Jessica D’lima , Simone E. Taylor , Elise Mitri , Andrew Harding , Jerry Lai , Elizabeth Manias
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引用次数: 0
摘要
背景在一项全国性多中心研究之后，我们开发了两种急诊科（ED）筛查工具来确定药物相关问题的风险；一种在急诊科就诊时使用，另一种在急诊科出院返回社区时使用。本研究旨在确定急诊科医护人员在将这些筛查工具应用于一系列病例情景时的相互评分可靠性。方法 在一家大型都市医院的急诊科开展了一项前瞻性横断面研究。在对一系列患者进行急诊室观察后，研究人员设计了 12 个病例情景，并将其纳入问卷调查，分发给 50 名医疗专业人员。结果15名医生、19名护士和16名药剂师填写了问卷。Fleiss'kappa显示，急诊室表现工具的总体评分者间可靠性为0.83（95% CI 0.83-0.84），表明评分者间的一致性接近完美。ED 出院工具的弗莱斯卡帕值为 0.83（95% CI 0.83-0.85），也显示出近乎完美的一致性。这些结果对于确保急诊科在筛查有用药相关问题风险的患者时决策的一致性具有重要意义。
Assessment of inter-rater reliability of screening tools to identify patients at risk of medication-related problems across the emergency department continuum of care
Background
Following a national multicentre study, two emergency department (ED) screening tools were developed to determine risk of medication-related problems; one for use at ED presentation and another at ED discharge to the community. This study aimed to determine the inter-rater reliability amongst ED health professionals when applying these screening tools to a series of case scenarios.
Methods
A prospective, cross-sectional study was undertaken in the ED of a major metropolitan hospital. Twelve case scenarios were developed following ED observation of a range of patients, which were incorporated into a questionnaire and distributed to 50 health professionals. Inter-rater reliabilities of each explanatory variable of the screening tools and overall assessment were calculated using Fleiss’ multi-rater kappa.
Results
The questionnaire was completed by 15 doctors, 19 nurses and 16 pharmacists. Fleiss’ kappa showed an overall inter-rater reliability for the ED presentation tool of 0.83 (95% CI 0.83–0.84), indicating near perfect agreement. Fleiss’ kappa for the ED discharge tool was 0.83 (95% CI 0.83–0.85), which also showed near perfect agreement.
Conclusions
The screening tools produced favourable inter-rater reliability amongst ED health professionals. These results have important implications for ensuring consistency of ED decision-making in screening patients at risk of developing medication-related problems.
期刊介绍：
Australasian Emergency Care is an international peer-reviewed journal dedicated to supporting emergency nurses, physicians, paramedics and other professionals in advancing the science and practice of emergency care, wherever it is delivered. As the official journal of the College of Emergency Nursing Australasia (CENA), Australasian Emergency Care is a conduit for clinical, applied, and theoretical research and knowledge that advances the science and practice of emergency care in original, innovative and challenging ways. The journal serves as a leading voice for the emergency care community, reflecting its inter-professional diversity, and the importance of collaboration and shared decision-making to achieve quality patient outcomes. It is strongly focussed on advancing the patient experience and quality of care across the emergency care continuum, spanning the pre-hospital, hospital and post-hospital settings within Australasia and beyond.
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