Department of Emergency and Critical Care Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Da, Ethiopia.
Department of Emergency and Critical Care Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Emerg Med. 2023 Mar 29;23(1):34. doi: 10.1186/s12873-023-00804-y.
Prolonged length of stay at the emergency department interferes with the main goal of emergency care and results in adverse patient outcomes like nosocomial infection, dissatisfaction, morbidity, and mortality. Despite this, little is known about the length of stay and the factors that influence it in Ethiopia's emergency department.
An institution-based cross-sectional study was conducted on 495 patients admitted at Amhara region comprehensive specialized hospitals emergency department from May 14 to June 15/2022. A systematic random sampling was employed to select study participants. A pretested structured interview-based questionnaire was used to collect data by using Kobo toolbox software. SPSS version 25 was used for data analysis. Bi-variable logistic regression analysis was carried out to select variables with P-value < 0.25. The significance of association was interpreted using an Adjusted Odds Ratio with a 95% confidence interval. Variables with P-value < 0.05 in the multivariable logistic regression analysis were inferred to be significantly associated with length of stay.
Out of 512 enrolled participants, 495 were participated with a response rate of 96.7%. The prevalence of prolonged length of stay in the adult emergency department was 46.5% (95%CI: 42.1, 51.1). Lack of insurance (AOR: 2.11; 95% CI: 1.22, 3.65), non-communicative presentation (AOR: 1.98; 95% CI: 1.07, 3.68), delayed consultation (AOR: 9.5; 95% CI: 5.00, 18.03), overcrowding (AOR: 4.98; 95% CI: 2.13, 11.68), and shift change experience (AOR: 3.67; 95% CI: 1.30, 10.37) were significantly associated with prolonged length of stay.
The result of this study is found to be high based on Ethiopian target emergency department patient length of stay. Lack of insurance, presentation without communication, delayed consultation, overcrowding, and shift change experience were significant factors for prolonged emergency department length of stay. Therefore, interventions like expansion of organizational setup are needed to decrease the length of stay to an acceptable level.
在急诊科停留时间过长会干扰急诊护理的主要目标,并导致医院感染、不满、发病率和死亡率等不良患者结局。尽管如此,人们对埃塞俄比亚急诊科的停留时间及其影响因素知之甚少。
这是一项在 2022 年 5 月 14 日至 6 月 15/15 日期间在阿姆哈拉地区综合专科医院急诊科入院的 495 名患者中进行的基于机构的横断面研究。采用系统随机抽样法选择研究对象。使用预测试的基于结构化访谈的问卷,使用 Kobo 工具包软件收集数据。使用 SPSS 版本 25 进行数据分析。采用双变量逻辑回归分析选择 P 值<0.25 的变量。使用调整后的优势比及其 95%置信区间来解释关联的显著性。多变量逻辑回归分析中 P 值<0.05 的变量被推断为与住院时间显著相关。
在纳入的 512 名参与者中,有 495 名参与者的回应率为 96.7%。成人急诊科住院时间延长的患病率为 46.5%(95%CI:42.1,51.1)。无保险(AOR:2.11;95%CI:1.22,3.65)、非沟通表现(AOR:1.98;95%CI:1.07,3.68)、延迟咨询(AOR:9.5;95%CI:5.00,18.03)、过度拥挤(AOR:4.98;95%CI:2.13,11.68)和轮班变化体验(AOR:3.67;95%CI:1.30,10.37)与住院时间延长显著相关。
根据埃塞俄比亚目标急诊科患者住院时间,本研究结果发现较高。无保险、无沟通表现、延迟咨询、过度拥挤和轮班变化体验是延长急诊科住院时间的重要因素。因此,需要扩大组织设置等干预措施,将住院时间缩短到可接受的水平。