Evaluation of Emergency Triage Using a Computerized Simulator

Study Overview
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Brief Summary
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A four-level triage scale (the Geneva Emergency Triage Scale, GETS) has been used since 1997 in our emergency department (ED). A recent evaluation of this scale showed that our instrument had an excellent intra-rater reliability but insufficient inter-rater reliability. We also observed a wide variability in the way triage nurses perform (J Clin Epidemiology, 2006 in press). These variations in the triage process are mainly explained by a poor standardization of vital signs measurement. Therefore, we have recently modified our triage instrument and introduced explicit criteria for vital signs evaluation during the triage process. The objectives of this study are: To evaluate the inter- and intra-rater reliability of our modified triage scale using a computer simulator To measure the impact of visual clues on the triage decisions when using the triage simulator To evaluate the performance of triage nurses and chief physicians in their triage decisions. We expect to observe: an improvement of the inter-rater reliability of our instrument compared to the previous version a better standardization and more systematic use of vital signs measurement a higher reliability when visual clues are given to the evaluator lower rates of under- and over-estimation of emergency levels.

Detailed Description
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A four-level triage scale (the Geneva Emergency Triage Scale, GETS) has been used since 1997 in our emergency department (ED). A recent evaluation of this scale showed that our instrument had an excellent intra-rater reliability but insufficient inter-rater reliability. We also observed a wide variability in the way triage nurses perform (J Clin Epidemiology, 2006 in press). These variations in the triage process are mainly explained by a poor standardization of vital signs measurement. Therefore, we have recently modified our triage instrument and introduced explicit criteria for vital signs evaluation during the triage process. The objectives of this study are: To evaluate the inter- and intra-rater reliability of our modified triage scale using a computer simulator To measure the impact of visual clues on the triage decisions when using the triage simulator To evaluate the performance of triage nurses and chief physicians in their triage decisions. We expect to observe: an improvement of the inter-rater reliability of our instrument compared to the previous version a better standardization and more systematic use of vital signs measurement a higher reliability when visual clues are given to the evaluator lower rates of under- and over-estimation of emergency levels.

Official Title
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Evaluation of a Four-Level Triage Scale (the Geneva Emergency Triage Scale) Using a Computer Triage Simulator

Conditions
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Emergencies

Intervention / Treatment
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* Behavioral: Visual clues


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Triage nurses Emergency physicians

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Behavioral: Visual clues|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Inter-rater and intra-rater reliability |  |  | 
| Performance of evaluators |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Impact of visual clues on reliability |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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triage