Darraj Adel, Hudays Ali, Hazazi Ahmed, Hobani Amal, Alghamdi Alya
Nursing Department, King Fahad Central Hospital, Health Affairs of Jazan, Ministry of Health, Jazan 82611, Saudi Arabia.
Community, Psychiatric, and Mental Health Nursing Department, College of Nursing, King Saud University, Riyadh 11495, Saudi Arabia.
Healthcare (Basel). 2023 Jan 29;11(3):385. doi: 10.3390/healthcare11030385.
Emergency department (ED) overcrowding is a global health issue that is associated with poor quality of care and affects the timeliness of treatment initiation. The purpose of this systematic review is to assess the association between overcrowding and delay in treatment. A systematic review was conducted using four databases (CINAHL, PubMed, Scopus, Cochrane Library), following the preferred reporting items for systematic reviews and meta-analysis (PRISMA). A structured search was conducted to identify peer-reviewed articles aimed at assessing the relationship between overcrowding and delay in treatment, published between January 2000 and January 2021. Only studies that were conducted in the ED settings were included, and that includes both triage and observation rooms. The studies were appraised using two quality appraisal tools including the critical appraisal skills programme (CASP) for cohort studies and the Joanna Briggs Institute (JBI) checklist tool for cross-sectional studies. A total of 567 studies screened, and 10 met the inclusion criteria. Of these studies, 8 were cohorts and 2 were cross-sectionals. The majority reported that overcrowding is associated with a delay in the initiation of antibiotics for patients with sepsis and pneumonia. The review identified that overcrowding might impact time-to-treatment and, thus, the quality of care delivered to the patient. However, further research aimed at finding feasible solutions to overcrowding is encouraged.
急诊科过度拥挤是一个全球性的健康问题，与医疗质量差相关，并影响治疗开始的及时性。本系统评价的目的是评估过度拥挤与治疗延迟之间的关联。按照系统评价和荟萃分析的首选报告项目（PRISMA），使用四个数据库（CINAHL、PubMed、Scopus、Cochrane图书馆）进行了系统评价。进行了结构化检索，以识别2000年1月至2021年1月期间发表的旨在评估过度拥挤与治疗延迟之间关系的同行评审文章。仅纳入在急诊科环境中进行的研究，包括分诊和观察室。使用两种质量评估工具对研究进行评估，包括用于队列研究的批判性评估技能计划（CASP）和用于横断面研究的乔安娜·布里格斯研究所（JBI）清单工具。共筛选了567项研究，10项符合纳入标准。在这些研究中，8项是队列研究，2项是横断面研究。大多数研究报告称，过度拥挤与脓毒症和肺炎患者抗生素治疗开始延迟有关。该评价发现，过度拥挤可能会影响治疗时间，从而影响为患者提供的护理质量。然而，鼓励开展进一步研究以寻找解决过度拥挤问题的可行方案。
