The assessment of concordance of triage codes in an emergency department

AIM: The triage forms filled in 2006 by nursing personnel dedicated to the triage in an Emergency Department were analysed. METHODS: The 37.323 triage forms were scrutinized to identify any discrepancies in severity codes assigned by the nurse and by the medical doctor, after the clinical and instrumental assessment. RESULTS: Four-hundred-forty discrepancies were identified (13% of those initially classified as discrepancies): 221 (50.2%) severity codes were overestimated and 219 underestimated. The percentage of discrepancies increased during night hours and at the morning shift change. Nurses who performed the triage less often, made an higher number of over or underestimates. Overall, the number of discrepancies was 0.5 per shift. CONCLUSIONS: The overall performance can be considered very good. A model for analysis of discrepancies can be proposed. A number of proposals have been advanced to further improve the nurses performance.