Validation of the Hong Kong Accident and Emergency Triage Guidelines

Abstract

Objective To validate the Hong Kong Accident and Emergency Triage guidelines. Design Retrospective chart review. Setting The Accident and Emergency Department of a tertiary hospital in Hong Kong. Participants Patients who attended the Accident and Emergency Department on one day in February 2012. Main outcome measures The inter-rater reliability in two pairs of nurses grouped according to experience and validity as compared with an expert panel. Results Of the 100 patients recruited and triaged into levels 1 to 5, the weighted kappa coefficient (inter-rater reliability) for the two pairs of nurses was 0.699 and 0.717, respectively. The weighted kappa coefficient for validity was 0.766. When only patients in triage levels 3 and 4 were included, the weighted kappa coefficient for reliability dropped to 0.632 and 0.585, respectively. The weighted kappa coefficient for validity also decreased to 0.558. Conclusions The overall inter-rater reliability and validity of the Guidelines appeared acceptable. Further revision of the Guidelines on triaging patients to levels 3 or 4 is probably necessary.