2.50
Hdl Handle:
http://hdl.handle.net/10755/163041
Type:
Presentation
Title:
Reliability of the Emergency Severity Index in the Pediatric Population
Abstract:
Reliability of the Emergency Severity Index in the Pediatric Population
Conference Sponsor:Emergency Nurses Association
Conference Year:2004
Author:Brecher, Deena, BSN, RN, CEN, MSN
P.I. Institution Name:University of Texas, School of Nursing
Title:Clinical Nurse Specialist
Contact Address:2129 El Paseo Street, #405, Houston, TX, 77054, USA
Purpose: The Emergency Severity Index (ESI), a five-level triage system, was published in 1999 as a reliable
and valid triage algorithm for patients over 14 years of age. The purpose of this study was to examine
whether or not the ESI (version 3), could be used to accurately triage pediatric patients into appropriate
triage acuity levels. The process of triage was examined from a systems theory perspective.
Design: A prospective, correlational design was used.
Setting: This study was conducted in a 59-bed emergency department with 80,000 visits per year, located
in an urban tertiary pediatric teaching hospital in a southern state.
Sample: A convenience sample of 168 triage assessments in patients 14 years of age or younger was
obtained. The sample had a mean age of 2 years old, was 45% Hispanic, and 58% male. Four out of five of
the triage acuity levels were represented (Levels 2-5).
Methodology: Four physicians volunteered to participate in the study. Prior to the start of data collection,
the research nurse and the four physicians were educated about ESI. Competency scenarios were evaluated
until there was 100% agreement. The research nurse worked with one physician per shift. Patients were
triaged by the research nurse who utilized the ESI algorithm to assign a triage acuity ranging from 1-5.
Within a mean time of 19 minutes, the physician read the triage note, observed the patient, and then
assigned an acuity using ESI. The physician was blinded to the research nurse's acuity until he/she revealed
his/her own. If there was disagreement, reasons for disagreement were recorded. Length of stay and disposition
were also recorded.
Results: Although a convenience sample was utilized, the sample was representative of the population
treated in that emergency center during the two weeks of data collection with respect to age, gender, and
ethnicity. Twenty-one level 2 patients, 29 level 3 patients, 38 level 4 patients, and 80 level 5 patients were
reported. Inter-rater agreement between the physician and the research nurse was excellent with a kappa
of .85. Using a chi-square analysis, a statistically significant association (p < .05) existed between triage acuity
and length of stay as well as triage acuity and disposition. Odds ratio analysis revealed that level two
patients were 7.5 times more likely than level five patients to stay greater than four hours. Level two
patients were 41.7 times more likely to be admitted than level five patients were.
Conclusions: Initial evidence supports the reliability of the ESI algorithm in this sample of pediatric
patients. Additional research is warranted to determine whether this reliability can be reproduced in other
pediatric or general emergency departments.
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.titleReliability of the Emergency Severity Index in the Pediatric Populationen_GB
dc.identifier.urihttp://hdl.handle.net/10755/163041-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Reliability of the Emergency Severity Index in the Pediatric Population</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">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Brecher, Deena, BSN, RN, CEN, MSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Texas, School of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Nurse Specialist</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2129 El Paseo Street, #405, Houston, TX, 77054, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">dbrecher@sbcglobal.net</td></tr><tr><td colspan="2" class="item-abstract">Purpose: The Emergency Severity Index (ESI), a five-level triage system, was published in 1999 as a reliable<br/>and valid triage algorithm for patients over 14 years of age. The purpose of this study was to examine<br/>whether or not the ESI (version 3), could be used to accurately triage pediatric patients into appropriate<br/>triage acuity levels. The process of triage was examined from a systems theory perspective.<br/>Design: A prospective, correlational design was used.<br/>Setting: This study was conducted in a 59-bed emergency department with 80,000 visits per year, located<br/>in an urban tertiary pediatric teaching hospital in a southern state.<br/>Sample: A convenience sample of 168 triage assessments in patients 14 years of age or younger was<br/>obtained. The sample had a mean age of 2 years old, was 45% Hispanic, and 58% male. Four out of five of<br/>the triage acuity levels were represented (Levels 2-5).<br/>Methodology: Four physicians volunteered to participate in the study. Prior to the start of data collection,<br/>the research nurse and the four physicians were educated about ESI. Competency scenarios were evaluated<br/>until there was 100% agreement. The research nurse worked with one physician per shift. Patients were<br/>triaged by the research nurse who utilized the ESI algorithm to assign a triage acuity ranging from 1-5.<br/>Within a mean time of 19 minutes, the physician read the triage note, observed the patient, and then<br/>assigned an acuity using ESI. The physician was blinded to the research nurse's acuity until he/she revealed<br/>his/her own. If there was disagreement, reasons for disagreement were recorded. Length of stay and disposition<br/>were also recorded. <br/>Results: Although a convenience sample was utilized, the sample was representative of the population<br/>treated in that emergency center during the two weeks of data collection with respect to age, gender, and<br/>ethnicity. Twenty-one level 2 patients, 29 level 3 patients, 38 level 4 patients, and 80 level 5 patients were<br/>reported. Inter-rater agreement between the physician and the research nurse was excellent with a kappa<br/>of .85. Using a chi-square analysis, a statistically significant association (p &lt; .05) existed between triage acuity<br/>and length of stay as well as triage acuity and disposition. Odds ratio analysis revealed that level two<br/>patients were 7.5 times more likely than level five patients to stay greater than four hours. Level two<br/>patients were 41.7 times more likely to be admitted than level five patients were.<br/>Conclusions: Initial evidence supports the reliability of the ESI algorithm in this sample of pediatric<br/>patients. Additional research is warranted to determine whether this reliability can be reproduced in other<br/>pediatric or general emergency departments.</td></tr></table>en_GB
dc.date.available2011-10-27T10:38:33Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:38:33Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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