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入住重症监护病房患者的急诊科滞留时间:患者及组织因素的影响

Emergency department boarding times for patients admitted to intensive care unit: Patient and organizational influences.

作者信息

Montgomery Phyllis, Godfrey Michelle, Mossey Sharolyn, Conlon Michael, Bailey Patricia

机构信息

School of Nursing, Laurentian University, Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada.

School of Nursing, Laurentian University, Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada.

出版信息

Int Emerg Nurs. 2014 Apr;22(2):105-11. doi: 10.1016/j.ienj.2013.06.004. Epub 2013 Aug 23.

Abstract

INTRODUCTION

Critically ill patients can be subject to prolonged stays in the emergency department following receipt of an order to admit to an intensive care unit. The purpose of this study was to explore patient and organizational influences on the duration of boarding times for intensive care bound patients.

METHODS

This exploratory descriptive study was situated in a Canadian hospital in northern Ontario. Through a six-month retrospective review of three data sources, information was collected pertaining to 16 patient and organizational variables detailing the emergency department boarding time of adults awaiting transfer to the intensive care unit. Data analysis involved descriptive and non-parametric methods.

RESULTS

The majority of the 122 critically ill patients boarded in the ED were male, 55 years of age or older, arriving by ground ambulance on a weekday, and had an admitting diagnosis of trauma. The median boarding time was 34 min, with a range of 0-1549 min. Patients designated as most acute, intubated, and undergoing multiple diagnostic procedures had statistically significantly shorter boarding times.

DISCUSSION

The study results provide a profile that may assist clinicians in understanding the complex and site-specific interplay of variables contributing to boarding of critically ill patients.

摘要

引言

重症患者在收到入住重症监护病房的医嘱后,可能会在急诊科停留较长时间。本研究的目的是探讨患者因素和组织因素对等待入住重症监护病房患者的滞留时间的影响。

方法

这项探索性描述性研究在安大略省北部的一家加拿大医院进行。通过对三个数据源进行为期六个月的回顾性分析,收集了与16个患者和组织变量相关的信息,这些变量详细说明了等待转至重症监护病房的成人在急诊科的滞留时间。数据分析采用描述性和非参数方法。

结果

在急诊科滞留的122例重症患者中,大多数为男性,年龄在55岁及以上,工作日乘坐地面救护车抵达,入院诊断为创伤。中位滞留时间为34分钟,范围为0至1549分钟。被指定为最危急、已插管且正在接受多项诊断程序的患者,其滞留时间在统计学上显著较短。

讨论

研究结果提供了一个概况,可能有助于临床医生理解导致重症患者滞留的各种变量之间复杂的、特定场所相互作用。

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