NEDOCS vs subjective evaluation, ¿Is the health personnel of the emergency department aware of its overcrowding?

INTRODUCTION

An emergency department (ED) is considered to be "overcrowded" when the number of patients exceeds its treatment capacity and it does not have the conditions to meet the needs of the next patient to be treated. This study evaluates overcrowding in the emergency department of a hospital in Colombia.

OBJECTIVE

To compare the objective NEDOCS scale with a subjective evaluation by ED health staff in order to evaluate the differences between the two.

METHODS

The NEDOCS scale was applied and a subjective overcrowding survey was administered to the medical staff and the charge nurse on duty 6 times per day (6:00 a.m., 9:00 a.m., 12:00 p.m., 3:00 p.m., 6:00 p.m. and 9:00 p.m.) for three consecutive weeks. The results were evaluated with a correlation analysis and measurement of agreement.

RESULTS

A median NEDOCS score of 137 was obtained for the total data. There was a moderately positive correlation between the NEDOCS and the subjective scales, with a rho of 0.58 ( (0.001). During times when the ED was the most crowded, 87% of the total subjective health staff evaluations underestimated the level of overcrowding.

CONCLUSIONS

Health staff do not perceive a risk due to ED overcrowding when the NEDOCS scores correspond to overcrowding categories equal to or over 5 (severely crowded and dangerously crowded), which poses a risk to patient safety and care.