Assessment of inter-rater reliability of screening tools to identify patients at risk of medication-related problems across the emergency department continuum of care.

D'lima, Jessica; Taylor, Simone E; Mitri, Elise A; Harding, Andrew M; Lai, Jerry; Manias, Elizabeth

doi:10.1016/j.auec.2023.10.005

Title

Assessment of inter-rater reliability of screening tools to identify patients at risk of medication-related problems across the emergency department continuum of care.

Publication Date

2023-11-14

Author(s)

D'lima, Jessica

Taylor, Simone E

Mitri, Elise A

Harding, Andrew M

Lai, Jerry

Manias, Elizabeth

Subject

Drug-related side effects and adverse reactions

Emergency medical services

Medication therapy management

Medication-related problems

Patient discharge

Patient transfer

Type of document

Journal Article

OrcId

#PLACEHOLDER_PARENT_METADATA_VALUE#

DOI

10.1016/j.auec.2023.10.005

Abstract

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. 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. 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. 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.

Link

link

Citation

Australasian Emergency Care 2023-11-14

Jornal Title

Australasian Emergency Care

ISSN

2588-994X

Austin Health

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