Ghanbarzehi Nezare, Balouchi Abbas, Sabzevari Sakineh, Darban Fatemeh, Khayat Nastaran Haydari
Msc of Nursing, Department of Nursing, Iranshahr University of Medical Sciences , Iranshahr, Iran .
Msc Nursing, Department of Nursing, Zabol University of Medical Sciences , Zabol, Iran .
J Clin Diagn Res. 2016 May;10(5):IC05-IC07. doi: 10.7860/JCDR/2016/20328.7866. Epub 2016 May 1.
The transfer of care occurs frequently between emergency medical technicians and emergency ward nurses during which emergency medical technicians transfer the patients from the society to the hospital. This transfer of care often occurs under crowded conditions and in high acuity which would pave the way for a disruption of communication.
This study aimed to investigate the effect of training Emergency Severity Index (ESI) triage on concordance of triage level between emergency medical technicians and triage nurses.
This interventional study was conducted on all triage nurses and emergency medical technicians in Iranshahr City in winter of 2014. Five triage nurses and 30 emergency medical technicians were included into the study using census. To collect data, Personal Information Form (PIF) and ESI Triage Criterion were used. During the project implementation, patients were separately classified before and after triage training by emergency medical technicians and triage nurses. To analyse the data, kappa coefficient under SPSS 16 statistical software was used.
According to the study results, Cohen's kappa concordance coefficient showed that triage concordance between emergency medical technicians and triage nurses before training was 0.20 which was at an unfavorable level. After training, Cohen's kappa concordance coefficient reached 0.62, which showed a desirable level of concordance as well as a significant difference after training.
It is recommended to train and use common triage system to facilitate transfer or delivery of care between emergency medical technicians and triage nurses.
在紧急医疗技术人员和急诊病房护士之间，护理交接频繁发生，在此期间，紧急医疗技术人员将患者从社会环境转送至医院。这种护理交接通常在拥挤的环境和高急症情况下进行，这可能会导致沟通中断。
本研究旨在调查培训急诊严重程度指数（ESI）分诊对紧急医疗技术人员和分诊护士之间分诊水平一致性的影响。
本干预性研究于2014年冬季在伊朗沙赫尔市的所有分诊护士和紧急医疗技术人员中进行。采用普查法，纳入了5名分诊护士和30名紧急医疗技术人员。为收集数据，使用了个人信息表（PIF）和ESI分诊标准。在项目实施过程中，紧急医疗技术人员和分诊护士在分诊培训前后分别对患者进行分类。使用SPSS 16统计软件中的kappa系数进行数据分析。
根据研究结果，Cohen's kappa一致性系数显示，培训前紧急医疗技术人员和分诊护士之间的分诊一致性为0.20，处于不利水平。培训后，Cohen's kappa一致性系数达到0.62，显示出理想的一致性水平，且培训后有显著差异。
建议培训并使用通用的分诊系统，以促进紧急医疗技术人员和分诊护士之间护理的交接或传递。
