Predicting patient disposition in a paediatric emergency department
- 2 December 2012
- journal article
- research article
- Published by Wiley in Journal of Paediatrics and Child Health
- Vol. 50 (10), E39-44
- https://doi.org/10.1111/jpc.12011
Abstract
The aim of this study is to directly compare published prediction tools with triage nurse (TN) predictions within a defined paediatric population. A prospective observational study carried out over a week in May 2010 in the Emergency Department (ED) at Princess Margaret Hospital for Children in Perth, Western Australia. TN predicted which patients would be admitted to hospital at the time of ED presentation. Data required for the other prediction tools (paediatric early warning score (PEWS); triage category and the Pediatric Risk of Admission Score (PRISA) and PRISA II were obtained from the notes following the patient's ED attendance. A total of 1223 patients presented during the study week, 91 patients were excluded and a total of 946 patients (83.6%) had TN predictions and were included in the analysis. TN predictions were compared against a PEWS ≥ 4, triage category 1, 2 and 3, PRISA ≥ 9 and PRISA II ≥ 2. TNs had the highest prediction accuracy (87.7%), followed by an elevated PEWS (82.9%), triage category of 1, 2, or 3 (82.9%). The PRISA and PRISA II score had an accuracy of 80.1% and 79.7%, respectively. When compared with validated prediction tools, the TN is the most accurate predictor of need to admit. This study provides valuable information in planning efficient flow of patients through the ED.Keywords
This publication has 8 references indexed in Scilit:
- Triage Assessment in Pediatric Emergency DepartmentsPediatric Emergency Care, 2010
- Can paediatric early warning score be used as a triage tool in paediatric accident and emergency?European Journal of Emergency Medicine, 2008
- Validity of the Manchester Triage System in paediatric emergency careEmergency Medicine Journal, 2006
- The Pediatric Risk of Hospital Admission Score: A Second-Generation Severity-of-Illness Score for Pediatric Emergency PatientsPublished by American Academy of Pediatrics (AAP) ,2005
- Evaluation of the pediatric risk of admission score in a pediatric emergency departmentAnnals of Emergency Medicine, 2003
- The PATRIARCH Study. Using outcome measures for league tables: Can a North American prediction of admission score be used in a United Kingdom children's emergency department?Emergency Medicine Journal, 2002
- Can emergency department triage nurses predict patients' dispositions?The American Journal of Emergency Medicine, 2001
- Triage: Limitations in Predicting Need for Emergent Care and Hospital Admission☆☆☆★★★Annals of Emergency Medicine, 1996