Efektivitas dan akurasi pediatric assessment triangle (PAT) dan pediatric early warning score (PEWS) terhadap kecepatan penilaian pasien anak di IGD: A systematic review
DOI: https://doi.org/10.33024/hjk.v20i2.2320
Akurasi Diagnosis Instalasi Gawat Darurat (IGD) Kecepatan Penilaian Pasien Anak; Pediatric Assessment Triangle (PAT) Pediatric Early Warning Score (PEWS)
Abstract
Background: Pediatric triage in Indonesia still faces challenges in the speed and accuracy of assessment due to the limitations of a standardized pediatric triage system. This situation demands the use of rapid, simple, and accurate initial assessment methods such as the Pediatric Assessment Triangle (PAT).
Purpose: To evaluate the effectiveness and accuracy of the pediatric assessment triangle (PAT) and the pediatric early warning score (PEWS) on the speed of assessment of pediatric patients in the emergency department (ED).
Method: This systematic review sampled research articles related to the use of the Pediatric Assessment Triangle (PAT) in pediatric triage in the ED from Scopus, Web of Science, EBSCO, and PubMed databases. The variables examined included effectiveness (speed of assessment) and diagnostic accuracy (sensitivity and specificity). The research instrument used the PRISMA guidelines for study selection and the JBI Critical Appraisal Tools for quality assessment. Analysis was conducted through narrative synthesis and comparison of results between studies.
Results: Six of the ten studies found that PAT can accelerate the triage process to just 13–15 seconds, with high accuracy (Area Under the Receiver Operating Characteristic Curve (AUROC) >0.96), sensitivity >90%, and specificity of up to 99%.
Conclusion: Digital-based PAT adaptations, such as Android applications and e-health, have been shown to improve healthcare worker skills, accelerate response times, and expand access to implementation. However, PAT's effectiveness is influenced by training level, clinical experience, and variations in service facilities.
Suggestion: Overall, the six articles found confirm that PAT is a fast, accurate, and adaptive initial triage method, making it worthy of recommendation in pediatric emergency department practice to improve service quality and pediatric patient safety.
Keywords: Assessment Speed; Diagnostic Accuracy; Emergency Department (ED); Pediatric Patients; Pediatric Assessment Triangle (PAT); Pediatric Early Warning Score (PEWS).
Pendahuluan: Triase anak di Indonesia masih menghadapi kendala kecepatan dan ketepatan penilaian akibat keterbatasan sistem triase pediatrik yang terstandar. Kondisi ini menuntut penggunaan metode penilaian awal yang cepat, sederhana, dan akurat seperti Pediatric Assessment Triangle (PAT).
Tujuan: Untuk mengevaluasi efektivitas dan akurasi pediatric assessment triangle (PAT) dan pediatric early warning score (PEWS) terhadap kecepatan penilaian pasien anak di IGD.
Metode: Penelitian tinjauan sistematis dengan sampel berupa artikel penelitian terkait penggunaan Pediatric Assessment Triangle (PAT) pada triase anak di IGD pada basis data Scopus, Web of Science, EBSCO, dan PubMed. Variabel yang dikaji meliputi efektivitas (kecepatan penilaian) dan akurasi diagnostik (sensitivitas dan spesifisitas). Instrumen penelitian menggunakan panduan PRISMA untuk seleksi studi dan JBI Critical Appraisal Tools untuk penilaian kualitas. Analisis dilakukan melalui sintesis naratif dan perbandingan hasil antar studi.
Hasil: 6 dari 10 studi menyatakan PAT mampu mempercepat proses triase hanya dalam 13–15 detik, dengan akurasi tinggi Area Under the Receiver Operating Characteristic curve (AUROC) >0.96, sensitivitas >90%, dan spesifisitas hingga 99%.
Simpulan: Adaptasi PAT berbasis digital, seperti aplikasi android dan e-health, terbukti meningkatkan keterampilan tenaga kesehatan, mempercepat waktu respon, serta memperluas akses implementasi. Namun, efektivitas PAT dipengaruhi oleh tingkat pelatihan, pengalaman klinis, serta variasi fasilitas pelayanan.
Saran: Secara keseluruhan, 6 artikel yang ditemukan menegaskan bahwa PAT merupakan metode triase awal yang cepat, akurat, dan adaptif, sehingga layak direkomendasikan dalam praktik gawat darurat pediatrik untuk meningkatkan mutu layanan dan keselamatan pasien anak.
Kata Kunci: Akurasi Diagnosis; Instalasi Gawat Darurat (IGD); Kecepatan Penilaian; Pasien Anak; Pediatric Assessment Triangle (PAT); Pediatric Early Warning Score (PEWS).
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