Repeatability of the Manchester Triage System for children

Objective The authors aimed to assess the repeatability of the Manchester Triage System (MTS) in children. Methods All emergency department nurses (n=43) from a general teaching hospital and a university children's hospital in The Netherlands triaged 20 written case scenarios using the Manchester Triage system. Second, at two emergency departments (EDs), real-life simultaneous triage of patients (<16 years) was performed by ED nurses and two research nurses. The written case scenarios and the patients included in the real-life simultaneous triage study were representative of children attending the ED, in age, problem and urgency level. The authors assessed inter-rater agreement using quadratic weighted kappa values. Results The weighted kappa between the nurses, triaging the case scenarios, was 0.83 (95% CI 0.74 to 0.91). In total, 88% (N=198) of the eligible ED patients were triaged simultaneously, with a weighted kappa of 0.65 (95% CI 0.56 to 0.72). Conclusions The MTS showed good to very good repeatability in paediatric emergency care

Perception of evidence-based practice and the professional environment of Primary Health Care nurses in the Spanish context: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>The study of the factors that encourage evidence-based clinical practice, such as structure, environment and professional skills, has contributed to an improvement in quality of care. Nevertheless, most of this research has been carried out in a hospital context, neglecting the area of primary health care. The main aim of this work was to assess the factors that influence an evidence-based clinical practice among nursing professionals in Primary Health Care.</p> <p>Methods</p> <p>A multicentre cross-sectional study was designed, taking the 619 Primary Care staff nurses at the Balearic Islands’ Primary Health Care Service, as the study population. The methodology applied consisted on a self-administered survey using the instruments <it>Evidence-Based Practice Questionnaire (EBPQ)</it> and <it>Nursing Work Index (NWI)</it>.</p> <p>Results</p> <p>Three hundred and seventy seven surveys were received (60.9% response rate). Self-assessment of skills and knowledge, obtained 66.6% of the maximum score. The <it>Knowledge/Skills</it> factor obtained the best scores among the staff with shorter professional experience. There was a significant difference in the <it>Attitude</it> factor (p = 0.008) in favour of nurses with management functions, as opposed to clinical nurses.</p> <p>Multivariate analysis showed a significant positive relationship between NWI and level of evidence-based practice (p < 0,0001).</p> <p>Conclusions</p> <p>Institutions ought to undertake serious reflection on the lack of skills of senior nurses about Evidence-Based Clinical Practice, even when they have more professional experience. Leadership emerge as a key role in the transferral of knowledge into clinical practice.</p