ارزیابی صحت تریاژ پرستاران در بخش اورژانس بیمارستان شهید باهنر کرمان: یک مطالعه‌ی مقطعی

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 رزیدنت، گروه طب اورژانس، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی کرمان، کرمان، ایران

2 استادیار، گروه طب اورژانس، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی کرمان، کرمان، ایران

3 دانشیار، گروه طب اورژانس، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی کرمان، کرمان، ایران

10.48305/jims.v42.i754.0029

چکیده

مقاله پژوهشی




مقدمه: تریاژ، فرایند ارزیابی و طبقه‌بندی بیماران به منظور بهبود مدیریت و ارائه‌ی خدمات است. یک سیستم تریاژ خوب باید قادر به شناسایی دقیق بیمارانی باشد که نیاز به مراقبت فوری پزشکی دارند. شاخص شدت اضطرار (Emergency severity index) ESI، در حال حاضر پرکاربردترین روش برای تریاژ و یک سیستم تریاژ معتبر است. هدف از این مطالعه، بررسی توانایی پرستاران بخش اورژانس در تریاژ صحیح بیماران با استفاده از ESI بود.
روش‌ها: مطالعه‌ی مقطعی حاضر، بر روی 272 بیمار مراجعه‌کننده به اورژانس بیمارستان شهید باهنر کرمان در تیرماه 1401 می‌باشد. تریاژ بیماران که توسط پرستاران اورژانس انجام شده بود با تریاژ تعیین شده توسط پزشکان مقایسه شد. ضریب کاپا بین دو گروه (پرستاران و پزشکان) برای تعیین توافق، مورد ارزیابی قرار گرفت.
یافته‌ها: تریاژ برای 72/1 درصد از 272 بیمار به درستی شناسایی شد، در حالی که 13/6 درصد تریاژ سبک و 14/3 درصد تریاژ سنگین شده بودند. اولویت تنها برای 56/6 درصد بیماران دقیق بود و به 7/1 درصد از بیماران، اولویت کمتری اختصاص داده شده بود. سطح توافق بین دو گروه، که با ضریب کاپا اندازه‌گیری شد برابر با 5/60 درصد بود.
نتیجه‌گیری: در این مطالعه توافق تریاژ به دست آمده در حد متوسط بود. با این حال فرایند تریاژ بیشتر از اینکه خطرناک باشد، ناکارآمد بود. برنامه‌های آموزشی طولانی‌مدت برای افزایش دقت تریاژ توصیه می‌شود.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Assessing the Accuracy of Nurse Triage in Emergency Department of Shahid Bahonar Hospital of Kerman: A Cross-Sectional Study

نویسندگان [English]

  • Fatemeh Bardsiri 1
  • Masoomeh Nazemi-Rafi 2
  • Amin Saberinia 3
1 Resident, Department of Emergency Medicine, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
2 Assistant Professor, Department of Emergency Medicine, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
3 Associate Professor, Department of Emergency Medicine, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
چکیده [English]

Background: Triage is the process of assessing and categorizing patients to improve management and service delivery. A reliable triage system should be capable of accurately identifying patients who require immediate medical attention. The emergency severity index (ESI) is currently the most widely used method for triage, and it is a validated triage system. This study aimed to assess the ability of emergency department nurses to triage patients utilizing ESI.
Methods: A cross-sectional study was conducted on 272 patients who were referred to the emergency department (ED) of Shahid Bahonar Hospital of Kerman in July 2022. The triage of the patients was performed by emergency nurses, and the results were compared with those determined by physicians. Cohen's kappa coefficient was evaluated between the two groups (nurses and physicians) to determine the inter-rater agreement.
Findings: The triage group was correctly identified for 72.1% (196) of the 272 patients, while 13.6% (37) were under-triaged and 14.3% (39) were over-triaged. The priority was accurate for only 56.6% of patients, and 7.1% of patients received a lower priority. The agreement level between the two groups was 60.5% (95% CI: 0.532-0.677) measured by the kappa coefficient.
Conclusion: In this study, the agreement that was found in terms of patients’ triage was average. Although the triage was more inefficient than risky, long-term training programs are highly recommended for enhancing the accuracy of the triage.

کلیدواژه‌ها [English]

  • Accuracy
  • Nurses
  • Physicians
  • Triage
  • Urgency

مراجع

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مجله دانشکده پزشکی اصفهان
دوره 42، شماره 754
هفته 2، فروردین
فروردین و اردیبهشت 1403
صفحه 29-34

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سابقه مقاله

  • تاریخ دریافت: 07 آذر 1402
  • تاریخ پذیرش: 16 اردیبهشت 1403

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