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Telephone triage by nurses in primary care out-of-hours services in Norway: an evaluation study based on written case scenarios

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dc.contributor.author Hansen, Elisabeth Holm
dc.contributor.author Hunskår, Steinar
dc.date.accessioned 2012-01-10T08:24:03Z
dc.date.available 2012-01-10T08:24:03Z
dc.date.issued 2011-01-24
dc.identifier.citation BMJ Quality & Safety 2011;20:390-396 en
dc.identifier.issn 2044-5415
dc.identifier.uri http://dx.doi.org/10.1136/bmjqs.2010.040824
dc.identifier.uri http://hdl.handle.net/1956/5384
dc.description.abstract Background: The use of nurses for telephone-based triage in out-of-hours services is increasing in several countries. No investigations have been carried out in Norway into the quality of decisions made by nurses regarding our priority degree system. There are three levels: acute, urgent and non-urgent. Methods: Nurses working in seven casualty clinics in out-of-hours districts in Norway (The Watchtowers) were all invited to participate in a study to assess priority grade on 20 written medical scenarios validated by an expert group. 83 nurses (response rate 76%) participated in the study. A one-out-of-five sample of the nurses assessed the same written cases after 3 months (n¼18, response rate 90%) as a testeretest assessment. Results: Among the acute, urgent and non-urgent scenarios, 82%, 74% and 81% were correctly classified according to national guidelines. There were significant differences in the proportion of correct classifications among the casualty clinics, but neither employment percentage nor profession or work experience affected the triage decision. The mean intraobserver variability measured by the Cohen kappa was 0.61 (CI 0.52 to 0.70), and there were significant differences in kappa with employment percentage. Casualty clinics and work experience did not affect intrarater agreement. Conclusion: Correct classification of acute and nonurgent cases among nurses was quite high. Work experience and employment percentage did not affect triage decision. The intrarater agreement was good and about the same as in previous studies performed in other countries. Kappa increased significantly with increasing employment percentage. en
dc.language.iso eng en
dc.publisher bmj publishing group en
dc.relation.ispartof <a href="http://hdl.handle.net/1956/5387" target="blank">Monitoring activities in out-of-hours emergency primary care in Norway. A special emphasis on nurses telephone triage and counselling</a> en
dc.rights Copyright 2011, BMJ Publishing Group Ltd & The Health Foundation en
dc.rights.uri http://creativecommons.org/licenses/by/2.0/ en
dc.title Telephone triage by nurses in primary care out-of-hours services in Norway: an evaluation study based on written case scenarios en
dc.type Peer reviewed en
dc.type Journal article en
dc.subject.nsi VDP::Medical disciplines: 700::Health sciences: 800 en
dc.subject.nsi VDP::Medical disciplines: 700::Health sciences: 800::Health service and health administration research: 806 en
dc.type.version publishedVersion en


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Copyright  2011, BMJ Publishing Group Ltd & The Health Foundation Except where otherwise noted, this item's license is described as Copyright 2011, BMJ Publishing Group Ltd & The Health Foundation

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