Kosowsky J M, Shindel S, Liu T, Hamilton C, Pancioli A M
Department of Emergency Medicine, University of Cincinnati College of Medicine, Center for Emergency Care, University Hospital, Inc., Cincinnati, OH 45267-0769, USA.
Am J Emerg Med. 2001 Jan;19(1):10-4. doi: 10.1053/ajem.2001.20033.
Early recognition of inpatient bed requirements might be helpful in expediting the admission process through the emergency department (ED). With this in mind, we asked whether ED triage nurses could accurately predict patients' in-hospital dispositions. A prediction was recorded for 521 ED patients, of whom 107 (20.5%) were ultimately admitted to the hospital. Nurses correctly anticipated 66 of 107 hospital admissions (sensitivity = 61.7%, PPV = 61.7%). With respect to predicting specific levels of inpatient care, nurses correctly anticipated 17 of 45 floor admissions (sensitivity = 37.8%, PPV = 34.7%), 14 of 33 step-down/monitored unit admissions (sensitivity = 42.4%, PPV = 48.3%), and 12 of 24 intensive care unit admissions (sensitivity = 50.0%, PPV = 66.7%). Lacking in sensitivity and positive predictive value, particularly with regard to specific levels of inpatient care, triage nurses' predictions may have limited potential to expedite the admission process.
尽早识别住院床位需求可能有助于加快通过急诊科（ED）的入院流程。考虑到这一点，我们询问急诊科分诊护士是否能够准确预测患者的院内处置情况。对521名急诊科患者进行了预测记录，其中107人（20.5%）最终入院。护士正确预测了107例入院患者中的66例（敏感性=61.7%，阳性预测值=61.7%）。关于预测具体的住院护理级别，护士正确预测了45例普通病房入院患者中的17例（敏感性=37.8%，阳性预测值=34.7%），33例逐步降级/监护病房入院患者中的14例（敏感性=42.4%，阳性预测值=48.3%），以及24例重症监护病房入院患者中的12例（敏感性=50.0%，阳性预测值=66.7%）。分诊护士的预测缺乏敏感性和阳性预测值，特别是在具体的住院护理级别方面，其预测在加快入院流程方面的潜力可能有限。
