Factors Predicting the Accuracy of Triage in Elderly Patients at Emergency Department

Authors

  • Suphunnee Haowchun Faculty of Nursing, Mahidol University
  • Sarinrut Sriprasong Faculty of Nursing, Mahidol University
  • Wallada Chanruangvanich Faculty of Nursing, Mahidol University

Keywords:

triage accuracy, elderly patients, emergency department, atypical presentation

Abstract

This study was the predictive correlation of atypical presentation, activity of daily living, cognitive impairment and nursing workload on the accuracy of triage in 500 elderly patients at emergency department of a tertiary hospital in Bangkok. Participants were selected by purposive sampling. Data were collected by demographic data record form, the accuracy triage form, atypical presentation assessment, Barthel Activities of Daily Living Index, six item cognitive impairment test, and nursing workload record form. The reliability of the atypical presentation assessment , Barthel Activities of Daily Living Index, six item cognitive impairment test were 0.84, 0.95, and 0.91, respectively. Data were analyzed by using descriptive statistics and binary logistic regression.
The results showed 65.4% of the accuracy of triage among elderly patients. About 31.8% of elderly patients had atypical presentation. From the analyzing predictive power, atypical presentation was predicted statistically significant the accuracy triage. Elderly patients who had atypical presentation had a 39.1% lower accuracy triage than those who had typical presentation (OR = .609; 95%CI = .411, .903, p = .014). The result suggested that nurses should be encouraged to learn about atypical symptoms to enable triage accuracy in elderly patients.

Downloads

Download data is not yet available.

References

Ashman JJ, Schappert SM, Santo L. Emergency Department Visits Among Adults Aged 60 and Over: United States, 2014–2017. National Center for Health Statistics Data Brief. 2020; 367:1-8.

Srihaphak S, Triamwetwutkrai K, Amornrojvorawut W, Pruksa M, Paisarn K, Thongkot N, et al. Operational Model of Emergency Medical System For the Elderly in Long Term Care Fund, Khon Kaen Province. National Institute for Emergency Medicine. 2018;4(19):1-5. (in Thai)

Sri-on J, Geriatric Emergencies. 3rd. Bankok: Faculty of Medicine Vajira Hospital, Navamindradhiraj University; 2021. (in Thai)

Ausserhofer D, Zaboli A, Pfeifer N, Solazzo P, Magnarelli G, Marsoner T, et al. Errors in nurse-led triage: An observational study. International journal of nursing studies. 2021; 113(2021):1-7.

Grossmann FF, Zumbrunn T, Frauchiger A, Delport K, Bingisser R, Nickel CH. At risk of undertriage? Testing the performance and accuracy of the emergency severity index in older emergency department patients. Annals of emergency medicine. 2012;60(3):317-25.e3.

Suamchaiyaphum K, Chanruangvanich W, Thosingha O, Momsomboon A. Factors Influencing the Accuracy of Emergency Severity Index-Based Emergency Patient Triage. Thai Journal of Nursing Council. 2019; 34(4):34-47. (in Thai)

Hinson JS, Martinez DA, Schmitz PSK, Toerper M, Radu D, Scheulen J, et al. Accuracy of emergency department triage using the Emergency Severity Index and independent predictors of under-triage and over-triage in Brazil: a retrospective cohort analysis. International journal of emergency medicine. 2018;11(1):1-10.

Wachiradilok P, Sirisuan T, Chaisit S, Setthasathien A. Patients Triage in Emergency Department in Thailand. Thai Journal of Nursing Council. 2016;31(2):96-108. (in Thai)

Irvine D, Sidani S, Hall LM. Finding value in nursing care: a framework for quality improvement and clinical evaluation. Nursing economic$. 1998;16(3):110-6, 31.

Binsama S, Naka K, Khupantavee N. Factors Influencing the Accuracy of Triage in Non-Trauma Patients by Emergency Nurses. Princess of Naradhiwas University Journal. 2021;13(3):24-39. (in Thai)

Phromdee A, Bunyapatkul P, Kanokkanchana P. Factors Influencing Compliance with Triage Protocol in Trauma Patients. Vajira Nursing Journal. 2017;19(1):19-32. (in Thai)

Cetin S, Eray O, Cebeci F, Coskun M, Gozkaya M. Factors affecting the accuracy of nurse triage in tertiary care emergency departments. Turkish Journal of Emergency Medicine. 2020;20(4):163-7.

Larthum K, Pearkao C. A Study of Quality of Emergency Patient Triage at Srinagarind Hospital. The National and International Graduate Research Conference 2017; 2017 March 10; Pote Sarasin Bulding. Khon Kaen: Khon Kaen University; 2017:1-12. (in Thai)

AlSerkal Y, AlBlooshi K, AlBlooshi S, Khan Y, Naqvi SA, Fincham C, et al. Triage Accuracy and Its Association with Patient Factors Using Emergency Severity Index: Findings from United Arab Emirates. Open Access Emergency Medicine. 2020;12:427-34.

Soontorn T, Sitthimongkol Y, Thosingha O, Viwatwongkasem C. Factors Influencing the Accuracy of Triage by Registered Nurses in Trauma Patients. Pacific Rim International Journal of Nursing Research. 2018;22(2):120-30.

Lopes MCBT, Lage JSS, Vancini-Campanharo CR, Okuno MFP, Batista REA. Factors associated with functional impairment of elderly patients in the emergency departments. Einstein (Sao Paulo). 2015;13(2):209-14.

Parke B, Hunter KF, Strain LA, Marck PB, Waugh EH, McClelland AJ. Facilitators and barriers to safe emergency department transitions for community dwelling older people with dementia and their caregivers: a social ecological study. International journal of nursing studies. 2013;50(9):1206-18.

Blomaard LC, Speksnijder C, Lucke JA, de Gelder J, Anten S, Schuit SCE, et al. Geriatric Screening, Triage Urgency, and 30-Day Mortality in Older Emergency Department Patients. Journal of the American Geriatrics Society. 2020;68(8):1755-62.

Malinovska A, Pitasch L, Geigy N, Nickel CH, Bingisser R. Modification of the Emergency Severity Index Improves Mortality Prediction in Older Patients. The western journal of emergency medicine. 2019;20(4):633-40.

Areeras P, Prachusilpa G. Nurse Staffing in Emergency Department, Queen Sirikit Hospital. Journal of The Royal Thai Army Nurses. 2017;18(Supplement):223-31. (in Thai)

Rossetti AC, Gaidzinski RR, Fugulin FM. Nursing workload in the emergency department: a methodological proposal. Revista latino-americana de enfermagem. 2013;21(Special):225-32.

Johnson KD, Gillespie GL, Vance K. Effects of Interruptions on Triage Process in Emergency Department: A Prospective, Observational Study. Journal of Nursing Care Quality. 2018;33(4):375-81.

Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. Journal of clinical epidemiology. 1996;49(12):1373-9.

Aree-Ue S,Youngcharoen P. The 6 Item Cognitive Function Test-Thai Version: Psychometric Property Testing. Ramathibodi Nursing Journal. 2020;26(2):188-202. (in Thai)

Hofman MR, van den Hanenberg F, Sierevelt IN, Tulner CR. Elderly patients with an atypical presentation of illness in the emergency department. The Netherlands journal of medicine. 2017;75(6):241-6.

Downloads

Published

18-08-2024

How to Cite

1.
Haowchun S, Sriprasong S, Chanruangvanich W. Factors Predicting the Accuracy of Triage in Elderly Patients at Emergency Department. J Royal Thai Army Nurses [Internet]. 2024 Aug. 18 [cited 2024 Dec. 22];25(2):186-94. Available from: https://he01.tci-thaijo.org/index.php/JRTAN/article/view/263696

Issue

Section

Research Articles