Clinical trial NCT00321243: Evaluation of Emergency Triage Using a Computerized Simulator
Official title: Evaluation of a Four-Level Triage Scale (the Geneva Emergency Triage Scale) Using a Computer Triage Simulator
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Emergencies
Keywords: triage
Lead sponsor: University Hospital, Geneva
Sponsor class: OTHER
First posted: 2006-05-03
Enrollment: 150
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL

Brief summary: 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: 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.

Eligibility criteria: Inclusion Criteria:

* Triage nurses
* Emergency physicians

Primary outcomes:
measure: Inter-rater and intra-rater reliability
measure: Performance of evaluators
Secondary outcomes:
measure: Impact of visual clues on reliability
Other outcomes:
Locations:
city: Geneva
country: Switzerland
facility: Geneva University Hospitals
Study officials:
affiliation: University Hospital, Geneva
name: Olivier T Rutschmann, MD, MPH
role: PRINCIPAL_INVESTIGATOR
References: