Assessing the Accuracy of Nurse Triage in Emergency Department of Shahid Bahonar Hospital of Kerman: A Cross-Sectional Study

Triage is the process of assessing and categorizing patients to improve management and service delivery. A reliable triage system should be capable of accurately identifying patients who require immediate medical attention. The emergency severity index (ESI) is currently the most widely used method for triage, and it is a validated triage system. This study aimed to assess the ability of emergency department nurses to triage patients utilizing ESI.

A cross-sectional study was conducted on 272 patients who were referred to the emergency department (ED) of Shahid Bahonar Hospital of Kerman in July 2022. The triage of the patients was performed by emergency nurses, and the results were compared with those determined by physicians. Cohen's kappa coefficient was evaluated between the two groups (nurses and physicians) to determine the inter-rater agreement.

The triage group was correctly identified for 72.1% (196) of the 272 patients, while 13.6% (37) were under-triaged and 14.3% (39) were over-triaged. The priority was accurate for only 56.6% of patients, and 7.1% of patients received a lower priority. The agreement level between the two groups was 60.5% (95% CI: 0.532-0.677) measured by the kappa coefficient.

In this study, the agreement that was found in terms of patients’ triage was average. Although the triage was more inefficient than risky, long-term training programs are highly recommended for enhancing the accuracy of the triage.