Interobserver agreement in Reception and Risk Stratification in Obstetrics implementation

Rev Bras Enferm. 2024 Dec 13;77(5):e20230361. doi: 10.1590/0034-7167-2023-0361. eCollection 2024.
[Article in English, Portuguese]

Abstract

Objectives: to analyze interobserver agreement in the Reception and Risk Stratification in Obstetrics protocol implementation.

Methods: a cross-sectional study carried out during Reception and Risk Stratification in Obstetrics implementation, conducted in a tertiary hospital in southern Brazil with 891 participants in January 2020. Descriptive and interobserver agreement analysis was carried out using the Kappa coefficient in the risk stratification assigned by the triage nurse and reviewed by the researcher.

Results: around half of the calls (55.6%) were stratified as not very urgent (green), followed by urgent (yellow) (31.8%), very urgent (orange) (9.3%), not urgent (blue) (3.4%) and no emerging stratification (red). Agreement analysis of revised stratification found Kappa values of 0.20 (blue), 0.54 (green), 0.77 (yellow) and 0.80 (orange).

Conclusions: most appointments were non-urgent. The agreement analysis between the revised and assigned risk stratification revealed greater interobserver agreement as the priority level increased.

Objetivos:: analizar la concordancia interobservador en la implementación del protocolo de Acogida y Clasificación de Riesgos en Obstetricia.

Métodos:: estudio transversal, realizado durante la implementación de la Clasificación de Acogida y Riesgo en Obstetricia, realizado en un hospital terciario del sur de Brasil con 891 participantes en enero de 2020. Se realizó un análisis descriptivo y de concordancia interobservador utilizando el coeficiente Kappa en la clasificación de riesgo asignado por el enfermero clasificador y revisado por el investigador.

Resultados:: alrededor de la mitad de las llamadas (55,6%) se clasificaron como no muy urgentes (verde), seguidas de urgentes (amarillo) (31,8%), muy urgentes (naranja) (9,3%), no urgentes (azul) (3,4%) y sin clasificación emergente (rojo). El análisis de concordancia de la clasificación revisada encontró valores Kappa de 0,20 (azul), 0,54 (verde), 0,77 amarillo y 0,80 (naranja).

Conclusiones:: la mayoría de las consultas no fueron muy urgentes. El análisis de concordancia entre la clasificación de riesgo revisada y asignada reveló una mayor concordancia interobservador a medida que aumentaba el nivel de prioridad.

MeSH terms

  • Adult
  • Brazil
  • Cross-Sectional Studies
  • Female
  • Humans
  • Observer Variation*
  • Obstetrics / methods
  • Obstetrics / standards
  • Obstetrics / statistics & numerical data
  • Pregnancy
  • Risk Assessment / methods
  • Risk Assessment / standards
  • Risk Assessment / statistics & numerical data
  • Triage / methods
  • Triage / standards
  • Triage / statistics & numerical data

Grants and funding

This work was carried out with the support of the e Coordination for the Improvement of Higher Education Personnel (CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) Brazil- Financing Code 001.