First evaluation of the paediatric version of the Swedish rapid emergency triage and treatment system shows good reliability

Abstract

Aim: To investigate the reliability of Retts-p, Rapid emergency triage and treatment system-paediatric, with regard to inter-rater and intra-rater agreement.

Method: Twenty nurses responsible for triaging both children and adults at the Emergency Department, Östersund County Hospital, Sweden, were randomly selected to take part in the study. The nurses were asked to use the Retts-p triage system to retrospectively assess the written case reports on 40 paediatric cases, aged from 6 month to 17.5 years, who attended the Emergency Department in 2010 with surgical, orthopaedic and medical symptoms. Using the information provided regarding appearance, symptoms, previous medical history and vital signs, the nurses selected the most appropriate Emergency Symptoms and Signs algorithm and placed the child in one of the five triage categories. Two test rounds were performed, 3 months apart, using the same cases, to study both the inter-rater and intra-rater agreement for the priority level and the triage algorithm chosen by the triage nurses.

Results: Good to very good agreement were shown for both inter-rater (quadratic κw 0.86, 95% CI 0.85-0.87) and intra-rater testing (quadratic κw 0.92, 95% CI 0.88-0.96).

Conclusion: Retts-p provided good to very good reliability in this first evaluation study of the triage system.

Keywords: Emergency; Paediatric; Reliability; Retts-p; Triage.