Characteristics of Patients who present to ED Triage with Pain and Leave without Being Seen

2.50
Hdl Handle:
http://hdl.handle.net/10755/306563
Category:
Abstract
Type:
Poster
Title:
Characteristics of Patients who present to ED Triage with Pain and Leave without Being Seen
Author(s):
Ballejos-Campos, Christina
Lead Author STTI Affiliation:
Non-member
Author Details:
Christina Ballejos-Campos, PhD, RN, CNS, christina.ballejos-campos@sharp.com
Abstract:

Research Abstract

Purpose: Research has not directly linked the lack of pain treatment with patients leaving the ED without being seen, however it can be hypothesized that patients are more likely to leave if pain is not treated promptly. The under treatment of pain at the first patient encounter can lead to poor patient outcomes and decreased patient satisfaction. Additionally there is an increased risk of patients leaving without being seen (LWOBS). The purpose of this study is to examine patient characteristics of those patients who present to ED Triage with pain as a chief complaint and leave prior to being seen by a provider.

Design: A retrospective, descriptive correlational design was used to determine the characteristics of patients who visited the emergency department with a chief complaint of pain and then left the ED without being seen.

Setting: The selected study site was a 19-bed ED, located in a large metropolitan area of Southern California that serves approximately 5,000 ED patients per month.

Participants/Subjects: Retrospective data was collected from patient electronic medical records (EMR) starting January 2006 through December 2008. Inclusion criteria included male and female patients, age 18-65 years, with a chief complaint of pain at triage, and who left the ED. Exclusion criteria included patients younger than 18 or older than 65, those who left before initial triage or who left against medical advice after being admitted as an inpatient, and duplicate records.

Methods: Descriptive statistics included the mean, median, mode and standard deviations for numerical variables to characterize the LWOBS patient who presented to ED triage with a chief complaint of pain.

Results/Outcomes: The sample included 1338 patients who met inclusion criteria. Of this patient population approximately 83% left without being seen, while 17% stayed to be seen by a physician prior to leaving the ED. Of those who left prior to being seen, approximately two-thirds were female (63%, n = 846), age 18 to 65 (M = 37, md + 35, SD = 12), and 62.5% had rated their pain as “moderate”. The sample was diverse, and of those patients who left prior to being seen, slightly less than half were Hispanic (43.3%, n = 174). Patients presented to the ED with the following specific pain related chief complaint: Abdominal (24%), Cardiac (16%), Non-Trauma Musculoskeletal (34%), and Traumatic (10.3%). Patients were staged in the following ESI levels: ESI Level 2(10.3 %), ESI Level 3 (70.3 %), ESI level 4 (18.7 %) and (.6%) 5. Approximately 70% (n = 941) patients met level 3 criteria.

Implications: Leaders within healthcare organizations struggle with ED overcrowding, increased LOS, while maintaining appropriate quality care. LWOBS prevention for populations known to be high risk is not only cost effective but also sensitive to the community’s unique healthcare needs. Implications for emergency nursing practice are twofold; (1) providing a process for triage to promptly and effectively treat acute pain and (2) providing the structure to safely administer treatment.

Keywords:
Pain and Left Without being Seen
Repository Posting Date:
9-Dec-2013
Date of Publication:
9-Dec-2013
Conference Date:
2013
Conference Name:
2013 ENA Leadership Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Nashville, Tennessee, USA
Description:
2013 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at Gaylord Resort and Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleCharacteristics of Patients who present to ED Triage with Pain and Leave without Being Seenen_GB
dc.contributor.authorBallejos-Campos, Christinaen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsChristina Ballejos-Campos, PhD, RN, CNS, christina.ballejos-campos@sharp.comen_GB
dc.identifier.urihttp://hdl.handle.net/10755/306563-
dc.description.abstract<p>Research Abstract</p><p>Purpose: Research has not directly linked the lack of pain treatment with patients leaving the ED without being seen, however it can be hypothesized that patients are more likely to leave if pain is not treated promptly. The under treatment of pain at the first patient encounter can lead to poor patient outcomes and decreased patient satisfaction. Additionally there is an increased risk of patients leaving without being seen (LWOBS). The purpose of this study is to examine patient characteristics of those patients who present to ED Triage with pain as a chief complaint and leave prior to being seen by a provider.</p><p>Design: A retrospective, descriptive correlational design was used to determine the characteristics of patients who visited the emergency department with a chief complaint of pain and then left the ED without being seen.</p><p>Setting: The selected study site was a 19-bed ED, located in a large metropolitan area of Southern California that serves approximately 5,000 ED patients per month.</p><p>Participants/Subjects: Retrospective data was collected from patient electronic medical records (EMR) starting January 2006 through December 2008. Inclusion criteria included male and female patients, age 18-65 years, with a chief complaint of pain at triage, and who left the ED. Exclusion criteria included patients younger than 18 or older than 65, those who left before initial triage or who left against medical advice after being admitted as an inpatient, and duplicate records.</p><p>Methods: Descriptive statistics included the mean, median, mode and standard deviations for numerical variables to characterize the LWOBS patient who presented to ED triage with a chief complaint of pain.</p><p> Results/Outcomes: The sample included 1338 patients who met inclusion criteria. Of this patient population approximately 83% left without being seen, while 17% stayed to be seen by a physician prior to leaving the ED. Of those who left prior to being seen, approximately two-thirds were female (63%, n = 846), age 18 to 65 (M = 37, md + 35, SD = 12), and 62.5% had rated their pain as “moderate”. The sample was diverse, and of those patients who left prior to being seen, slightly less than half were Hispanic (43.3%, n = 174). Patients presented to the ED with the following specific pain related chief complaint: Abdominal (24%), Cardiac (16%), Non-Trauma Musculoskeletal (34%), and Traumatic (10.3%). Patients were staged in the following ESI levels: ESI Level 2(10.3 %), ESI Level 3 (70.3 %), ESI level 4 (18.7 %) and (.6%) 5. Approximately 70% (n = 941) patients met level 3 criteria.</p><p>Implications: Leaders within healthcare organizations struggle with ED overcrowding, increased LOS, while maintaining appropriate quality care. LWOBS prevention for populations known to be high risk is not only cost effective but also sensitive to the community’s unique healthcare needs. Implications for emergency nursing practice are twofold; (1) providing a process for triage to promptly and effectively treat acute pain and (2) providing the structure to safely administer treatment.</p>en_GB
dc.subjectPain and Left Without being Seenen_GB
dc.date.available2013-12-09T16:59:50Z-
dc.date.issued2013-12-09-
dc.date.accessioned2013-12-09T16:59:50Z-
dc.conference.date2013en_GB
dc.conference.name2013 ENA Leadership Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationNashville, Tennessee, USAen_GB
dc.description2013 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at Gaylord Resort and Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.