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  • Title: Manchester Triage in Sweden - interrater reliability and accuracy.
    Author: Olofsson P, Gellerstedt M, Carlström ED.
    Journal: Int Emerg Nurs; 2009 Jul; 17(3):143-8. PubMed ID: 19577200.
    Abstract:
    INTRODUCTION: This study investigates the interrater reliability and the accuracy of Manchester Triage (MTS) at emergency departments in Western Sweden. METHODS: A group of 79 nurses from seven emergency departments assessed simulated patient cases and assigned triage categories using the same principles as in their daily work. K statistics, accuracy, over-triage and under-triage were then analyzed. The nurses performed 1027 triage assessments. RESULTS: The result showed an unweighted kappa value of 0.61, a linear weighted kappa value of 0.71, and a quadratic weighted kappa value of 0.81. The determined accuracy was 92% and 91% for the two most urgent categories, but significantly lower for the less urgent categories. CONCLUSIONS: Patients in need of urgent care were identified in more than nine out of 10 cases. The high level of over-triage and under-triage in the less urgent categories resulted in low agreement and accuracy. This may suggest that the resources of emergency departments can be overused for non-urgent patients.
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