HUBUNGAN TINGKAT CANADIAN TRIAGE ACUITY SCALE DENGAN NATIONAL EARLY WARNING SCORE PADA PASIEN DI RUANG INSTALASI GAWAT DARURAT RSUD UMAR WIRAHADIKUSUMAH
Bibliographic record
Abstract
Instalasi Gawat Darurat (IGD) RSUD Umar Wirahadikusumah memiliki beban pelayanan tinggi sehingga membutuhkan proses triage yang cepat, tepat, dan akurat. Canadian Triage Acuity Scale (CTAS) digunakan untuk menentukan prioritas penanganan berdasarkan gambaran klinis, sedangkan National Early Warning Score (NEWS) menilai parameter fisiologis untuk mendeteksi risiko perburukan. Ketidaksesuaian antara kedua instrumen berpotensi menimbulkan undertriage maupun overtriage yang dapat berdampak pada keselamatan pasien. Penelitian ini bertujuan untuk mengetahui hubungan antara tingkat CTAS dan skor NEWS pada pasien di IGD RSUD Umar Wirahadikusumah. Penelitian ini menggunakan desain analitik korelasional dengan pendekatan cross-sectional. Sebanyak 307 pasien diambil sebagai sampel dengan teknik simple random sampling selama shift pagi, siang dan malam. Pengumpulan data menggunakan lembar observasi CTAS dan NEWS, kemudian dianalisis menggunakan uji korelasi Rank-Spearman. Hasil penelitian menunjukkan adanya hubungan positif dan signifikan antara tingkat CTAS dan skor NEWS dengan nilai rho sebesar 0,184 dan nilai signifikansi <0,001. Hasil analisis lebih lanjut menunjukkan bahwa 62 pasien (20,2%) mengalami undertriage, 156 pasien (50,8%) mengalami overtriage, dan 89 pasien (29,0%) telah diklasifikasikan secara sesuai. Proporsi overtriage lebih tinggi dibandingkan undertriage, namun keberadaan keduanya menegaskan adanya potensi ketidaktepatan dalam penetapan prioritas kegawatan. Temuan ini mengindikasikan bahwa CTAS dan NEWS menilai aspek kegawatan yang berbeda tetapi saling melengkapi. Integrasi kedua instrumen berpotensi meningkatkan ketepatan prioritas triage, memperkuat deteksi dini risiko, serta meningkatkan keselamatan pasien dan efektivitas pelayanan di Instalasi Gawat Darurat. The Emergency Department of Umar Wirahadikusumah Regional Hospital carries a high service burden, requiring a triage process that is fast, precise, and accurate. The Canadian Triage Acuity Scale (CTAS) is used to determine treatment priority based on clinical presentation, while the National Early Warning Score (NEWS) assesses physiological parameters to detect the risk of clinical deterioration. Discrepancies between these two instruments may lead to undertriage or overtriage, both of which can affect patient safety. This study aims to determine the correlation between CTAS levels and NEWS scores among patients in the Emergency Department of RSUD Umar Wirahadikusumah. This research employed a correlational analytic design with a cross-sectional approach. A total of 307 patients were selected using simple random sampling across morning, afternoon, and night shifts. Data were collected using CTAS and NEWS observation sheets and analyzed using the Spearman Rank correlation test. The results showed a positive and significant correlation between CTAS levels and NEWS scores, with a rho value of 0.184 and p value of <0.001. Further analysis revealed that 62 patients (20.2%) experienced undertriage, 156 patients (50.8%) experienced overtriage, and 89 patients (29.0%) were classified appropriately. The proportion of overtriage was higher than undertriage, although the presence of both indicates the potential for inaccuracies in determining emergency care priorities. These findings suggest that CTAS and NEWS assess different but complementary aspects of patient acuity. Integrating both instruments may enhance the accuracy of triage prioritization, strengthen early risk detection, and improve patient safety and service effectiveness in the Emergency Department.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.020 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".