An Audit of the Appropriateness of Teletriage Nursing Advice

TELEMEDICINE JOURNAL AND e-HEALTHVolume 10, Number 1, 2004© Mary Ann Liebert, Inc.An Audit of the Appropriateness of Teletriage Nursing Advice1 2JOHN C. HOGENBIRK, M.Sc., and RAYMOND W. PONG, Ph.D.ABSTRACTThis study assessed the appropriateness of advice given by teletriage nurses to patients innorthern Ontario. Assessments used audiotapes and printed records of 73 calls, selected fromapproximately 350 calls based on sound quality, completeness, and consent of caller and tele-triage nurse. Audits were conducted independently by one family physician, one nurse prac-titioner, and one registered nurse with teletriage experience. In 56% of the 73 calls, all threeauditors judged the nurse’s advice as “appropriate.” In 92% of the 73 calls, at least two of thethree auditors judged the teletriage nurse’s advice as “appropriate.” All calls were rated as“appropriate” by at least one auditor. If not “appropriate,” then auditors were three timesmore likely to rate the advice as “overly-cautious” rather than “insufficient.” The percentageof calls with the same rating varied from 62% to 86% with an outlier of 33%. Nurse practi-tioners tended to rate the appropriateness of the advice slightly, but significantly lower thanthe rating given by family physicians or registered nurses. Interestingly, nurse practitionerstended to rate aspects of the nurse–caller interaction advice as slightly and significantly bet-ter than the rating chosen by family physicians or ...