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类风湿病患者优先排序分诊系统的评估

Evaluation of a rheumatology patient prioritization triage system.

作者信息

Layton Katharine, Tovar Elizabeth, Wiggins Amanda T, Rayens Mary Kay, Salt Elizabeth

机构信息

University of Kentucky.

College of Nursing, University of Kentucky.

出版信息

J Am Assoc Nurse Pract. 2016 Oct;28(10):541-545. doi: 10.1002/2327-6924.12367. Epub 2016 Apr 20.

Abstract

PURPOSE

Patient triage systems have been used to prioritize referred patients to facilitate timely treatment of acutely ill patients, but there is limited data to support the effectiveness of these systems as implemented in the clinic setting. Therefore, the purpose of this study was to evaluate the accuracy of a specialty provider triage system.

DATA SOURCES

A prospective study design was conducted (N = 103) to compare the pre- and postappointment provider-assigned, prioritization system acuity scores. The intraclass correlation coefficient (ICC), paired t-test, and the Bland-Altman plotting method were used to summarize and analyze the data.

CONCLUSIONS

The ICC between the pre- and postappointment acuity scores was 0.50 (p < .001) with no significant difference between the average means (t = -1.17; p = .24). The Bland-Altman plot suggests scores were typically within the limits of agreement. Our findings suggest the specialty provider triage system was effective at accurately classifying rheumatologic patient acuity in this sample.

IMPLICATIONS FOR PRACTICE

When resources are limited and delayed evaluations and treatments result in negative health outcomes, the use of triage systems is likely an effective strategy to reduce the impact of limited provider availability relative to patient census.

摘要

目的

患者分诊系统已被用于对转诊患者进行优先级排序,以促进对急症患者的及时治疗,但在临床环境中实施这些系统有效性的数据有限。因此,本研究的目的是评估专科医生分诊系统的准确性。

数据来源

进行了一项前瞻性研究设计(N = 103),以比较预约前后医生指定的优先级系统 acuity 评分。使用组内相关系数(ICC)、配对 t 检验和 Bland-Altman 绘图方法对数据进行汇总和分析。

结论

预约前后 acuity 评分之间的 ICC 为 0.50(p <.001),平均均值之间无显著差异(t = -1.17;p =.24)。Bland-Altman 图表明评分通常在一致性界限内。我们的研究结果表明,专科医生分诊系统在准确分类该样本中的风湿病患者 acuity 方面是有效的。

对实践的启示

当资源有限且延迟评估和治疗会导致负面健康结果时,使用分诊系统可能是一种有效的策略,以减少相对于患者数量而言有限的医生可用性的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8029/5543331/e7b1ef18e5ba/nihms883780f1.jpg

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