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Original ArticleOpen Access
Accuracy of Pediatric Triage at Siriraj Hospital, Bangkok, Thailand
Kriengsoontornkij W 
,
Homcheon B ,
Chomchai C ,
Neamsomboon W
,
Homcheon B ,
Chomchai C ,
Neamsomboon W Background: Siriraj Hospital is a busy 2,500-bed hospital located in Bangkok, Thailand. It has over 1.7 million outpatients,
including 120,000 emergency room visits a year, 20,000 of which are pediatric patients. The Pediatric Triage (Pedtriage)
system has been in used since the year 2001, but the factors that affect the performance of triage nurse have not been
evaluated.
Objective: To compare the performance non-pediatric nurses who are responsible for pediatric patients in the emergency
room before and after pediatric triage training at Siriraj Hospital.
Material and Method: Pediatric Triage Training was set up for emergency room and outpatient department nurses between
June and October 2006. The training consisted of 5 hours of didactic sessions on the concepts of pediatric triage and 4-5 hour
sessions where the nurses were allowed to triage actual pediatric patients under the supervision of a triage-training nurse. A
pre-test and post-test examination was administered. The outcome of triage performance was categorized into under-triage
if the patient had an urgent or emergent condition and was triaged as non-urgent, over-triage if a patient had a non-urgent
condition and was triaged as urgent or emergent. Statistical description included percent, averages, and standard deviation
where appropriate. A standard 4x4 contingency table was used to calculate the sensitivity and specificity. For comparison of
performance, a post-hoc analysis was done where the nurses were divided into two groups, those with work experience of less
than or equal to 5 years (group 1) and more than 5 years (group 2). An independent samples t-test was used to determine the
difference in performance between the two groups.
Results: Overall, performance on pre-test - post-test differed significantly before and after training. The nurses in Group 1
had higher pre-test scores (Group 1 mean = 62.35%, Group 2 mean = 52.41%, p-value = 0.001), were less likely to
overtriage (Group 1 mean = 4.11%, Group 2 mean = 6.46%, p-value = 0.021) and had higher specificity of triage than
Group 2 (Group 1 mean = 95.61, Group 2 = 92.39, p-value = 0.019). However, the nurses in Group 2 had more
improvement in their post-test scores (percent of improvement from pre-test: Group 1 mean = 8.56%, Group 2 = 34.69%,
p-value = 0.005).
Conclusion: Work experience is an important consideration in the triage knowledge and performance of non-pediatric
nurses during triage training.
Keywords: Pediatric triage, Performance, Nurse, Work-year
including 120,000 emergency room visits a year, 20,000 of which are pediatric patients. The Pediatric Triage (Pedtriage)
system has been in used since the year 2001, but the factors that affect the performance of triage nurse have not been
evaluated.
Objective: To compare the performance non-pediatric nurses who are responsible for pediatric patients in the emergency
room before and after pediatric triage training at Siriraj Hospital.
Material and Method: Pediatric Triage Training was set up for emergency room and outpatient department nurses between
June and October 2006. The training consisted of 5 hours of didactic sessions on the concepts of pediatric triage and 4-5 hour
sessions where the nurses were allowed to triage actual pediatric patients under the supervision of a triage-training nurse. A
pre-test and post-test examination was administered. The outcome of triage performance was categorized into under-triage
if the patient had an urgent or emergent condition and was triaged as non-urgent, over-triage if a patient had a non-urgent
condition and was triaged as urgent or emergent. Statistical description included percent, averages, and standard deviation
where appropriate. A standard 4x4 contingency table was used to calculate the sensitivity and specificity. For comparison of
performance, a post-hoc analysis was done where the nurses were divided into two groups, those with work experience of less
than or equal to 5 years (group 1) and more than 5 years (group 2). An independent samples t-test was used to determine the
difference in performance between the two groups.
Results: Overall, performance on pre-test - post-test differed significantly before and after training. The nurses in Group 1
had higher pre-test scores (Group 1 mean = 62.35%, Group 2 mean = 52.41%, p-value = 0.001), were less likely to
overtriage (Group 1 mean = 4.11%, Group 2 mean = 6.46%, p-value = 0.021) and had higher specificity of triage than
Group 2 (Group 1 mean = 95.61, Group 2 = 92.39, p-value = 0.019). However, the nurses in Group 2 had more
improvement in their post-test scores (percent of improvement from pre-test: Group 1 mean = 8.56%, Group 2 = 34.69%,
p-value = 0.005).
Conclusion: Work experience is an important consideration in the triage knowledge and performance of non-pediatric
nurses during triage training.
Keywords: Pediatric triage, Performance, Nurse, Work-year
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