Inter-rater reliability in the Paediatric Observation Priority Score (POPS)

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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).


Retrospective observational study.


Single-centre paediatric emergency department.


12 participants from a convenience sample of 21 nursing staff.


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.


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).


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

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