title: A reliability study of the rapid emergency triage and treatment system for children.
abstract: BACKGROUND
  To evaluate inter- and intrarater reliability of a new Scandinavian triage system for children, the Rapid Emergency Triage and Treatment System-pediatric (RETTS-p).
  
  
  METHODS
  Two observational studies were conducted at the Pediatric Emergency Department (PED), St. Olav's University Hospital, Trondheim, Norway. Using RETTS-p, nurses assign one of five triage priority levels to each patient on the basis of clinical signs and symptoms evaluations and vital parameter measurements. Study 1: Prior to the introduction of RETTS-p in 2012, all nurses in the PED completed a theoretical and practical training. Four months later, 19 nurses triaged 20 fictive but realistic pediatric cases two times 9 months apart (Waves A and B). Study 2: Nurse pairs consisting of a regular nurse and a research nurse simultaneously and independently triaged 200 pediatric patients who were referred with various common medical and surgical complaints.
  
  
  RESULTS
  Study 1: Kendall's W for Waves A and B were 0.822 and 0.844, respectively. Using a mixed linear model, we found no difference in triage priority levels between Waves A and B. Compared to a consensus level made by the research group, the nurses rated 85.1 % fictive cases correctly, and 99 % were rated correctly or within one adjacent priority score. Study 2: The interrater correlation coefficient in a linear mixed model was 0.762, confirming a high interrater reliability in real-life triaging.
  
  
  CONCLUSIONS
  We found a very high degree of agreement between nurses who used RETTS-p to prioritize children, both in a theoretical case scenarios study, but also in real-life triaging.
  
  
  CONCLUSIONS
  RETTS-p may be a credible and robust triage system, but it has not been validated yet.
authors.affiliation: Department of Pediatrics, St. Olav's University Hospital, Trondheim, Norway.
authors.forename: Brita
authors.initials: B
authors.lastname: Henning
authors.affiliation: Regional Centre for Child and Youth Mental Health and Child Welfare, Trondheim, Norway.
authors.forename: Stian
authors.initials: S
authors.lastname: Lydersen
authors.affiliation: Department of Pediatrics, St. Olav's University Hospital, Trondheim, Norway. henrik.dollner@ntnu.no.|Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway. henrik.dollner@ntnu.no.
authors.forename: Henrik
authors.initials: H
authors.lastname: Døllner
mesh_terms: D002648:Child; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D009664:Norway; D015203:Reproducibility of Results; D013997:Time Factors; D014218:Triage / Q000379:methods*