International Emergency Nursing
Volume 17, Issue 3 , Pages 143-148, July 2009

Manchester Triage in Sweden – Interrater reliability and accuracy

  • Pia Olofsson, BSc, RN (Leader of Research and Development Team)

      Affiliations

    • Department of Emergency Medicin, Nu-sjukvården, Trollhättan, Sweden
    • ,
  • Martin Gellerstedt, PhD (Senior Lecturer)

      Affiliations

    • Statistics/Informatics, University West, Department of Informatics, Trollhättan, Sweden
    • ,
  • Eric D. Carlström, PhD, MA, RN (Senior Lecturer, Director of Research)

      Affiliations

    • Health Management, Policy and Economics, Director of Research, University West, Department of Nursing, Health and Culture, SE-461 86 Trollhättan, Sweden
    • Corresponding Author InformationCorresponding author. Tel.: +46 702738126; fax: +46 520223099.

Received 30 July 2008; received in revised form 29 November 2008; accepted 30 November 2008.

Abstract 

Introduction

This study investigates the interrater reliability and the accuracy of Manchester Triage (MTS) at emergency departments in Western Sweden.

Methods

A group of 79 nurses from seven emergency departments assessed simulated patient cases and assigned triage categories using the same principles as in their daily work. K statistics, accuracy, over-triage and under-triage were then analyzed. The nurses performed 1027 triage assessments.

Results

The result showed an unweighted κ value of 0.61, a linear weighted κ value of 0.71, and a quadratic weighted κ value of 0.81. The determined accuracy was 92% and 91% for the two most urgent categories, but significantly lower for the less urgent categories.

Conclusions

Patients in need of urgent care were identified in more than nine out of 10 cases. The high level of over-triage and under-triage in the less urgent categories resulted in low agreement and accuracy. This may suggest that the resources of emergency departments can be overused for non-urgent patients.

Keywords: Triage, Reliability, Emergency care, Sweden

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PII: S1755-599X(08)00134-1

doi:10.1016/j.ienj.2008.11.008

International Emergency Nursing
Volume 17, Issue 3 , Pages 143-148, July 2009

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