한국형 응급환자 분류도구의 간호사 간 신뢰도 평가
Inter-rater Reliability of Korean Triage and Acuity Scale (KTAS) among the Research Nurses and the Triage Nurses
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목적 : 본 연구는 한국형 응급환자 분류도구(Korean Triage and Acuity Scale, KTAS)와 소아 한국형 응급환자 분류도구(Pediatric Korean Triage and Acuity Sclae, PedKTAS)의 평가자 간 신뢰도를 평가한 전향적 조사 연구이다. 연구방법 : 2018년 1월부터 6월까지 일개 지역응급의료센터에서 자료를 수집하였다. 내원한 성인 환자 400명(15세 이상)과 소아 환자 400명(15세 미만)을 대상으로 연구자와 중증도 분류 간호사 간 신뢰도를 평가하였다. 결과 : KTAS의 신뢰도는 κ=.73 (95% CI =.68~.78)으로 Substantial 수준과 퍼센트 일치도는 77.0%로 평가되었고 PedKTAS의 신뢰도는 κ=.76 (95% CI = .71~.82)으로 Substantial 수준과 퍼센트 일치도는 83.8%로 평가되었다. 결과 : KTAS의 평가자 간 신뢰도는 적합한 수준이었으나 퍼센트 일치도는 적합한 기준인 80%보다 낮았다. PedKTAS의는 평가자 간 신뢰도와 퍼센트 일치도는 적합한 수준으로 확인되었다. 향후 신뢰도를 개선하기 위한 지속적인 노력이 필요하다.
Abstract
Purpose: The study aims to assess the inter-rater reliability of the Korean Triage and Acuity Scale between the research nurses and the triage nurses. Methods: Interrater reliability was measured on 400 adult (≧15) and 400 pediatric (<15) patients who visited the emergency medical center from January 4 to June 30, 2018. Results: The study result showed that the inter-rater reliability of the Korean Triage and Acuity Scale was substantial, with κ=.73 (95% Confidence interval= .68-.78) and 77.0 percent agreement. The inter-rater of Pediatric Korean Triage and Acuity Scale was also substantial, with κ=.76 (95% Confidence interval= .71-.82) and 83.8 percent agreement. Conclusion: Although the inter-rater reliability of the Korean Triage and Acuity Scale was acceptable, the percent agreement was lower than the desirable level (<80.0%). It was confirmed that Pediatric Korean Triage and Acuity Scale had an acceptable level of inter-rater reliability and percent agreement for clinical use. Efforts should be made to improve the reliability in the future.
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