Does the Level of Pain Affect Waiting Times in the Emergency Department?

Paper

Friday, 21 July 2006

This presentation is part of : Programs and Models in Acute Care

Erlinda C. Wheeler, DNS, RN¹, Thomas Hardie, EdD, RN, CS, NP¹, Ibironke Akanji², Erin Schonewolf², Janna Scott², and Bethany Sterling². (1) Department of Nursing, University of Delaware, Newark, DE, USA, (2) School of Nursing, University of Delaware, Newark, DE, USA

Learning Objective #1: Determine if the level of pain affects waiting time in the emergency department.
Learning Objective #2: Determine whether race affects the waiting time in emergency department.

Background: Pain is the leading cause for individuals to seek emergency care. Previous studies have concluded that acute pain conditions were under evaluated and under treated in the Emergency Department (ED). A review of literature indicated that the majority of patients who present with acute pain on arrival to ED are not treated with adequate amount of analgesics or other forms of pain management. There is paucity of information about how the severity of pain influences the amount of time spent in the ED before being seen by a physician. Therefore, our study focuses on what role pain plays regarding time to treatment in the ED. Purpose: To determine if the level of pain affects the waiting time in the emergency department. Methods: The National Hospital Ambulatory Medical Survey CDC’s 2003 data was used in this study. The sample consisted of 12,860 Caucasian and African-American adults with a mean age of 43.43 years. Analysis of covariance was used to explore differences in length of waiting time in the emergency room based on race, triage nurses rating of the immediacy of the need to be seen by a physician and the level of pain the patient reported. Results/Conclusions: The findings showed that patient’s reports of pain have little or no effect on the length of waiting time. Given the sample size we feel there is adequate power to detect the effect of pain in determining the length of waiting time to see a physician if it were present. In addition, African Americans had a statistically significant longer wait (9.35 minutes) than Caucasians. The effect of race might be interpreted as another example of health disparities or could be a hospital level effect which was not examined within this model.

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