影响患者在急诊科住院时间的因素:一项运动时间观察性研究。

IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE Australasian Emergency Care Pub Date : 2023-05-02 DOI:10.1016/j.auec.2023.04.002
Karlie Payne , Dante Risi , Anna O’Hare , Simon Binks , Kate Curtis
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引用次数: 0

摘要

目的:急诊科住院时间的增加影响了获得急救的机会,并与患者发病率增加、过度拥挤、患者和工作人员满意度降低有关。我们试图确定混合ED住院时间增加的因素。方法:在卧龙岗医院进行了一项连续72小时的实时观察性研究。干预、评估和治疗的时间由专门的紧急医疗或护士观察员记录。计算从分诊到每个事件的时间,并进行描述性分析。自由文本评论采用归纳内容分析法进行分析。结果:收集了389名符合条件的患者中381人的数据。最大的延误发生在需要CT、专家检查和/或住院床位的患者身上。登记员和执业护士在做出入院或出院的决定方面效率最高。从分诊到专家检查的时间随着要求的次数而增加(一次148分钟,两次224分钟,三次285分钟)。住院时间最长的是心理健康和儿科患者。结论:造成ED住院时间的主要延误是CT成像和专家检查。ED的过度拥挤需要有针对性的、针对特定地点的干预措施。
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Factors that contribute to patient length of stay in the emergency department: A time in motion observational study

Objectives

Increased Emergency Department length of stay impacts access to emergency care and is associated with increased patient morbidity, overcrowding, reduced patient and staff satisfaction. We sought to determine the contributing factors to increased length of stay in our mixed ED.

Methods

A real-time observational study was conducted at Wollongong Hospital over a continuous 72-h period. Times of intervention, assessment and treatment were recorded by dedicated emergency medical or nurse observers. The time from triage to each event was calculated and descriptive analyses performed. Free text comments were analysed using inductive content analysis.

Results

Data were collected on 381 of 389 eligible patients. The largest time delays were experienced by patients who required a CT, specialist review and/or an inpatient bed. Registrars and nurse practitioners were the most efficient in reaching a decision to admit or discharge. The time from triage to specialist review increased with the number requested (148 min for one, 224 min for two and 285 min for three). The longest length of stay was experienced by mental health and paediatric patients.

Conclusions

The main delays contributing to ED length of stay were CT imaging and specialist reviews. Overcrowding in ED need targeted, site-specific interventions.

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来源期刊
Australasian Emergency Care
Australasian Emergency Care Nursing-Emergency Nursing
CiteScore
3.30
自引率
5.60%
发文量
82
审稿时长
37 days
期刊介绍: Australasian Emergency Care is an international peer-reviewed journal dedicated to supporting emergency nurses, physicians, paramedics and other professionals in advancing the science and practice of emergency care, wherever it is delivered. As the official journal of the College of Emergency Nursing Australasia (CENA), Australasian Emergency Care is a conduit for clinical, applied, and theoretical research and knowledge that advances the science and practice of emergency care in original, innovative and challenging ways. The journal serves as a leading voice for the emergency care community, reflecting its inter-professional diversity, and the importance of collaboration and shared decision-making to achieve quality patient outcomes. It is strongly focussed on advancing the patient experience and quality of care across the emergency care continuum, spanning the pre-hospital, hospital and post-hospital settings within Australasia and beyond.
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