric Canadian Triage and Acuity Scale

Reliability of a Computerized Version of the Pediatric Canadian Triage and Acuity Scale

Interrater Agreement between Nurses for the Pediatric Canadian Triage and Acuity Scale in a Tertiary Care Center

The effect of training on nurse agreement using an electronic triage system

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