Implementating the Emergency Severity Index Triage System in the Homeland of Hippocrates

2.50
Hdl Handle:
http://hdl.handle.net/10755/162972
Type:
Presentation
Title:
Implementating the Emergency Severity Index Triage System in the Homeland of Hippocrates
Abstract:
Implementating the Emergency Severity Index Triage System in the Homeland of Hippocrates
Conference Sponsor:Emergency Nurses Association
Conference Year:2005
Author:Kyranou, Maria, RN, MSc
P.I. Institution Name:Papageorgiou General Hospital (UCSF School of Nursing)
Title:Emergency Nurse
Department of Nursing Education & Continuous Development
Contact Address:, Thessaloniki, Greece
Co-Authors:Chouta Athanasia; Georgiadis Georgios; Oulousidis Dimitris; Tsiviki Anastasia
Purpose: Different triage systems have been developed and implemented in emergency departments, including the Australian National Triage Scale, the Canadian Triage and Acuity Scale, the Manchester Triage System, and the Emergency Severity Index (ESI). Implementation of a new triage system depends on strengths and weaknesses of available systems as well as organizational and cultural characteristics of an emergency department (ED). The purpose of this study was to evaluate the implementation of the ESI system in an emergency department in Greece by comparing an early phase of implementation to a later phase. Design: This retrospective, descriptive study examined patient records and hospital reports as well as nurses? interviews. Descriptive and inferential statistics were used for analyses. Setting: The study was conducted at an emergency department of a large tertiary, teaching hospital in Thessaloniki, Greece. This emergency department is one of eight departments that provide emergency and trauma care to 2,000,000 citizens. At any given time, on an alternating schedule, only two of the eight emergency departments operate 24 hours a day, and this results in overcrowded waiting rooms. Sample: During the study period from November 2, 2003 to September 30, 2004, 50,410 patients visited the emergency department and their patient records were reviewed retrospectively. The sample was divided into two groups. The first group included all patients who visited the emergency department in the first two months of the study period (n = 5,905), which was during the initial stage of ESI implementation (Phase I). The second group included all patients who visited the emergency department during the remainder of the study period (n = 44,505) (Phase II). Methodology: Patients? records and hospital reports were screened for predictive validity outcomes associated with triage levels for both study phases so that comparisons could be made. In addition, data were gathered and comparisons were made related to admission rates, length of stay, mortality at triage, and patients leaving the emergency department after triage. Reliability of the ESI system was tested by measuring inter-rater agreement and test-retest agreement among 15 triage nurses who had at least one year of experience in triage guidelines at the hospital. Results: The following results pertain to Phase I - Phase II and triage categories 1 through 5. Admission rates: (1)100% - 100%, (2) 64.3% - 89.2%, (3) 22.8% - 33.6%, (4) 4.9% - 2.6%, and (5) 2.4% - 0.38%. Length of stay in minutes: (1) 1 - 1, (2) 4 - 4, (3) 24 - 17, (4) 72 - 62, and (5) 91 - 69. Mortality: 0.2% - 0.08%. Number of patients leaving the emergency department after triage: 4.47% - 3.18%. Inter-rater agreement: 88.5% - 84.5%. Test-retest agreement: 92% - 96%. Conclusions: Utilization of a newly implemented ESI system was shown to be reliable and valid in this Greek emergency department. Outcomes improve with experience and through continuous follow-up during the implementation process.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImplementating the Emergency Severity Index Triage System in the Homeland of Hippocratesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162972-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Implementating the Emergency Severity Index Triage System in the Homeland of Hippocrates</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Kyranou, Maria, RN, MSc</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Papageorgiou General Hospital (UCSF School of Nursing)</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Emergency Nurse<br/>Department of Nursing Education &amp; Continuous Development<br/></td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, Thessaloniki, Greece</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">mkyranou@itsa.ucsf.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Chouta Athanasia; Georgiadis Georgios; Oulousidis Dimitris; Tsiviki Anastasia<br/></td></tr><tr><td colspan="2" class="item-abstract">Purpose: Different triage systems have been developed and implemented in emergency departments, including the Australian National Triage Scale, the Canadian Triage and Acuity Scale, the Manchester Triage System, and the Emergency Severity Index (ESI). Implementation of a new triage system depends on strengths and weaknesses of available systems as well as organizational and cultural characteristics of an emergency department (ED). The purpose of this study was to evaluate the implementation of the ESI system in an emergency department in Greece by comparing an early phase of implementation to a later phase. Design: This retrospective, descriptive study examined patient records and hospital reports as well as nurses? interviews. Descriptive and inferential statistics were used for analyses. Setting: The study was conducted at an emergency department of a large tertiary, teaching hospital in Thessaloniki, Greece. This emergency department is one of eight departments that provide emergency and trauma care to 2,000,000 citizens. At any given time, on an alternating schedule, only two of the eight emergency departments operate 24 hours a day, and this results in overcrowded waiting rooms. Sample: During the study period from November 2, 2003 to September 30, 2004, 50,410 patients visited the emergency department and their patient records were reviewed retrospectively. The sample was divided into two groups. The first group included all patients who visited the emergency department in the first two months of the study period (n = 5,905), which was during the initial stage of ESI implementation (Phase I). The second group included all patients who visited the emergency department during the remainder of the study period (n = 44,505) (Phase II). Methodology: Patients? records and hospital reports were screened for predictive validity outcomes associated with triage levels for both study phases so that comparisons could be made. In addition, data were gathered and comparisons were made related to admission rates, length of stay, mortality at triage, and patients leaving the emergency department after triage. Reliability of the ESI system was tested by measuring inter-rater agreement and test-retest agreement among 15 triage nurses who had at least one year of experience in triage guidelines at the hospital. Results: The following results pertain to Phase I - Phase II and triage categories 1 through 5. Admission rates: (1)100% - 100%, (2) 64.3% - 89.2%, (3) 22.8% - 33.6%, (4) 4.9% - 2.6%, and (5) 2.4% - 0.38%. Length of stay in minutes: (1) 1 - 1, (2) 4 - 4, (3) 24 - 17, (4) 72 - 62, and (5) 91 - 69. Mortality: 0.2% - 0.08%. Number of patients leaving the emergency department after triage: 4.47% - 3.18%. Inter-rater agreement: 88.5% - 84.5%. Test-retest agreement: 92% - 96%. Conclusions: Utilization of a newly implemented ESI system was shown to be reliable and valid in this Greek emergency department. Outcomes improve with experience and through continuous follow-up during the implementation process.</td></tr></table>en_GB
dc.date.available2011-10-27T10:37:20Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:37:20Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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