scholarly journals Medical practice differences among internal medicine fellows during in-hospital Emergency Department 24-hour shifts

2019 ◽  
Author(s):  
Marina Repušić Babacanli ◽  
Matea Kolačević Zeljković ◽  
Alen Babacanli ◽  
Vida Olujić ◽  
Sandra Radovanić ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Emergency Department ◽  
Medical Practice ◽  
University Hospital ◽  
Limited Data ◽  
Hospital Emergency ◽  
Specific Knowledge ◽  
Cross Sectional ◽  
Emergency Medical Team ◽  
Using Data

Abstract Background There are limited data which show how Emergency Department (ED)-specific knowledge and skills are acquired throughout the internal medicine fellowship, especially during 24-hour shifts. The aim of the study was to assess the differences in medical practice between fellows among different fellowship-years in ED settings. Methods We conducted a cross-sectional, retrospective study at a large university hospital using data on every ED examination done during 2016. All data were taken from the hospital information system. We compared 1st-year fellows with all older fellows, as well as 5th-year fellows with all younger fellows. Results In 2016, 55 fellows had ≥ 15 24-hour shifts with 3 attending fellows during one shift. A total of 19’916 patients were examined by attending fellows in the ED. When compared to 2nd-year fellows, 1st-year fellows examined more patients brought to ED by out-of-hospital emergency medical team and had significantly higher share of examined patients per 24-hour shift with lower length of stay. When compared to 5th-year fellows, 1st-year fellows examined older patients, but had lower share of examined patients during one 24-hour shift and participated in fewer CPR cases. When compared to younger fellows, 5th-year fellows participated in more CPR cases and had higher proportion of patients admitted to hospital. Conclusion To our knowledge, this is the first report on the ED medical practice differences among fellows of different fellowship-year. When compared to other fellows, 1st-year fellows participated less in CPR cases, but were faster in providing medical care in ED. 5th-year fellows had the highest proportion of patients admitted to hospital and more CPR cases.

scholarly journals Medical Practice Differences Among Internal Medicine Fellows During in-hospital Emergency Department 24-hour Shifts

2020 ◽  
Author(s):  
Marina Repusic ◽  
Matea Kolacevic Zeljkovic ◽  
Alen Babacanli ◽  
Vida Olujic ◽  
Sandra Radovanic ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Emergency Department ◽  
Medical Practice ◽  
University Hospital ◽  
Limited Data ◽  
Hospital Emergency ◽  
Specific Knowledge ◽  
Cross Sectional ◽  
Emergency Medical Team ◽  
Using Data

Abstract Background There are limited data which show how Emergency Department (ED)-specific knowledge and skills are acquired throughout the internal medicine fellowship, especially during 24-hour shifts. The aim of the study was to assess the differences in medical practice between fellows among different fellowship-years in ED settings. Methods We conducted a cross-sectional, retrospective study at a large university hospital using data on every ED examination done during 2016. All data were taken from the hospital information system. We compared 1st-year fellows with all older fellows, as well as 5th-year fellows with all younger fellows. Results In 2016, 55 fellows had ≥ 15 24-hour shifts with 3 attending fellows during one shift. A total of 19’916 patients were examined by attending fellows in the ED. When compared to 2nd-year fellows, 1st-year fellows examined more patients brought to ED by out-of-hospital emergency medical team and had significantly higher share of examined patients per 24-hour shift with lower length of stay. When compared to 5th-year fellows, 1st-year fellows examined older patients, but had lower share of examined patients during one 24-hour shift and participated in fewer CPR cases. When compared to younger fellows, 5th-year fellows participated in more CPR cases and had higher proportion of patients admitted to hospital. Conclusion To our knowledge, this is the first report on the ED medical practice differences among fellows of different fellowship-year. When compared to other fellows, 1st-year fellows participated less in CPR cases, but were faster in providing medical care in ED. 5th-year fellows had the highest proportion of patients admitted to hospital and more CPR cases.

scholarly journals Patient Opinion of Visiting Therapy Dogs in a Hospital Emergency Department

2020 ◽  
Vol 17 (8) ◽  
pp. 2968
Author(s):  
Joanne Reddekopp ◽  
Colleen Anne Dell ◽  
Betty Rohr ◽  
Barbara Fornssler ◽  
Maryellen Gibson ◽  
...  
Keyword(s):  
Emergency Department ◽  
University Hospital ◽  
Therapy Dogs ◽  
Hospital Emergency ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Therapy Dog ◽  
Significant Difference ◽  
Patient Opinion

To date there have been no studies examining whether patients want emergency department (ED) therapy dog programs. This patient-oriented study examined the opinions of patients about whether they would want to be visited by a therapy dog in the Royal University Hospital ED. Cross-sectional survey data were collected over a six week period from a convenience sample of 100 adult patients who had not been visited by a therapy dog in the ED. Most (80%) indicated they would want a visit by a therapy dog as an ED patient. A higher proportion of individuals who currently have a pet dog (95%) or identify as having lots of experience with dogs (71%) were more likely to indicate this want compared to those without a dog (90%) or little to no experience with dogs (62%). The majority were also of the opinion that patients may want to visit a therapy dog in the ED to reduce anxiety (92%) and frustration (87%) as well as to increase comfort (90%) and satisfaction (90%) and to a lesser extent to reduce pain (59%). There was no significant difference in findings by gender or age, other than a higher proportion of older adults and females identifying cultural background and tradition as a possible reason that patients may not want to be visited by a therapy dog. The findings of this study can help guide considerations for future ED therapy dog programs.

scholarly journals Epidemiology of Knife Injuries at Ain Shams University Hospital Emergency Department from 2018 to 2019: A Cross-Sectional Study

2021 ◽  
Vol Volume 13 ◽  
pp. 561-567
Author(s):  
Manar M Ellaban ◽  
Eman Afifi ◽  
Moustafa El Houssinie ◽  
Jon Mark Hirshon ◽  
Mohamed El-Shinawi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Hospital Emergency Department ◽  
Sectional Study ◽  
Hospital Emergency ◽  
Cross Sectional

scholarly journals Discharge against medical advice from the emergency department in a university hospital

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Feras H. Abuzeyad ◽  
Moonis Farooq ◽  
Salah Farhat Alam ◽  
Mudhaffar Ismael Ibrahim ◽  
Luma Bashmi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cross Sectional Study ◽  
Small Sample ◽  
Medical Advice ◽  
University Hospital ◽  
High Risk Population ◽  
Cross Sectional ◽  
Against Medical Advice ◽  
Level 3 ◽  
Collection Form

Abstract Background Patients discharged against medical advice (DAMA) act as a high-risk population for the Emergency Department (ED), regardless of their presentations, and can pose a serious burden for the hospital. This study examines the prevalence, demographic and clinical characteristics, reasons, and clinical outcomes of a small sample of DAMA patients in a teaching university hospital, including readmission, morbidity, and mortality. Methods A prospective, descriptive cross-sectional study was conducted in the ED of King Hamad University Hospital (KHUH) with 98,992 patient visits during a 1-year period from June 2018 to June 2019. Consenting DAMA patients were asked to complete a data collection form. Results Patients (n = 413) had a mean age of 44.1 years with a female majority (57.1%). The majority were categorized as triage level-3 (87.7%). The main reasons for DAMA included refusal of the procedure/operation (23.2%), long ED waiting time (22.2%), subjective improvement with treatment (17.7%), and children at home (14.8%), whereas the least selected reason was dissatisfaction with medical care (1.2%). Follow-up of DAMA patients revealed that 86 cases (20.8%) were readmitted to the ED within 72 h of which 41 (47.7%) cases were morbidity and 2 (2.3%) were mortality. Marital status was a predictor of DAMA patients who revisit the ED within 72 h. Conclusion The results act as a pilot study to examine a small sample of DAMA patients’ characteristics, diagnosis, and ED revisits. Hospitals should investigate further the DAMA population on a larger scale, reasons for refusing procedures, and utilize this knowledge to improve the healthcare process.

scholarly journals An assessment of the quality indicators of operative and non-operative times in a public university hospital

2015 ◽  
Vol 13 (4) ◽  
pp. 594-599 ◽  
Author(s):  
Altair da Silva Costa Jr ◽  
Luiz Eduardo Villaça Leão ◽  
Maykon Anderson Pires de Novais ◽  
Paola Zucchi
Keyword(s):  
Standard Deviation ◽  
Operating Room ◽  
Operative Time ◽  
Patient Flow ◽  
Cross Sectional Study ◽  
Public University ◽  
Major Effect ◽  
University Hospital ◽  
Cross Sectional ◽  
Using Data

ABSTRACT Objective To assess the operative time indicators in a public university hospital. Methods A descriptive cross-sectional study was conducted using data from operating room database. The sample was obtained from January 2011 to January 2012. The operations performed in sequence in the same operating room, between 7:00 am and 5:00 pm, elective or emergency, were included. The procedures with incomplete data in the system were excluded, as well as the operations performed after 5:00 pm or on weekends or holidays. Results We measured the operative and non-operative time of 8,420 operations. The operative time (mean and standard deviation) of anesthesias and operations were 177.6±110 and 129.8±97.1 minutes, respectively. The total time of the patient in operative room (mean and standard deviation) was 196.8±113.2. The non-operative time, e.g., between the arrival of the patient and the onset of anesthesia was 14.3±17.3 minutes. The time to set the next patient in operating room was 119.8±79.6 minutes. Our total non-operative time was 155 minutes. Conclusion Delays frequently occurred in our operating room and had a major effect on patient flow and resource utilization. The non-operative time was longer than the operative time. It is possible to increase the operating room capacity by management and training of the professionals involved. The indicators provided a tool to improve operating room efficiency.

scholarly journals Factors affecting prehospital time delay of the injured patients arriving at the Emergency Department of Beni-Suef University Hospital in Egypt: A cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252044
Author(s):  
Doaa Mahmoud Khalil ◽  
Elmorsy Elmorsy ◽  
Ahmed Arafa ◽  
Hesham Ahmed Nafady ◽  
Lamiaa Saleh
Keyword(s):  
Emergency Department ◽  
Time Delay ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Consciousness Level ◽  
Injured Patients ◽  
Prehospital Time

Purpose This study aimed to assess the factors affecting the prehospital time delay of the injured patients arriving at the Emergency Department of Beni-Suef University Hospital in Upper Egypt. Materials and methods In this cross-sectional study, the following data were retrieved from the hospital records of 632 injured patients between 1/1/2018 and 31/3/2018: age, sex, residence, means of transportation to the hospital, prehospital time delay, consciousness level on admission, source of injury, and type of worst injury. Results The prehospital time delay (>one hour) of the injured patients was positively associated with age >60 years and rural residence but inversely associated with consciousness level with odds ratios (95% confidence intervals) of 5.14 (2.26–11.68), 3.49 (2.22–5.48), and 0.56 (0.32–0.96), respectively. Conclusion The prehospital time delay of the injured patients arriving at the Emergency Department of Beni-Suef University Hospital in Egypt was associated with old age, rural residence, and consciousness level.

scholarly journals SIKAP DAN PENGETAHUAN PERAWAT BERHUBUNGAN DENGAN PELAKSANAAN TRIAGE

2018 ◽  
Vol 9 (02) ◽  
pp. 154
Author(s):  
Dewi Ratna Sari ◽  
Sutanta .
Keyword(s):  
Emergency Department ◽  
Clinical Decision Making ◽  
Initial Assessment ◽  
Rank Test ◽  
P Value ◽  
Hospital Emergency Department ◽  
Hospital Emergency ◽  
Cross Sectional ◽  
Spearman Rank ◽  
Emergency Units

ABSTRAKPerawat yang bekerja di unit gawat darurat (UGD) harus memiliki sikap, ketrampilan dan kemampuan untuk mengatur kemampuan fungsional dalam berbagai kondisi. Perawat harus mampu memprioritaskan perawatan pasien atas dasar pengambilan keputusan klinis dimana keterampilan penting bagi perawat dalam penilaian awal. Untuk mendukung hal tersebut diperlukan pengetahuan, sikap dan ketrampilan dalam hal pemisahan jenis dan kegawatan pasien dalam triage, sehingga dalam penanganan pasien bisa lebih optimal dan terarah. Tujuan penelitian untuk mengetahui hubungan sikap dan pengetahuan perawat dalam pelaksanaan triage di UGD RSUD Wonosari. Penelitian ini menggunakan survei analitik korelasi dengan pendekatan cross sectional. Populasi penelitian berjumlah 15 perawat yang bekerja di ruang gawat darurat, dengan metode pengambilan sampel secara total sampling. Instrumen penelitian berupa kuisioner, metode analisa data menggunakan uji spearman rank dan regresi linier berganda. Hasil penelitian tidak terdapat hubungan antara sikap dengan pelaksanaan triage di UGD RSUD Wonosari, hal ini ditunjukkan dari hasil uji Spearman rank dengan nilai sig 0,354>p-value 0,05. Terdapat hubungan antara pengetahuan dengan pelaksanaan triage di UGD RSUD Wonosari. Hal ini ditunjukkan dari nilai rank spearman 0,004 < p-value 0,05. Sehingga pelaksanaan triage dipengaruhi faktor lain yang tidak terangkum dalam analisis ini. Kesimpulan tidak ada hubungan antara sikap dengan pelaksanaan triage di UGD RSUD Wonosari. Ada hubungan antara pengetahuan dengan pelaksanaan triage di UGD RSUD Wonosari.Kata Kunci: sikap, pengetahuan, pelaksanaan triageNURSE’S ATTITUDE AND KNOWLEDGE RELATED WITH IMPLEMENTATION OF TRIAGEABSTRACTNurses working in emergency units must have the attitude, skills and ability to organize functional abilities under various conditions. Nurses should be able to prioritize patient care on the basis of clinical decision-making where skills are important to nurses in the initial assessment. To support it requires knowledge, attitude and skills in terms of separation of types and gravity of patients in triage, so that in the handling of patients can be more optimal and directed. The purpose of this research is to know the relationship of attitude and knowledge of nurses in the implementation of triage in emergency units Wonosari Hospital. This research uses analytic correlation survey with cross sectional approach. The study population was 15 nurses working in the emergency room, with sampling method in total sampling. The research instrument is questionnaire, data analysis method using spearman rank test and multiple linear regression. The result of this research shows that there is no correlation between attitude with triage implementation in emergency units Wonosari Hospital, it is shown from Spearman rank test with sig value 0,354> p-value 0,05. There is a relationship between knowledge with triage implementation at Wonosari Hospital emergency department. It is shown from spearman rank value 0,004 <p-value 0,05. So the implementation of triage is influenced by other factors not summarized in this analysis. Conclusion there is no relation between attitude with triage implementation in Wonosari Hospital emergency department. There is a relationship between knowledge with triage implementation in emergency units Wonosari Hospital.Keywords: attitude, knowledge, implementation of triage

scholarly journals A comparison of pain registration by Visual Analog Scale and Numeric Rating Scale – a cross-sectional study of primary triage registration

2020 ◽  
Author(s):  
Jofrid Kollltveit ◽  
Malin Osaland ◽  
Marianne Reimers ◽  
Magnus Berle
Keyword(s):  
Emergency Department ◽  
Visual Analog Scale ◽  
Rating Scale ◽  
Emergency Admission ◽  
Numeric Rating Scale ◽  
University Hospital ◽  
Analog Scale ◽  
Cross Sectional ◽  
Significant Difference ◽  
Numeric Rating

BackgroundPain is a subjective sensation; self-reporting is important for quantifying pain intensity. There are several different validated tools for this, such as Visual Analog Scale and Numeric Rating Scale. In the clinic, these terms are often used as equivalent. The objective of this study was to examine correlation and agreement between the pain registration tools in triage in an emergency department.Materials and MethodsThe study was performed in the Department of Emergency Medicine at Haukeland University Hospital in the period June-August 2019. We registered the pain score with two tools in 200 unselected patients in emergency admission with pain. In addition, we registrered gender, age, triage and general department affiliation.ResultsWe found a strong correlation between the pain registration tools by Spearmans correlation test (rho=0,930, p<0,001). There were no significant difference between the pain registration tools within the subgroups. Bland-Altman analysis show agreement between the two pain registration tools.ConclusionsIn an Emergency Department triage is it acceptable to use Visual Analog Scale and Numeric Rating Scale as equivalent, as long as the correct terminology is used.

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