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Comparison of knowledge level of triage in 119 EMTs (119 구급대원의 중증도 분류 지식 정도 및 교육 전·후 비교)

  • Lee, Hyo-Ju;Cho, Keun-Ja
    • The Korean Journal of Emergency Medical Services
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    • v.18 no.1
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    • pp.43-54
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    • 2014
  • Purpose : The purpose of this study was to provide appropriate direction for triage education by investigating the knowledge level of triage in 119 EMTs before and after the triage education. Methods : The questionnaire was filled out by newly assigned 33 EMTs in the fire service academy in I metropolitan city from November 1, 2013. The data were analyzed using SPSS WIN 21.0 program. Results : The lowest knowledge level by 119 triage was the potential emergency related question, but that by case-based triage was the semi-emergency related questions. The knowledge score by case-based triage before education was 51.14 points. This was lower than knowledge score by 119 triage, that is, 75.70 points. After education, the knowledge level by 119 triage was significantly improved(p =.000). However, there was no significant difference in the knowledge level by case-based triage(p =.236). Conclusion : It is necessary to provide systematic and periodic education and training for 119 EMTs toward triage to improve triage accuracy and efficient circulation of the emergency medical service system. Especially, it is very important to provide case-based triage education for field application.

Comparison of KTAS(Korean Triage and Acuity Scale) results by Triage Classifier (중증도 분류자 직종에 따른 중증도 분류 결과의 차이 비교)

  • Huh, Young-Jin;Oh, Mi-Ra;Kim, Se-Hyung;Han, So-Hyun;Pak, Yun-Suk
    • Journal of Convergence for Information Technology
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    • v.10 no.4
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    • pp.98-103
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    • 2020
  • The purpose of this study was to determine whether the results of KTAS(Korean Triage and Acuity Scale) triage classifier differ according to the occupations. We analyzed a total of 10,960,359 cases of data sent to the NEDIS from January 1st, 2016 to December 31th, 2017. The triage classifier were MD(Medical Doctor), R(Resident), INT(Intern), GP(General Practitioner), RN(Registered Nurses) and EMT(Emergency Medical Technician). The consistency between the initial triage and final triage results was the highest GP(98.9%) and the lowest INT(80.2%). The results of over-triage classification was the lowest by GP(0.6%) and the highest for INT(16.0%). Also, the results of under-triage classification was the lowest by MD, EMT(0.4%) and the highest for INT(3.8%). The results of KTAS triage classifier significantly differ from according to the occupations(p<0.001). Triage classification should not differ from according to occupations and skill. It is necessary to strengthen the classifier's capacity for accurate triage classifications.

Concept Analysis of Triage Competency in Emergency Nursing (응급실 간호사의 중증도 분류 역량에 대한 개념분석)

  • Moon, Sun Hee;Park, Yeon Hwan
    • Journal of Korean Critical Care Nursing
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    • v.10 no.3
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    • pp.41-52
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    • 2017
  • Purpose : This concept analysis identified attributes and defined triage competency among emergency nurses. Method : Walker and Avant's approach was used to guide the concept analysis. A literature review was completed including 26 studies, 5 reports of related associations, and 5 books. Results : The concept of triage competency in emergency nurses was identified as five attributes: clinical judgment, expert assessment, management of medical resources, timely decision, and communication. Antecedents of the concept were triage education and emergency room experience. The consequences of the concept were efficiency of care, patient rating, and safety. Triage competency in emergency nurses was defined as the comprehensive ability to prioritize patients' urgency and allocate limited medical resources. Conclusion : This study is meaningful since it clarified triage competency among emergency nurses. The attributes and empirical indicators of this study will likely lay the foundation for development of triage competency metrics.

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Clinical Considerations When Applying Vital Signs in Pediatric Korean Triage and Acuity Scale

  • Lee, Bongjin;Kim, Do Kyun;Park, June Dong;Kwak, Young Ho
    • Journal of Korean Medical Science
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    • v.32 no.10
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    • pp.1702-1707
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    • 2017
  • Initial vital signs of children at the emergency department may be abnormal because of anxiety and irritability, resulting in unrealistic triage levels. This study aimed to evaluate the effectiveness of pediatric triage by clinical decision based on the patient's general condition. The Pediatric Korean Triage and Acuity Scale (PedKTAS) has been used nationwide for triage since 2016. The triage level, as assessed by an experienced triage nurse and based on the patient's clinical condition, was defined as the 'real practice (RP)-level,' while the re-calculated triage level, as assessed by the direct application of initial vital signs, was defined as the 'simulation (S)-level.' A total of 22,841 patients were triaged during the study period. The hospitalization rate according to RP-PedKTAS levels exhibited a significant correlation with the expected hospitalization rate suggested by the Pediatric Canadian Triage and Acuity Scale (CTAS) (P = 0.002), whereas the S-PedKTAS levels did not (P = 0.151). Compared with the previously reported pediatric CTAS level-specific hospitalization rate and intensive care unit (ICU) admission rate, RP-PedKTAS was significantly correlated with both hospitalization rate and ICU admission rate (P = 0.001 and P = 0.012, respectively). However, S-PedKTAS showed no significant correlation in both (P = 0.267 and P = 0.188, respectively). The determination of triage levels based on clinical decision rather than the direct application of abnormal initial vital signs to PedKTAS is more accurate in predicting the hospitalization rate and ICU admission rate.

The Suitability of the CDC Field Triage for Korean Trauma Care

  • Choi, Kang Kook;Jang, Myung Jin;Lee, Min A;Lee, Gil Jae;Yoo, Byungchul;Park, Youngeun;Lee, Jung Nam
    • Journal of Trauma and Injury
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    • v.33 no.1
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    • pp.13-17
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    • 2020
  • Purpose: Accurate and appropriate prehospital field triage is essential for a trauma system. The Korean trauma system (established in 2014) uses the trauma field triage algorithm of the United States Centers for Disease Control and Prevention (CDC). This study evaluated the suitability of the CDC field triage criteria for major trauma cases (injury severity score >15) in Korea. Methods: This retrospective cohort study evaluated trauma patients who presented at the authors' regional trauma center from January 1 to May 7, 2017. The undertriage and overtriage rates of each CDC field triage step were calculated. Receiver operating characteristic curves were constructed, and the area under the curve (AUC) was evaluated for each step. Results: Among the 1,009 enrolled patients, 168 (16.7%) had major trauma. The undertriage/overtriage rates of each step (steps I, II, III, and IV) of CDC field triage were 9.2%/47.4%, 6.3%/50.8%, 4.5%/59.4%, and 5.3%/78.9%, respectively. The AUC values of each CDC triage step were 0.722, 0.783, 0.791, and 0.615, respectively. The AUC values of the separate components of each step (physiologic criteria, anatomic criteria, mechanism-of-injury criteria, and special considerations) were 0.722, 0.648, 0.647, and 0.456, respectively. Conclusions: The CDC field triage system is acceptable, but not ideal, for Korean trauma care. If we follow the protocol, it would be preferable to omit step IV. The Korean Triage and Acuity Scale may be a good indicator for in-hospital triage. However, a new triage protocol that is simple to estimate on-scene while having good performance should be developed.

Triage Accuracy of Pediatric Patients using the Korean Triage and Acuity Scale in Emergency Departments (한국형응급환자분류도구를 적용한 응급실에서 소아 환자의 중증도 분류 정확성)

  • Moon, Sun-Hee;Shim, Jae Lan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.626-634
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    • 2018
  • This retrospective study investigates the accuracy of triage procedures for pediatric patients in emergency departments (EDs) using the Korean Triage and Acuity Scale (KTAS). The study includes 250 randomly selected initial nursing records and clinical outcomes of pediatric patients who visited one regional ED or a local ED from October 2016 to September 2017. The collected data were analyzed by a qualified expert to determine the true triage score. The accuracy of triage was defined as the agreement between the triage score of the emergency nurses (ENs) and the true triage score as determined by the expert. Based on expert comments, the cause of the triage error was analyzed and the KTAS score was compared with the discharge, length of stay (LOS), and medical cost. The results showed that the degree of agreement in the triage score between the experts and the ENs was excellent (weighted kappa=0.77). Among the causes of triage discordance, the most frequent was the incorrect application of vital signs to the KTAS algorithm criteria (n=13). Patients with high severity KTAS levels 1 and 2 were discharged less often (${\chi}=43.25$, p<0.001). There were significant differences in the length of stay (F=12.39, p<0.001) and cost (F=11.78, p<0.001) between KTAS scores when adjusting for age. The results of this study indicate that KTAS is highly accurate in EDs. Hence, the newly developed triage tool is becoming well established in Korea.

Inter-rater Reliability of Korean Triage and Acuity Scale (KTAS) among the Research Nurses and the Triage Nurses (한국형 응급환자 분류도구의 간호사 간 신뢰도 평가)

  • Yang, Jungeun;Lee, Eunja
    • Journal of East-West Nursing Research
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    • v.26 no.1
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    • pp.91-99
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    • 2020
  • Purpose: The study aims to assess the inter-rater reliability of the Korean Triage and Acuity Scale between the research nurses and the triage nurses. Methods: Interrater reliability was measured on 400 adult (≧15) and 400 pediatric (<15) patients who visited the emergency medical center from January 4 to June 30, 2018. Results: The study result showed that the inter-rater reliability of the Korean Triage and Acuity Scale was substantial, with κ=.73 (95% Confidence interval= .68-.78) and 77.0 percent agreement. The inter-rater of Pediatric Korean Triage and Acuity Scale was also substantial, with κ=.76 (95% Confidence interval= .71-.82) and 83.8 percent agreement. Conclusion: Although the inter-rater reliability of the Korean Triage and Acuity Scale was acceptable, the percent agreement was lower than the desirable level (<80.0%). It was confirmed that Pediatric Korean Triage and Acuity Scale had an acceptable level of inter-rater reliability and percent agreement for clinical use. Efforts should be made to improve the reliability in the future.

Severity of Emergency Patient classified by Triage System (중증도 분류체계를 이용한 중증도분류(Triage))

  • Bae, Jung-Hee;Sohn, Sue-Kyung
    • The Journal of Korean Academic Society of Nursing Education
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    • v.7 no.2
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    • pp.264-274
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    • 2001
  • About the patients who visited the emergency department of a hospital, investigative study was performed to assess and to classify them with triage tool, and to estimate the characteristics of them. 210 patients older than 15 years were investigated. Among them 11 patients who had responded inappropriately were excluded and remaining 210 patients were chosen as study subjects. Investigation had been performed for 30 days from Jan. 10, 2001 to Feb. 9, 2001. The triage tool was designed through the modification of triage tools developed by Kim and Choi. The data were analyzed with the SPSS program using mean, standard deviation, frequency, percentage, ANOVA and Scheffe's test. The results were as follows: 1. Of the characteristics of the study subjects, mean age of patients were 55.76 years and 70-79 years group which included 41 patients(20.6%) were most numerous. 101 (51.8%) patients visited emergency room by 119 emergency service and 91(45.7%) patients walked with assistance. 127 patients were cared in internal medicine department. 2. The distribution of triage scores were from minimum 6 points to maximum 18 points with mean $13.76{\pm}2.58$ points. 3. Triage scores had significant relationship with age(F=13.349,P=0.000), visiting method (F=8.832, P=0.000), walking status(F=28.185, p=0.000), care department(F=2.596, P=0.019), and preexisting disease(F=12.012, P=0.000). 4. After trage there were no urgent patient, 35 emergent patients(17.6%),109 subemergent patients(54.8%), and 55 nonemergent patients (27.6%). The result of emergency care were 80 admission(40.2%), 59 discharge (29.6%), 34 ICU admission(17.1%), 14 transfer to other hospital(7%), 10 operation (5%), and 2 death (2%). 5. About the time required for triage, mean duration to triage were $7.54{\pm}2.28$ mins in emergent patients, mean $7.23{\pm}2.50$ mins in subemergent patients and mean $6.49{\pm}2.19$ mins in nonemergent patients. There were no differences in duration to triage according to the severity of triage. 6. Time required in emergency treatment were mean $116.23{\pm}88.10$ in emergent patients mean $101.61{\pm}73.27$ in subemergent patients and mean $81.56{\pm}61.01$ in nonemergent patients. There were no significant difference among groups. This study depicted that triage scores were below the middle level and there were many geriatric patients in this hospital. Among the characteristics of patients, age, visiting method, walking status, care department, and accompanying disease could be data for triage of emergency patients. With triage score of a patient, the outcome of emergency care of a patient could be anticipated and this could be basal data in determining the priority of emergency nursing.

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Effects of a Web-Based Korean Triage and Acuity Scale Learning Program on Triage Self-Efficacy and Triage Performance Ability for Nurses in Emergency Department (웹기반 한국형 중증도 분류 체계 학습프로그램이 응급실간호사의 중증도 분류에 대한 자기효능감 및 수행능력에 미치는 효과)

  • Kim, Hyo-Jin;Kang, Hee-Young
    • Journal of Korean Academy of Nursing
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    • v.49 no.2
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    • pp.171-180
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    • 2019
  • Purpose: The Korean Triage and Acuity Scale (KTAS) is a tool used to classify the severity and urgency of emergency department (ED) patients, focusing on their symptoms. In consideration of the importance of the KTAS, a web-based learning program has emerged as a new mode of education; it enables ED triage nurses to access it anytime and anywhere, and according to their own learning abilities. This study aimed to develop a web-based KTAS learning program and evaluate its effects on self-efficacy and triage performance ability in ED nurses. Methods: A quasi-experimental design with a non-equivalent control group pretest-posttest was used. The conceptual framework was Bandura's self-efficacy theory. There were 30 participants in the experimental group and 29 in the control group. The experimental group attended an orientation and 4 sessions of a web-based KTAS learning program. The learning program lasted 280 minutes over five weeks, consisting of 40 minutes of orientation and four 60-minute sessions. Results: The scores of self-efficacy, triage performance ability in KTAS level, and chief complaints significantly increased in the experimental group compared to the control group. In addition, the numbers of under-triage in KTAS significantly decreased in the experimental group in comparison to the control group. Conclusion: The results suggest that the learning program was effective in improving ED nurses' level of self-efficacy and triage performance ability (KTAS level and KTAS chief complaint). Accordingly, the web-based KTAS learning program can be applied as an education intervention to improve ED nurses' triage skill.

Factors Influencing Triage Nurses' the Korean Triage and Acuity Scale Performance Ability (응급실 초진 간호사의 한국형 응급 환자 분류도구 수행능력에 영향을 미치는 요인)

  • Lee, Eun Kyoung;Kim, Ji-Soo
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.1
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    • pp.94-102
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    • 2018
  • Purpose: The purpose of this study was to examine triage nurses' the Korean triage and acuity scale(KTAS) performance ability, perception of importance, education needs and identify the factors influencing triage nurses' the KTAS performance ability. Methods: A descriptive correlational study was conducted among 146 emergency nurses working in 13 hospitals from March to May, 2017. Data were collected utilizing a questionnaire developed to measure performance ability, perception of importance, and educational needs of 192 items of the KTAS. Statistical analysis included t-test, analysis of variance, correlation analysis and multiple regression analysis. Results: The triage nurses' the KTAS performance ability was rated as 3.3/4.0 points, perception of importance as 3.2/4.0 points, and education needs as 3.1/4.0 points. Factors influencing the KTAS performance of the participants were perception of importance, education needs, and work experience at the emergency department, explaining 26.7% of total variance. Conclusion: The KTAS performance ability of triage nurses could be improved through training programs designed to enhance their perception of importance and provide knowledge about the KTAS. Nurses' emergency department work experience needs to be considered as an important factor for the KTAS performance ability.