Methods: This retrospective study investigates the accuracy of triage procedures by pediatric patients in emergency departments using the Korean Triage and Acuity Scale. The study includes 250 randomly selected initial nursing records and clinical outcomes of pediatric patients who visited one regional emergency department or a local emergency department from October 2016 to September 2017. Twenty-four variables were assessed, including chief complaint, vital signs according to the initial nursing records, and clinical outcomes. The collected data were analyzed by a qualified expert to determine the true triage score. Three triage experts, a certified emergency nurse, the Korean Triage Acuity Scale provider and instructor, and a nurse recommended for excellent emergency department experience and competence determined the true KTAS. The accuracy of triage was defined as the agreement between the triage score of the emergency nurses and the true triage score as determined by the experts. Based on expert comments, the cause of the triage error was analyzed and the Korean Triage and Acuity Scale score was compared with the discharge, length of stay, and medical cost.
Results: The results showed that the degree of agreement with regard to the triage score between the experts and the emergency nurses was excellent (weighted kappa =.77). Among the causes of triage discordance, the most frequent was the incorrect application of vital signs to the Korean Triage and Acuity Scale algorithm criteria (n = 13). Patients with high severity levels of Korean Triage and Acuity Scale 1 and 2 were discharged less often (χ = 43.25, p<.001). There were significant differences in the length of stay (F=12.39, p<.001) and cost (F=11.78, p<.001) between the Korean Triage and Acuity Scale scores when adjusting for age.
Conclusion:
The results of this study indicate that Korean Triage and Acuity Scale is highly accurate in emergency departments. Hence, the newly developed triage tool is becoming well established in Korea.