Construction of emergency triage assessment tool for early identification of acute posterior circulation ischemic stroke

LUO Cuifang; SHI Lei; DU Zhongnian; CHEN Siyu; FU Xian

doi:10.16460/j.issn1008-9969.2025.08.074

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Journal of Nursing ›› 2025, Vol. 32 ›› Issue (8) : 74-78. DOI: 10.16460/j.issn1008-9969.2025.08.074

Construction of emergency triage assessment tool for early identification of acute posterior circulation ischemic stroke

LUO Cuifang^1,2a, SHI Lei¹, DU Zhongnian^2a, CHEN Siyu^2b, FU Xian^2b

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Abstract

Objective To construct an assessment tool specifically designed for emergency settings to help identify acute posterior-circulation ischemic stroke (APCIS) patients during initial assessment. Methods Through literature review, the Delphi method was used to conduct two rounds of consultation with 23 experts in the field of emergency nursing management, stroke center, and neurology and nursing. Results The effective recovery rates of the two rounds of consultation were 92% and 100%, the expert authority coefficients 0.959 and 0.970, and the Kendall’s concordance coefficients 0.230 and 0.341, respectively (P<0.001). The final triage assessment tool for APCIS comprised two dimensions with eight assessment items, incorporated three triage nurse decision pathways, and established one stroke center admission criterion. Conclusion The constructed assessment tool for pre-examination and triage of APCIS is scientific and rigorous, and this reliable instrument provides an evidence-base foundation for optimizing emergency triage workflows and improving efficiency, while advancing specialized emergency nursing competencies.

Key words

posterior circulation ischemic / stroke / early identification / pre-examination and triage

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LUO Cuifang, SHI Lei, DU Zhongnian, CHEN Siyu, FU Xian. Construction of emergency triage assessment tool for early identification of acute posterior circulation ischemic stroke[J]. Journal of Nursing. 2025, 32(8): 74-78 https://doi.org/10.16460/j.issn1008-9969.2025.08.074

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