Asthma Management: The Effect of an Emergency Department Carepath of Patient Outcomes

2.50
Hdl Handle:
http://hdl.handle.net/10755/162585
Type:
Presentation
Title:
Asthma Management: The Effect of an Emergency Department Carepath of Patient Outcomes
Abstract:
Asthma Management: The Effect of an Emergency Department Carepath of Patient Outcomes
Conference Sponsor:Emergency Nurses Association
Conference Year:1996
Author:Steinmann, Rebecca, RN, MS, CEN, CCRN
Co-Authors:Louise Strauss, RN, BSN and E.R. McFadden, Jr., MD
Purpose: Asthma is an airway disorder affecting 10 to 12 million Americans. The emergency department is a frequent source of care for patients experiencing exacerbations of their disease. The Total Quality Management philosophy posits that standardizing processes reduces variance, resulting in improved outcomes at decreased cost. This study describes the effect of standardizing ED asthma management, using a carepath, on such patient outcomes as ED length of stay, the number and appropriateness of inpatient admission, return visits to the ED, and cost.

Design: This descriptive study compares patient data from an 8 month pre-carepath period to data obtained in the 12 months following implementation of the standardized treatment regimen.

Setting: This study was conducted in the Adult Emergency Department of an urban, teaching facility.

Sample: All patients 16 years or older presenting to the Adult Ed with an exacerbation of asthma were included in the study. The sample includes 955 patients (429 pre-carepath and 526 carepath patients).

Methodology: A retrospective chart audit was used to obtain demographic and clinical data for all patients presenting with an exacerbation of asthma during the study periods. Data from the pre-carepath and carepath groups were analyzed using descriptive statistics and StudentÆs t-tests.

Results: There were no significant differences between the demographic or clinical features of pre-carepath and carepath patients. Managing asthma care with the carepath resulted in: 1) a 50 minute decrease in the ED length of stay (P<0.001); 2) decreased inpatient admissions (general nursing units decreased 27%; intensive care units decreased 41% (P<0.005 for both); 3) decreased number of inappropriate admissions (P<0.005); 4) decreased return visits to the ED within 24 hours (P<0.001); 5) decreased estimated cost/case 37% (P<0.01).

Conclusions: Managing asthma using a carepath resulted in positive patient outcomes. Standardization provides a vehicle for further research to objectively measure the efficacy of treatment to allow continuous improvement in patient care. [Research Poster Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAsthma Management: The Effect of an Emergency Department Carepath of Patient Outcomesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162585-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Asthma Management: The Effect of an Emergency Department Carepath of Patient Outcomes</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1996</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Steinmann, Rebecca, RN, MS, CEN, CCRN</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">res@ena.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Louise Strauss, RN, BSN and E.R. McFadden, Jr., MD</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Asthma is an airway disorder affecting 10 to 12 million Americans. The emergency department is a frequent source of care for patients experiencing exacerbations of their disease. The Total Quality Management philosophy posits that standardizing processes reduces variance, resulting in improved outcomes at decreased cost. This study describes the effect of standardizing ED asthma management, using a carepath, on such patient outcomes as ED length of stay, the number and appropriateness of inpatient admission, return visits to the ED, and cost.<br/><br/>Design: This descriptive study compares patient data from an 8 month pre-carepath period to data obtained in the 12 months following implementation of the standardized treatment regimen.<br/><br/>Setting: This study was conducted in the Adult Emergency Department of an urban, teaching facility.<br/><br/>Sample: All patients 16 years or older presenting to the Adult Ed with an exacerbation of asthma were included in the study. The sample includes 955 patients (429 pre-carepath and 526 carepath patients).<br/><br/>Methodology: A retrospective chart audit was used to obtain demographic and clinical data for all patients presenting with an exacerbation of asthma during the study periods. Data from the pre-carepath and carepath groups were analyzed using descriptive statistics and Student&AElig;s t-tests.<br/><br/>Results: There were no significant differences between the demographic or clinical features of pre-carepath and carepath patients. Managing asthma care with the carepath resulted in: 1) a 50 minute decrease in the ED length of stay (P&lt;0.001); 2) decreased inpatient admissions (general nursing units decreased 27%; intensive care units decreased 41% (P&lt;0.005 for both); 3) decreased number of inappropriate admissions (P&lt;0.005); 4) decreased return visits to the ED within 24 hours (P&lt;0.001); 5) decreased estimated cost/case 37% (P&lt;0.01).<br/><br/>Conclusions: Managing asthma using a carepath resulted in positive patient outcomes. Standardization provides a vehicle for further research to objectively measure the efficacy of treatment to allow continuous improvement in patient care. [Research Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:30:40Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:30:40Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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