Paper
Thursday, 20 July 2006
This presentation is part of : Outcomes Measurement
Emergency Department Interventions for Patients Admitted to a Critical Care Unit from an Emergency Department on Outcomes of Hospital Mortality and Length of Stay
Karen M. Clark, PhD, MSN, CCRN, Organizational Systems and Adult Health, University of Maryland School of Nursing, Rockville, MD, USA
Learning Objective #1: To identify effect of process on flow of critical care patients with admissions originating from the ED on hospital mortality and length of stay.
Learning Objective #2: Discuss outcomes of wait times for specified interventions, and implications on future practice; access and quality of care.
Emergency department visits are on the increase. Difficulties in moving patients out of the ED and into in-patient beds exist. Critically ill patients, requiring critical care interventions, often are managed in the ED while waiting for long periods of time for available beds. Little is known of the outcomes after hospitalized for this acutely ill population. The purpose of this study was to determine the effect of wait times, such as from admission order for an ICU bed to transfer from the ED to the ICU bed, on outcomes of hospital mortality and length of stay. The study design was a non-experimental, exploratory, retrospective, comparative analysis on a secondary data set. The final sample size was 1,536. Exploratory analysis employing logistic and linear regression was used with descriptive analysis and correlations using SPSS 11.5. Findings: it was more likely the longer the wait in the ED after an admission order, the higher mortality for the hospitalization; time to first medication, once in the ED, the more likely the increase in the hospital length of stay; and time to first medication effected the wait time from receiving the ICU admission order to leaving the ED. These findings may be reflective of overall hospital system issues as opposed to individual hospital or department process. Investigating processes of ED interventions and the impact on outcomes may provide the information to revise practice. Measuring timeliness of nursing interventions, collaborative physician/nurse interactions, could provide necessary statistical data to promote the value of nursing interventions. Collecting substantiated data driven by valid and reliable outcomes would support policy changes to increase the available resources in our healthcare system, with subsequent impact on access and quality outcomes. .

See more of Outcomes Measurement
See more of The 17th International Nursing Research Congress Focusing on Evidence-Based Practice (19-22 July 2006)