title: A comparison of parental and nursing assessments of level of illness or injury in a pediatric emergency department.
abstract: BACKGROUND
  The 5-tier Emergency Severity Index (ESI) score is a well-accepted, validated triage tool with good interrater reliability. Parental perception of illness severity has not been compared to ESI score.
  
  
  OBJECTIVE
  This study compares parental assessment of severity of illness to triage nurse acuity.
  
  
  METHODS
  Prospective and descriptive.
  
  
  METHODS
  Large, urban pediatric emergency department (ED).
  
  
  METHODS
  Parents/guardians of patients younger than 18 years.
  
  
  METHODS
  The triage nurse assigned an ESI score, and the parent/ guardian assigned all patients a severity score on a scale of 1 to 5 (1, most sick and 5, least sick). Mean severity scores were compared between the groups.
  
  
  RESULTS
  There were 142 participants with a mean patient age of 6.15 years. The mean participant and nurse severity scores were 3.01 and 3.35, respectively, with an intraclass correlation coefficient of 0.203 (P = 0.008). Most frequently, the parent/guardian and triage nurse assigned the same score (n = 44, 31%). Seventy-six percent of the parent/ guardian scores were within 1 point of the triage nurse score.
  
  
  CONCLUSIONS
  Close agreement exists between parent/guardian and nurse ESI scores, illustrating objectivity in parent/guardian assessments. This study provides a springboard for future studies regarding ED use after educating families on ED triage.
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Children's Hospital of Pittsburgh, Pittsburgh, PA 64108, USA. vlkestner@cmh.edu
authors.forename: Valerie
authors.initials: V
authors.lastname: Kestner
authors.forename: Ev
authors.initials: E
authors.lastname: Vogeley
authors.forename: Raymond D
authors.initials: RD
authors.lastname: Pitetti
authors.forename: Qing
authors.initials: Q
authors.lastname: Sun
authors.forename: Kala N
authors.initials: KN
authors.lastname: Parker
authors.forename: Lisa
authors.initials: L
authors.lastname: Maloney
mesh_terms: D002648:Child; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009730:Nursing Assessment; D010290:Parents; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014218:Triage; D014505:Urban Population