分诊护士能够有效且可靠地评估急诊科患者的复杂程度。
Triage nurses validly and reliably estimate emergency department patient complexity.
作者信息
Vance Jenny, Sprivulis Peter
机构信息
Emergency Department, Fremantle Hospital, Fremantle, Western Australia, Australia.
出版信息
Emerg Med Australas. 2005 Aug;17(4):382-6. doi: 10.1111/j.1742-6723.2005.00761.x.
OBJECTIVE
To access the validity and reliability of triage nurse estimates of ED patient complexity.
METHODS
Prospective, single-blinded evaluation of triage nurse estimates of patient complexity, where a high-complexity patient is defined as a patient requiring two or more procedures or investigations or consultations. Validity of complexity estimates was assessed by comparison with the number of actual procedures, investigations and consultations requested. Reliability of triage nurse estimates of complexity was assessed by comparison with assessment nurse estimates of complexity.
RESULTS
The specific proportion of agreement and spearman correlation coefficient of triage nurse estimates of complexity with actual procedure, investigations and consultation use were 0.83 (95% confidence interval [CI] 0.79-0.88) and 0.59 (95% CI 0.51-0.66), respectively. The specific proportion of agreement and kappa of triage nurse estimates of complexity with assessment nurse estimates were 0.80 (95% CI 0.73-0.87) and 0.59 (95% CI 0.47-0.71), respectively.
CONCLUSIONS
Triage nurses make valid and reliable estimates of patient complexity. This information might be used to guide ED work flow and ED casemix system analysis.
目的
评估分诊护士对急诊患者病情复杂程度评估的有效性和可靠性。
方法
对分诊护士对患者病情复杂程度的评估进行前瞻性、单盲评估，其中高病情复杂程度患者定义为需要两项或更多项检查、检验或会诊的患者。通过与实际要求的检查、检验和会诊数量进行比较，评估病情复杂程度评估的有效性。通过与评估护士对病情复杂程度的评估进行比较，评估分诊护士对病情复杂程度评估的可靠性。
结果
分诊护士对病情复杂程度的评估与实际检查、检验和会诊使用情况的一致性具体比例及Spearman相关系数分别为0.83（95%置信区间[CI]0.79 - 0.88）和0.59（95%CI 0.51 - 0.66）。分诊护士对病情复杂程度的评估与评估护士评估的一致性具体比例及kappa值分别为0.80（95%CI 0.73 - 0.87）和0.59（95%CI 0.47 - 0.71）。
结论
分诊护士对患者病情复杂程度的评估是有效且可靠的。该信息可用于指导急诊工作流程及急诊病例组合系统分析。
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