PubMed · 7090055
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M Tunçer, E Yilgör, G Erdem. A new, simple three-step method for determining gestational age.. https://pubmed.ncbi.nlm.nih.gov/7090055/
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Triage nurse ordering of tests can reduce patient time in the emergency department. This benefit must be balanced with the extra expense and potential morbidity of unnecessary tests. This study examined whether triage nurse ordering of lab tests and X-rays correlated with physician ordering. In Phase I, a prospective study, triage nurses completed an order form for each patient triaged during randomly selected 2-hour blocks over a 3-week period. In Phase II, Phase I was repeated with test ordering guidelines derived from Phase I results. Correlations of nurse and physician orders were analyzed by kappa statistics and paired t tests. In Phase I, 176 patients were enrolled of a possible 204 (82%). In Phase II, 350 patients were enrolled of a possible 418 (84%). The percentage of nurse overordering of tests in Phase I was 35%; In Phase II, it was 34% (P NS). Kappa values were determined for blood testing (Phase I, 0.48; Phase II, 0.54 [P = .048]), for X-ray (Phase I, 0.68; Phase II, 0.65 [P = .523]), for urinalysis (Phase I, 0.76; Phase II, 0.67 [P = .338]), and for electrocardiogram (Phase I, 0.78; Phase II, 0.77 [P = .438]). The improved lab correlation in Phase II resulted from the nurses ordering fewer tests (P = .046). Nurses deviated from the test ordering guidelines in 37% of patients. Triage nurse ordering of X-rays, electrocardiogram, and urinalysis has moderate to substantial correlation with physician ordering. Correlation of triage nurse and physician ordering of tests can be improved with the use of test ordering guidelines.
The aim of this study was to design and test the reliability of an assessment tool that could be used by physiotherapists to quantify the mobility of wheelchair-dependent paraplegics. The assessment tool examined six key tasks fundamental to the mobility of wheelchair-dependent paraplegics, comprising moving from lying to sitting, completing a horizontal transfer, completing a vertical transfer, pushing on flat ground, pushing on ramps and negotiating kerbs. A six-point scoring system was used to assess the level of mobility attained by subjects on each task. The scoring system was different for each task and took into account the level of assistance and time required to complete the task or the complexity of the task. Twenty wheelchair-dependent paraplegics were assessed independently by two therapists using the assessment tool. The Cohen's Weighted Kappas describing inter-rater reliability of each task ranged between 0.82-0.96, indicating a high reliability between therapists. It was concluded that the assessment tool is a reliable way of assessing the mobility of wheelchair-dependent paraplegics.