title: The Emergency Triage Education Kit: improving paediatric triage.
abstract: OBJECTIVE
  The Emergency Triage Education Kit (ETEK) was published in 2007. To date, the impact of ETEK has not been measured. The purpose of this study was to measure the effectiveness of ETEK on paediatric triage.
  
  
  METHODS
  A retrospective chart audit was undertaken in a tertiary paediatric hospital. Its' aim was to review the completeness of documentation recorded at the point of triage after a standardised documentation framework was introduced and to measure inter-rater agreement. Primary assessment and physiological discriminators documented at the point of triage were compared with those from the paediatric physiological discriminator table (PPDT) within ETEK. Using an audit tool developed by the researchers, a parallel decision-making pathway was used to ascertain whether the original ATS score could be substantiated by the PPDT. Improvement in documentation of the primary assessment and inter-rater agreement was measured over time.
  
  
  RESULTS
  600 triage records were selected; 200 each from 2007, 2008 and 2010. Triage documentation that did not support parallel decision-making decreased significantly according to the year of presentation (2007; 112 (56%), 2008; 106 (53%), 2010; 13 (7%), P<0.001). When parallel decision-making was facilitated by an improvement in triage documentation, there was improvement in matched triage scores (2007; 54%, 2008; 69%, 2010; 72%, P=0.01).
  
  
  CONCLUSIONS
  The introduction of ETEK has had a significant impact in this ED, particularly when combined with education sessions. The use of the PPDT as a framework to guide documentation and triage language facilitated parallel decision-making and auditing, and led to an improvement in inter-rater agreement when applied to children.
authors.affiliation: Department of Emergency Medicine, Royal Children's Hospital, Herston Road, Herston, Brisbane, Queensland 4029, Australia; School of Population Health, The University of Queensland, Herston Road, Herston, Brisbane, Queensland 4006, Australia; Nursing Research Unit, Royal Children's Hospital, Herston Road, Herston, Brisbane, Queensland 4029, Australia. Electronic address: lorelle_malyon@health.qld.gov.au.
authors.forename: Lorelle
authors.initials: L
authors.lastname: Malyon
authors.affiliation: Nursing Research Unit, Royal Children's Hospital, Herston Road, Herston, Brisbane, Queensland 4029, Australia; Children's Nutrition Research Centre, The University of Queensland, Herston Road, Herston, Brisbane, Queensland 4006, Australia; Queensland Children's Medical Research Institute, The University of Queensland, Herston Road, Herston, Brisbane, Queensland 4006, Australia.
authors.forename: Alison
authors.initials: A
authors.lastname: Williams
authors.affiliation: School of Population Health, The University of Queensland, Herston Road, Herston, Brisbane, Queensland 4006, Australia; Queensland Children's Medical Research Institute, The University of Queensland, Herston Road, Herston, Brisbane, Queensland 4006, Australia.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Ware
mesh_terms: D000293:Adolescent; D001315:Australia; D002648:Child; D004506:Education, Nursing / Q000379:methods*; D016529:Emergency Nursing / Q000193:education* / Q000592:standards; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008485:Medical Audit; D015588:Observer Variation; D010372:Pediatrics / Q000193:education* / Q000592:standards; D014218:Triage / Q000592:standards*
keywords: Audit; ETEK; Emergency; Hospital; Paediatric; Triage