1. Agreement of triage decisions between gastroenterologists and nurses in a hospital endoscopy unit
- Author
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Inns S, Wong J, McPhedran D, De Guzman G, Broome K, Sim D, and Sandford R
- Subjects
Comparative Study ,Endoscopy ,Nurses ,Referral and consultation ,Triage ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Stephen Inns,1,2 Jeffrey Wong,1 Dena McPhedran,1 Gladys De Guzman,1 Katherine Broome,1 Dalice Sim,2 Rosemarie Sandford1,† 1Hutt Valley DHB Endoscopy Unit, Hutt Valley DHB, Lower Hutt, Wellington, New Zealand; 2Department of Medicine, Otago University, Wellington School of Medicine, Wellington, New Zealand †Mrs Rosemarie Sandford passed away on December 1, 2015 Introduction: Efficient and accurate triage of endoscopy referrals is essential. Many of the decisions made are based on national and local triage criteria. Standardizing this approach for nurse use could maintain quality, address clinical risk and significantly improve resource utilization.Aims: This study aimed to compare gastroenterologist and nurse triage of unselected gastroenterology referrals in order to evaluate the proportion of referrals felt able to be triaged to endoscopy and the inter-rater agreement between a triage gastroenterologist and endoscopy nurses for clinical triage decisions regarding the urgency of gastroscopy and colonoscopy.Methods: The proportion of referrals triaged to endoscopy by a consultant gastroenterologist performing triage as a part of normal practice and two endoscopy nurses using a decision algorithm was measured. The inter-rater agreement for the triage category decision (urgency of referral) between the three triage clinicians was assessed. An adjudication panel provided a consensus decision triage category decision in cases where there was not complete agreement between the three triage clinicians.Results: Each clinician assessed 105 referrals. Nurse A was able to triage 54 (51%) referrals to a triage category and Nurse B 44 (42%) referrals. Cohen’s κ was run to determine if there was agreement between clinicians for the triage categories allocated. The agreement between the two nurses was substantial (k=0.645, P
- Published
- 2018