Research forum abstract
Poster session 5: Administration
305: Reliability of Emergency Severity Index Version 4

https://doi.org/10.1016/j.annemergmed.2009.06.336Get rights and content

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Study Objectives

The aim of this study is to test the reliability of Emergency Severity Index 4 (ESI-4) in different setting, Korea from North America. We also tried to evaluate the effect of implementing the ESI-4 and its effect on self-efficacy.

Methods

This study was carried out from August 1, 2008 to August 31, 2008 in a single regional emergency center (level 1 center). Target patients for the validation were those who visited the center with age of 15 years or older. The study for effect of ESI-4 had been done for 5 days from January 12, 2009.

The collection of the ESI-4 data was done by triage nurses. These nurses had finished the standardized course and had gone through multiple conferences with emergency physicians about clinical cases

Results

Total of 2,982 patients visited the emergency center during the study period. We enrolled 478 (16.2%) patients to evaluate the ESI-4 between triage nurses and research nurses, and another 442 (14.8%) patients for triage nurses and the emergency resident. The weighted kappa was 0.49 (0.39-0.55), and 0.47 (0.39-0.55), respectively. Triage nurses were divided into two groups by their clinical experience (3 years), the weighted kappa was 0.47 (0.35-0.58) for the junior group, and 0.50 (0.41-0.59)

Conclusion

For validating the ESI-4, moderate level of reliability was measured among nurses and between nurses and an emergency physician in a Korean single ED. Analysis of the effect of the ESI-4 showed similar effects for each group, but higher self-efficacy for more experience group.

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