The Hashemite University, P.O box 330127, Zarqa 13115, Jordan.
Fakeeh College for Medical Sciences, P.O. box 2537, Jeddah 21461, Saudi Arabia.
Int Emerg Nurs. 2021 May;56:100981. doi: 10.1016/j.ienj.2021.100981. Epub 2021 Mar 8.
Pain is the most common reason for cancer-related emergency department (ED) visits and a precursor of the urgency of oncological emergencies.
To identify the incidence of oncological emergencies with the chief complaint of pain and evaluate ED recognition and quality of care in managing the associated emergency.
This was a retrospective observational study of cancer patients presented to three EDs during the four-year study period.
The study's sample consisted of 252 patients admitted with oncological emergencies with a chief complaint of pain. Some oncological emergencies were more likely to be prioritized appropriately, such as febrile neutropenia and increased intracranial pressure. However, most patients with spinal cord compression and cardiac tamponade were more likely to be triaged to less urgent triage categories. Timeliness of ED care was suboptimal for most patients, particularly among those assigned to less urgent triage categories. Indicators for the low quality of care extended beyond ED with multiple adverse events in the hospital.
Triage nurses are expected to use the oncological emergencies' prevalent symptoms to allocate the patients to high triage urgency accurately. Patient waiting to be seen expected to be reassessed periodically to ensure waiting remain safe. Hospitals can adopt or establish pathways, protocols, or standardized order sets to fast-track patients with oncological emergencies. The health information system should be available to monitor and improve the delivered care continuously.
疼痛是癌症相关急诊就诊最常见的原因，也是肿瘤急症紧迫性的先兆。
确定以疼痛为主要诉求的肿瘤急症的发生率，并评估急诊对相关急症管理的识别和护理质量。
这是一项对在四年研究期间到三个急诊就诊的癌症患者进行的回顾性观察性研究。
本研究的样本包括 252 名因肿瘤急症伴有疼痛主诉而入院的患者。一些肿瘤急症更有可能得到适当的优先处理，如发热性中性粒细胞减少症和颅内压增高。然而，大多数脊髓压迫和心脏压塞患者更有可能被分诊到不太紧急的分诊类别。大多数患者的急诊护理及时性都不理想，尤其是那些被分配到不太紧急的分诊类别的患者。护理质量差的指标不仅限于急诊，还包括医院内的多个不良事件。
分诊护士应使用常见的肿瘤急症症状，准确地将患者分配到高分诊紧急程度。预期需要等待的患者应定期重新评估，以确保等待过程安全。医院可以采用或建立途径、方案或标准化医嘱集，以便快速处理肿瘤急症患者。应提供卫生信息系统以持续监测和改进所提供的护理。
