Aim: To determine the association between time to first analgesic medication and emergency department length of stay (ED LOS).
Design: Retrospective cohort study.
Method: We conducted this study in a large, inner-city emergency department and included adult patients who presented with pain as a symptom and received analgesic medication(s). Study participants were identified from a random selection of 2,000 adult patients who presented between August-October 2018. The relationship between ED LOS and time to first analgesic medication was described using bivariate and multivariate linear regression.
Results: Of the 2,000 randomly selected patients presenting between August and October 2018, 727 (36.35%) had pain as a symptom on arrival, 423 (21.15%) had analgesic medication administered. The median time to first analgesic medication was in 62 (interquartile range: 36-105) minutes and median ED LOS was 218 (interquartile range: 160-317.5) minutes. After adjusting for the effects of sex, urgency of the presentation, emergency department location first seen by clinician, departure destination and workload metrics (average daily time to be seen and daily access block). Time to first analgesic medication was independently associated with ED LOS, contributing to 6.96% of the variance in the multivariate model.
Conclusion: Providing analgesic medication faster to patients presenting in pain, in addition to previously demonstrated positive patient outcomes, may decrease their ED LOS.
Impact: Reducing ED LOS through faster pain care, benefits the patient through faster pain relief and can benefit the department by reducing the total amount of care delivered in the emergency department. Reducing total care delivery frees up resources to improve the care to all emergency department patients.
目的: 确认镇痛药物的使用与留滞时间(ED LOS))之间的关联。 设计: 回顾性队列研究。 方法: 我们在一个大型市中心急诊室进行了此项研究,其中纳入了出现疼痛症状并使用镇痛药物的成年患者。我们从2018年8月至10月之间出现的2000名成年患者中随机选择患者参与研究,并使用双变量和多元线性回归描述急诊留滞时间(ED LOS)与首次使用镇痛药物之间的关系。 结果: 在2018年8月至10月期间随机选择的2000名中,有727名(36.35%)患者到达医院时有疼痛症状,其中423名(21.15%)服用了镇痛药。首次使用镇痛药物的中位时间为62分钟(四分位距:36-105),急诊留滞时间(ED LOS)的中位时间为218分钟(四分位距:160-317.5)。根据性别、陈述的紧急程度、临床医生首先看到的急诊室位置、出发地点和工作量指标(平均每日查看次数和每日访问)进行调整。首次使用镇痛药物的时间与急诊留滞时间(ED LOS)独立相关,其占多元模型的6.96%。 结论: 除了先前证实的积极患者结果外,为出现疼痛的患者更快地提供镇痛药物可能减少患者的急诊留滞时间(ED LOS)。 影响: 通过更快的疼痛护理减少急诊留滞时间(ED LOS),通过更快的疼痛缓解使患者受益,并通过减少急诊室提供的护理总量使部门受益。减少护理总量能够空出更多资源,以改善对所有急诊室患者的护理。.
Keywords: analgesia; emergency department; health services research; linear regression; multivariate modelling; nursing care; pain.
© 2019 John Wiley & Sons Ltd.