Tomás Hernández Ruipérez1, César Leal Costa2, María de Gracia Adánez Martínez3, Bartolomé García Pérez4, Daniel Nova López5, José Luis Díaz Agea6. 1. Servicio de Urgencias. Hospital Clínico Universitario Virgen de la Arrixaca. Simulación Clínica. Murcia, España. 2. Unidad Simulación Clínica. Facultad de Enfermería. Universidad Católica de Murcia (UCAM). Murcia, España. 3. Servicio de Urgencias. Hospital Clínico Universitario Virgen de la Arrixaca. Simulación Clínica. Facultad de Enfermería. Universidad Católica de Murcia (UCAM). Murcia, España. 4. Unidad de Corta Estancia. Hospital Clínico Universitario Virgen de la Arrixaca. Facultad de Ciencias de la Salud. Universidad Católica de Murcia (UCAM). Murcia, España. 5. Servicio de Urgencias. Hospital Clínico Universitario Virgen de la Arrixaca. Murcia, España. 6. Facultad de Enfermería. Universidad Católica de Murcia (UCAM). Murcia, España.
Abstract
OBJECTIVES: To determine whether the Emergency Severity Index (ESI) is valid for triage according to evidence based on classifying real patients in a general referral hospital's emergency department. MATERIAL AND METHODS: Observational, cross-sectional descriptive study carried out in the emergency department of Hospital Clínico Universitario Virgen de la Arrixaca in Murcia. Thirty-two nurses used the ESI algorithm to triage 410 patients as they arrived seeking care. The results were compared to a gold standard (a triage expert's opinion, which was later confirmed by an expert committee after discussion, if necessary, of cases for which opinions were not unanimous). We calculated sensitivity, specificity, under- and over-triage rates, as well as descriptive statistics about resource assignment, exitus, patients who left without being seen, destination on discharge, and times. RESULTS: ESI was highly correlated with resources (ρ = -0.717, P < .01) and moderately correlated with destination on discharge (ρ = -0.437, P < .01). Regarding time spent in the department, we found that patients assigned ESI levels 1 and 2 had significantly longer stays, and those assigned ESI levels 4 and 5 had significantly shorter stays (p < 0,001). Interobserver agreement was good or very good, indicating that this triage tool is reliable. CONCLUSION: This pilot of the ESI triage algorithm in the emergency department of a referral hospital found evidence supporting the system's validity.
OBJECTIVES: To determine whether the Emergency Severity Index (ESI) is valid for triage according to evidence based on classifying real patients in a general referral hospital's emergency department. MATERIAL AND METHODS: Observational, cross-sectional descriptive study carried out in the emergency department of Hospital Clínico Universitario Virgen de la Arrixaca in Murcia. Thirty-two nurses used the ESI algorithm to triage 410 patients as they arrived seeking care. The results were compared to a gold standard (a triage expert's opinion, which was later confirmed by an expert committee after discussion, if necessary, of cases for which opinions were not unanimous). We calculated sensitivity, specificity, under- and over-triage rates, as well as descriptive statistics about resource assignment, exitus, patients who left without being seen, destination on discharge, and times. RESULTS: ESI was highly correlated with resources (ρ = -0.717, P < .01) and moderately correlated with destination on discharge (ρ = -0.437, P < .01). Regarding time spent in the department, we found that patients assigned ESI levels 1 and 2 had significantly longer stays, and those assigned ESI levels 4 and 5 had significantly shorter stays (p < 0,001). Interobserver agreement was good or very good, indicating that this triage tool is reliable. CONCLUSION: This pilot of the ESI triage algorithm in the emergency department of a referral hospital found evidence supporting the system's validity.
Entities:
Keywords:
ESI; Emergency Severity Index; Enfermería; Hospital emergency health services; Nursing; Servicio de urgencias hospitalario; Triage; Triaje
Authors: Luis Miguel Cairós-Ventura; Maria de Las Mercedes Novo-Muñoz; José Ángel Rodríguez-Gómez; Ángela María Ortega-Benítez; Elena María Ortega-Barreda; Armando Aguirre-Jaime Journal: Int J Environ Res Public Health Date: 2019-11-18 Impact factor: 3.390