Using the Delphi method to establish pediatric emergency triage criteria in a grade A tertiary women’s and children’s hospital in China

Zhao, Yingying; He, Lin; Hu, Juan; Zhao, Jing; Li, Mingxuan; Huang, Lisha; Jin, Quan; Wang, Lan; Wang, Jianxiong

doi:10.1186/s12913-022-08528-8

Cited by 4 publications

(1 citation statement)

References 24 publications

(18 reference statements)

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“…At present, emergency overcrowding and emergency detention has become a global problem, which also restricts the development of emergency care in our country [1] . In order to shorten the stay time of emergency department, the " ve-level triage method" is mostly used abroad at the present stage, such as American triage severity index (ESI), Canadian injury and urgency scale (CTAS) and Manchester triage system (MTS) [2][3][4][5] . However, most hospitals in China adopt the triage model of "four levels and three zones".…”

Section: Instructionmentioning

confidence: 99%

Discussion on the prediction model of early judgment of critical risk in emergency patients

Li,

Lv,

et al. 2024

Preprint

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Objective: To establish a predictive model for early assessment of critical risk in emergency patients and evaluate its clinical clinical benefits. Method: Clinical data of 3859 patients who visited the emergency department at Hebei General Hospital from November 2021 to December 2021 were selected. The enrolled patients were randomly divided into a training set (2703 cases) and a validation set (1156 cases) in a 7:3 ratio. In the training set, a predictive model was established based on the results of multivariate logistic stepwise regression analysis. At the same time, risk levels were divided, and the predictive efficacy and clinical benefits of the predictive model were verified. Result: There was no statistically significant difference in clinical data between the training and validation set (P>0.05), indicating comparability between the two groups. Multivariate logistic stepwise regression analysis showed that Gender, age, HR, R, SBP, SPO2, consciousness, pupil, mental state, and pain score were independent risk factors for early assessment of critical risk (P<0.05), and a predictive model was established based on this. Using conditional inference tree, critical risks are classified into low risk (P≤0.075), medium risk (0.075＜P≤0.656), and high risk (P>0.656). Furthermore, the prediction model was internally validated in both the training and validation sets, with a training set AUC of 0.926 [95% CI (0.912-0.939), P<0.001] and a validation set AUC of 0.911 [95% CI (0.886-0.936), P<0.001], indicating good discrimination of the prediction model; The calibration curve of the training set fits the standard curve, while the calibration curve of the validation set model slightly deviates from the standard curve. In the Hosmer Limeshow test, the results of the two groups were P=0.180 and P=0.546, respectively, indicating good calibration of the predicted model; The DCA curve suggests that both groups of people can achieve good clinical benefits. Conclusion: Establishing a predictive model for early assessment of emergency critical risk is helpful for early identification and intervention of emergency critical patients.

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Section: Instructionmentioning

confidence: 99%

Discussion on the prediction model of early judgment of critical risk in emergency patients

Li,

Lv,

et al. 2024

Preprint

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Patients’ expectancy scale of acupuncture: Development and clinical performance test

Yang,

Xia,

et al. 2023

Complementary Therapies in Clinical Practice

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Reliability and validity of Chengdu pediatric emergency triage criteria: case study of a single center in China

Zhao

et al. 2023

BMC Pediatr

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Background We aimed to examine the reliability and validity of Chengdu pediatric emergency triage criteria in order to provide a reference for the development of pediatric emergency triage within other hospitals. Methods We developed Chengdu pediatric emergency triage criteria based on the conditions/symptom, vital signs, and the Pediatric Early Warning Score system within our hospital using the Delphi method in 2020. The simulation scenario triage and real-life triage which were conducted in our hospital during January - March 2021, and the retrospective study of triage records extracted from our hospital’s health information system in February 2022, were used to measure the agreement in triage decisions between the triage nurses, and between the triage nurses and the expert team. Results For the 20 simulation cases, the Kappa value of triage decisions between the triage nurses was 0.6 (95% CI 0.352–0.849), and the Kappa value of triage decisions between the triage nurses and the expert team was 0.73 (95% CI 0.540–0.911). For the 252 cases in the real-life triage, the Kappa value of triage decisions between the triage nurses and the expert team was 0.824 (95% CI 0.680–0.962). For the 20,540 cases selected for the retrospective study of triage records, the Kappa value of triage decisions between the triage nurses was 0.702 (95% CI 0.691–0.713); that between Triage Nurse 1 and the expert team was 0.634 (95% CI 0.623–0.647); and that between Triage Nurse 2 and the expert team was 0.725 (95% CI 0.713–0.736). The overall agreement rate in triage decisions between the triage nurses and the expert team in the simulation scenario triage was 80%; that between the triage nurses and the expert team in the real-life triage was 97.6%; and that between the triage nurses in the retrospective study was 91.9%. In the retrospective study, the agreement rates in triage decisions between Triage Nurse 1 and the expert team, and between Triage Nurse 2 and the expert team, were 88.0% and 92.3%, respectively. Conclusion Chengdu pediatric emergency triage criteria that developed within our hospital is reliable and valid, and can promote rapid and effective triage by triage nurses.

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Using the Delphi method to establish pediatric emergency triage criteria in a grade A tertiary women’s and children’s hospital in China

Cited by 4 publications

References 24 publications

Discussion on the prediction model of early judgment of critical risk in emergency patients

Discussion on the prediction model of early judgment of critical risk in emergency patients

Patients’ expectancy scale of acupuncture: Development and clinical performance test

Reliability and validity of Chengdu pediatric emergency triage criteria: case study of a single center in China

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