Interobserver agreement in Reception and Risk Stratification in Obstetrics implementation.
Manuela Beatriz Velho, Luciana Santos Pimentel, Fernanda Amâncio Soares da Silva and 5 others
PMID 39699415WHAT IT FOUND
Nurses and an obstetric resident disagreed on 230 of 891 pregnant women's triage levels.
Nurses more often assigned a higher urgency than the review. Agreement was stronger for urgent cases.
Key findings
01In 891 obstetric emergency records, the nurse's assigned risk level and the researcher's revised risk level disagreed in 230 cases (25.7%).
02Agreement was weak for the lowest priority level, moderate for the next level, and strong for urgent levels.
03Most disagreement was nurses assigning a more urgent level than the review (184 cases), with fewer assigning a less urgent level (44 cases).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study used retrospective medical records, so missing or incomplete entries could bias the comparison. Time between arrival and triage, and time between triage and medical care, were not recorded, so those parts of the protocol could not be analyzed. The review was done by one researcher after the fact, and the paper does not report a second blinded reviewer. All records came from one month at one tertiary hospital, so the results may not apply to other settings or other months. No cases were stratified as red, so agreement for the most urgent level was not tested. The sample size was checked after data analysis, not planned before it.
Declared interests
The work was supported by CAPES Brazil, Financing Code 001. No other funding or conflict statement is given in the supplied text.
The easy way to misread this
Do not read this as proof that the triage protocol reduces waiting time or adverse outcomes. The study only compared two reviewers' risk ratings in records, and the authors state that outcome reduction cannot be concluded from this non-interventional study.