Reproducibilidad del sistema de triaje pediátrico TRIPED-GM

IF 1.1 Q4 NURSING

Enfermeria Clinica Pub Date : 2025-05-01 DOI:10.1016/j.enfcli.2025.502191

M. Concepción Míguez-Navarro , Gloria Guerrero-Márquez , Carmen Ignacio Cerro

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引用次数: 0

Abstract

Introduction

The triage system aims to determine the level of urgency of patients in order to provide appropriate care and reduce morbidity and mortality. It is essential that the system used is valid, reliable and easy to use. The TRIPED-GM system is a five-level classification system exclusively for pediatric age, which includes 6 steps, 3 of which are mandatory (PAT, guiding sign/symptom, and priority rectifiers).

Objective

To determine the reproducibility of the TRIPED-GM system when used on patients evaluated consecutively by 2 nurses.

Method

Observational, descriptive, cross-sectional study involving 237 patients under 16 years of age who attended a third-level pediatric emergency service. Reliability was measured using kappa (κ), lineal kappa (κp), and quadratic kappa (κp²) índices, which compared the priority assigned by 2 research nurses and 16 paediatric emergency nurses with over a year of experience in triage. Patients were classified consecutively and blindly.

Results

There was agreement in 221 (93.2%) patients. The overall concordance was: κ = 0.84 (95%CI: 0.77-0.91), κp = 0.85 (95%CI: 0.78-0.92), κp² = 0.85 (95%CI: 0.78-0.92). There were no differences in the assignment of more than one priority level in any patient. Concordance in the mandatory steps was: Pediatric Assessment Triangle: κ = 0.82 (95%CI: 0.68-0.96), Main reason for consultation: κ = 0.76 (95%CI: 0.62-0.89), Rectifiers: κ = 0.94 (95%CI: 0.88-1). Concordance was higher in patients who consulted for illness compared to those for trauma/accidents: κ = 0.84 (95%CI: 0.76-0.92) vs. κ = 0.79 (95%CI: 0.57-1).

Conclusion

The TRIPED-GM pediatric triage system is reliable for use in emergency services with patients of similar characteristics.

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TRIPED-GM儿童分拣系统的可重复性

分诊系统旨在确定患者的紧急程度，以便提供适当的护理，降低发病率和死亡率。系统的有效性、可靠性和易用性是至关重要的。TRIPED-GM系统是一个专门针对儿童年龄的五级分类系统，包括6个步骤，其中3个是强制性的（PAT、指导性体征/症状和优先纠正）。目的探讨TRIPED-GM系统在2名护士连续评价患者时的可重复性。方法采用观察性、描述性、横断面研究，纳入237例16岁以下的三级儿科急诊患者。信度采用kappa （κ）、线性kappa （κp）和二次kappa （κp2） índices进行测量，比较2名研究护士和16名具有一年以上分诊经验的儿科急诊护士分配的优先级。患者按顺序盲目分类。结果221例（93.2%）患者的结论一致。整体和谐是:κ= 0.84(95%置信区间:0.77—-0.91),κp = 0.85(95%置信区间:0.78—-0.92),κp2 = 0.85(95%置信区间:0.78—-0.92)。在任何患者中，分配一个以上的优先级没有差异。强制性步骤的一致性为：儿童评估三角：κ = 0.82 (95%CI: 0.68-0.96)，主要咨询原因：κ = 0.76 (95%CI: 0.62-0.89)，整改因素：κ = 0.94 （95%CI: 0.88-1）。与创伤/意外事故患者相比，疾病患者的一致性更高：κ = 0.84 （95%CI: 0.76-0.92）比κ = 0.79 （95%CI: 0.57-1）。结论TRIPED-GM儿科分诊系统适用于具有相似特点的急诊科。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Enfermeria Clinica NURSING-

CiteScore

2.00

自引率

0.00%

发文量

期刊介绍： Enfermería Clínica is a peer-reviewed scientific journal that is a useful and necessary tool for nursing professionals from the different areas of nursing (healthcare, administration, education and research) as well as for healthcare professionals involved in caring for persons, families and the community. It is the only Spanish nursing journal that mainly publishes original research. The aim of the Journal is to promote increased knowledge through the publication of original research and other studies that may help nursing professionals improve their daily practice. This objective is pursued throughout the different sections that comprise the Journal: Original Articles and Short Original Articles, Special Articles, Patient Care and Letters to the Editor. There is also an Evidence-Based Nursing section that includes comments about original articles of special interest written by experts.