• Louise Nissen, Hans Kirkegaard, Noel Perez, Ulf Hørlyk, and Louise P Larsen.
• Departments of aEmergency bOccupational Medicine, Regional Hospital of Herning, Herning cResearch Center for Emergency Medicine, University of Aarhus, Aarhus, Denmark.
• Eur J Emerg Med. 2014 Feb 1; 21 (1): 37-41.

ObjectiveThe purpose of this study was to evaluate the inter-rater agreement among nurses using the triage system RETTS-HEV (rapid emergency triage and treatment system - hospital unit west) in a Danish emergency department (ED).BackgroundThe use of triage systems in Denmark has been implemented recently together with structural changes in hospital organization. Testing and evaluation is therefore needed. The RETTS-HEV is a five-scale triage system being used in the ED of Herning, Denmark, since May 2010. The ED is semilarge, with 29 000 annual visits.Materials And MethodsConsecutive patients presenting to the ED were assessed by both a duty and a study nurse using RETTS-HEV. Nurses did not receive training before the study. In all, 146 patients were enroled and a blinded, paired and simultaneous triage was conducted independently to evaluate inter-rater agreement using Fleiss κ.ResultsA total of 155 patients were triaged over a 10-day period and complete data were available for 146 patients. We found the overall agreement to be good [Fleiss κ 0.60 (95% confidence interval 0.48; 0.72)]. The κ estimate was higher for the group of patients who required immediate attention [0.83 (95% confidence interval 0.18; 1.47)].ConclusionThe study found good inter-rater agreement between two independent observers not receiving any new triage training before the study.

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