Agreement of triage decisions between gastroenterologists and nurses in a hospital endoscopy unit

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. This study aimed to c...

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Bibliographic Details
Published in:Clinical and experimental gastroenterology 2018-01, Vol.11, p.399-403
Main Authors: Inns, Stephen, Wong, Jeffrey, McPhedran, Dena, De Guzman, Gladys, Broome, Katherine, Sim, Dalice, Sandford, Rosemarie
Format: Article
Language:English
Subjects:
Algorithms
Colonoscopy
Comparative Study
Consultants (Persons)
Decision making
Emergency medical care
Endoscopy
Gastroenterology
Hospitals
Medical care quality
Medical referrals
Medical research
Nurses
Nursing research
Original Research
Referral and consultation
Studies
Systematic review
Triage
Workloads
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Summary: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. 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. 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. 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 ( =0.645,
ISSN:1178-7023
1178-7023
DOI:10.2147/CEG.S159516