EVALUATION OF THE ACCURACY OF THE EMERGENCY DEPARTMENT'S NURSES’ TRIAGE DECISION USING THE ESI SYSTEM

Abstract

Objective: Emergency triage is extremely important in reducing morbidity and mortality. The aim of this study is to compare the accuracy of triage categorization decisions of triage nurses with the Emergency Severity Index (ESI) system categorization determined after the emergency room evaluation of patients. Materials and Method: In this descriptive, cross-sectional study, patients who were admitted to Akdeniz University Hospital Emergency Service Adult Triage Area between 01-14 March 2018 and then admitted to the emergency department were evaluated retrospectively. Results: Triage scores of 3324 patients were analyzed. The kappa concordance value between the score of the triage nurse and the scores of the physicians using ESI was found to be 0.416. It was determined that the triage staff gave a triage score 1/4 lower than the ESI. In the presence of tachypnea, an increase in the low triage rate and a decrease in the high triage rate of the patients were found. It was determined that the most accurate triage scores were given in nephrological and cardiovascular disorders. The most faulty triage decisions were eye disorders and oncological emergencies. In patients between the ages of 18-65, statistically significantly higher triage was performed. Patients with chronic diseases and a history of continuous drug use were given lower triage. Conclusion: In order to increase the accuracy of triage, it is necessary to increase the medical knowledge of the triage nurse and to provide practical training especially on real cases with a triage score of 2-4.