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Inter-rater reliability in the Paediatric Observation Priority Score (POPS)
  1. Lisa Langton1,
  2. Adam Bonfield1,
  3. Damian Roland1,2
  1. 1 Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, University Hospitals of Leicester NHS Trust, Leicester, UK
  2. 2 SAPPHIRE Group, Health Services, University of Leicester, Leicester, UK
  1. Correspondence to Dr Adam Bonfield, Children’s Emergency Department, University Hospitals of Leicester NHS Trust, Leicester LE1 7RH, UK; ab798{at}


Objective The primary objective of this study was to determine the level of inter-rater reliability between nursing staff for the Paediatric Observation Priority Score (POPS).

Design Retrospective observational study.

Setting Single-centre paediatric emergency department.

Participants 12 participants from a convenience sample of 21 nursing staff.

Interventions Participants were shown video footage of three pre-recorded paediatric assessments and asked to record their own POPS for each child. The participants were blinded to the original, in-person POPS. Further data were gathered in the form of a questionnaire to determine the level of training and experience the candidate had using the POPS score prior to undertaking this study.

Main outcome measures Inter-rater reliability among participants scoring of the POPS.

Results Overall kappa value for case 1 was 0.74 (95% CI 0.605 to 0.865), case 2 was 1 (perfect agreement) and case 3 was 0.66 (95% CI 0.58 to 0.744).

Conclusion This study suggests there is good inter-rater reliability between different nurses’ use of POPS in assessing sick children in the emergency department.

  • nursing
  • inter-rater reliability
  • early warning score
  • emergency severity index

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  • Contributors LL undertook the design and research of this project while being supervised by DR. All named authors have contributed to the data interpretation and writing up of the article for publication.

  • Competing interests None declared.

  • Patient consent Written consent was sought prior to the POPS being recorded for each case.

  • Ethics approval DeMontfort University Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data gathered have been presented within the article submitted for publication.