title: Effect of Triage Training on Concordance of Triage Level between Triage Nurses and Emergency Medical Technicians.
abstract: BACKGROUND
  The transfer of care occurs frequently between emergency medical technicians and emergency ward nurses during which emergency medical technicians transfer the patients from the society to the hospital. This transfer of care often occurs under crowded conditions and in high acuity which would pave the way for a disruption of communication.
  
  
  OBJECTIVE
  This study aimed to investigate the effect of training Emergency Severity Index (ESI) triage on concordance of triage level between emergency medical technicians and triage nurses.
  
  
  METHODS
  This interventional study was conducted on all triage nurses and emergency medical technicians in Iranshahr City in winter of 2014. Five triage nurses and 30 emergency medical technicians were included into the study using census. To collect data, Personal Information Form (PIF) and ESI Triage Criterion were used. During the project implementation, patients were separately classified before and after triage training by emergency medical technicians and triage nurses. To analyse the data, kappa coefficient under SPSS 16 statistical software was used.
  
  
  RESULTS
  According to the study results, Cohen's kappa concordance coefficient showed that triage concordance between emergency medical technicians and triage nurses before training was 0.20 which was at an unfavorable level. After training, Cohen's kappa concordance coefficient reached 0.62, which showed a desirable level of concordance as well as a significant difference after training.
  
  
  CONCLUSIONS
  It is recommended to train and use common triage system to facilitate transfer or delivery of care between emergency medical technicians and triage nurses.
authors.affiliation: Msc of Nursing, Department of Nursing, Iranshahr University of Medical Sciences , Iranshahr, Iran .
authors.forename: Nezare
authors.initials: N
authors.lastname: Ghanbarzehi
authors.affiliation: Msc Nursing, Department of Nursing, Zabol University of Medical Sciences , Zabol, Iran .
authors.forename: Abbas
authors.initials: A
authors.lastname: Balouchi
authors.affiliation: PhD, Assistant Professor, Nursing Education, Kerman University of Medical Science , Kerman, Iran .
authors.forename: Sakineh
authors.initials: S
authors.lastname: Sabzevari
authors.affiliation: Msc of Nursing, Department of Nursing Iranshahr University of Medical Sciences , Iranshahr, Iran .
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Darban
authors.affiliation: Msc of Nursing, Department of Nursing Iranshahr University of Medical Sciences , Iranshahr, Iran .
authors.forename: Nastaran Haydari
authors.initials: NH
authors.lastname: Khayat
keywords: Emergency severity index (ESI); Emergency ward; Emergency ward nurses