Scandinavian journal of caring sciences
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Multicenter Study Clinical Trial
Accuracy and concordance of nurses in emergency department triage.
In the emergency department (ED) Registered Nurses (RNs) often perform triage, i.e. the sorting and prioritizing of patients. The allocation of acuity ratings is commonly based on a triage scale. To date, three reliable 5-level triage scales exist, of which the Canadian Triage and Acuity Scale (CTAS) is one. ⋯ Of the 7,550 triage ratings, 57.6% were triaged in concordance with the expected outcome and no scenario was triaged into the same triage level by all RNs. Inter-rater agreement for all RNs was kappa = 0.46 (unweighted) and kappa = 0.71 (weighted). The fact that the kappa-values are only moderate to good and the low concordance between the RNs call for further studies, especially from a patient safety perspective.
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The purpose of the study was to determine the feasibility of conducting a family level intervention study in a clinical setting: (a) by evaluating nurses' and families' attitude towards the intervention and (b) assess the impact of the intervention on parents' wellbeing, coping behaviour, hardiness and adaptation. The research is descriptive-longitudinal and took place at the Children's Hospital of the Landspitali University Hospital in Reykjavik, Iceland. Eight nurses working at the Children's Hospital and 10 families of children and adolescents newly diagnosed with cancer participated in the study. ⋯ Both mothers and fathers scored significantly higher on wellbeing after the intervention than before, but no significant difference was found in coping, hardiness or adaptation. Offering an educational and support intervention in a clinical setting for families of children and adolescents newly diagnosed with cancer can be feasible. Researchers and clinicians may want to enhance the intervention, test it on a bigger sample and with a control group.