TY - JOUR
T1 - Assessment of inter-rater reliability of screening tools to identify patients at risk of medication-related problems across the emergency department continuum of care
AU - D'lima, Jessica
AU - Taylor, Simone E.
AU - Mitri, Elise
AU - Harding, Andrew
AU - Lai, Jerry
AU - Manias, Elizabeth
N1 - Publisher Copyright:
© 2023 The Authors
PY - 2024/6
Y1 - 2024/6
N2 - 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.
AB - 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.
KW - Drug-related side effects and adverse reactions
KW - Emergency medical services
KW - Medication therapy management
KW - Medication-related problems
KW - Patient discharge
KW - Patient transfer
UR - http://www.scopus.com/inward/record.url?scp=85176790715&partnerID=8YFLogxK
U2 - 10.1016/j.auec.2023.10.005
DO - 10.1016/j.auec.2023.10.005
M3 - Article
C2 - 37973428
AN - SCOPUS:85176790715
SN - 2589-1375
VL - 27
SP - 136
EP - 141
JO - Australasian Emergency Care
JF - Australasian Emergency Care
IS - 2
ER -