测量在一个大型的学术三级护理儿科急诊科的过度拥挤
Yamini Jadcherla1, Michael Stoner1, Sara Helwig1
1From the Nationwide Children's Hospital, The Ohio State University.
Pediatric emergency care
|September 10, 2024
概括
一个修改后的国家急诊部过度拥挤得分 (mNEDOCS) 有效地衡量了儿科急诊部过度拥挤. 较高的mNEDOCS分数与急诊室停留时间的增加,更多的患者离开而不见,以及更高的回访率相关.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健服务研究 医疗服务研究
- 儿科医疗保健 儿科医疗保健
背景情况:
- 紧急病房过度拥挤在成年人群中是一个重大问题,但它对儿科急诊室的影响不太清楚.
- 已确立的过度拥挤得分需要对儿科特定应用进行验证.
研究的目的:
- 评估修改后的国家急救部门拥挤评分 (mNEDOCS) 与儿科急救部门的关键绩效指标之间的关联.
- 确定mNEDOCS作为衡量第三级护理儿科环境中拥挤情况的实用性.
主要方法:
- 通过修改呼吸机标准,国家急诊部过度拥挤评分 (NEDOCS) 被调整为儿科使用 (mNEDOCS).
- 追溯分析2016-2019年电子健康记录数据,包括患者特征,处置,停留时间 (LOS),留下未见 (LWBS) 率和回访率.
- 统计方法包括描述性统计,斯皮尔曼相关性和多变量分析,以评估mNEDOCS和ED指标之间的关联.
主要成果:
- 修改后的NEDOCS显示了与ED LOS,LWBS率和72小时回访的积极相关性.
- 每增加mNEDOCS类别都与LWBS几率翻一番 (OR,2.03) 和ED LOS增加27分钟有关.
- 较高的mNEDOCS类别也使72小时复诊的几率增加了6%,并且与医院LOS负相关.
结论:
- mNEDOCS是评估儿科急诊室过度拥挤的一个有价值的工具,显示了与ED LOS,LWBS和回访的积极关联.
- 这些发现与成人ED过度拥挤数据一致,支持mNEDOCS概念的概括性.
- 建议进行进一步的研究,以充分了解儿童群体中mNEDOCS和医院LOS之间的关系.
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