Does emergency department workload adversely influence timely analgesia?

EMA - Emergency Medicine Australasia

Volumn 21, Issue 1, 2009, Pages 52-58

  Mitchell, Rob ^a,b   Kelly, Anne Maree ^b,c,e   Kerr, Debra ^b,d  

^a MONASH UNIVERSITY   (Australia)

^b WESTERN HEALTH   (Australia)

^c Emergency Department   (Australia)

^d UNIVERSITY OF MELBOURNE   (Australia)

^e SUNSHINE HOSPITAL   (Australia)

Author keywords

Analgesia; Overcrowding; Workload

Indexed keywords

ANALGESIC AGENT;

ACUTE DISEASE; ADULT; ANALGESIA; ARTICLE; BILIARY TRACT PAIN; CONTROLLED STUDY; EMERGENCY WARD; FEMALE; FEMUR NECK FRACTURE; HAZARD RATIO; HEALTH CARE QUALITY; HUMAN; KIDNEY COLIC; MAJOR CLINICAL STUDY; MALE; OBSERVATIONAL STUDY; PAIN ASSESSMENT; PATIENT CARE; PRIORITY JOURNAL; SAMPLE SIZE; SCORING SYSTEM; WORKLOAD; WRIST FRACTURE;

ANALGESIA; EMERGENCY SERVICE, HOSPITAL; FEMALE; HUMANS; MALE; MIDDLE AGED; MULTIVARIATE ANALYSIS; PAIN; PROCESS ASSESSMENT (HEALTH CARE); QUALITY ASSURANCE, HEALTH CARE; RANDOM ALLOCATION; RETROSPECTIVE STUDIES; TIME FACTORS; VICTORIA; WORKLOAD;

EID: 60649116538     PISSN: 17426731     EISSN: 17426723     Source Type: Journal    
DOI: 10.1111/j.1742-6723.2008.01145.x     Document Type: Article

References (38)

1. British Association for Emergency Medicine. Guidelines for the Management of Pain in Adults Cited 8 May 2007.] Available from URL: http://www. collemergmed.ac.uk/temp/1958-nagement-of-Pain-in-Adults.pdf.
2. British Association for Emergency Medicine. Standards for Emergency Departments. January 2006 Cited 8 May 2007.] Available from URL: http://www.emergencymed.org.uk/BAEM/CEC/assets/cec-standards-emerg-depts.pdf.
3. Arendts G, Fry M. Factors associated with delay to opiate analgesia in emergency departments. J. Pain 2006 7 : 682 6.
4. Vassiliadis J, Hitos K, Hill CT. Factors influencing prehospital and emergency department analgesia administration to patients with femoral neck fractures. Emerg. Med. (Fremantle) 2002 14 : 261 6.
5. Tanabe P, Buschmann M. A prospective study of ED pain management practices and the patient's perspective. J. Emerg. Nurs. 1999 25 : 171 7.
6. Grant PS. Analgesia delivery in the ED. Am. J. Emerg. Med. 2006 24 : 806 9.
7. Reichl M, Bodiwala GG. Use of analgesia in severe pain in the accident and emergency department. Arch. Emerg. Med. 1987 4 : 25 31.
8. Abbuhl FB, Reed DB. Time to analgesia for patients with painful extremity injuries transported to the emergency department by ambulance. Prehosp. Emerg. Care 2003 7 : 445 7.
9. Rupp T, Delaney KA. Inadequate analgesia in emergency medicine. Ann. Emerg. Med. 2004 43 : 494 503.
10. Miner J, Biros M, Trainor A, Hubbard D, Beltram M. Patient and physician perceptions as risk factors for oligoanalgesia: a prospective observational study of the relief of pain in the emergency department. Acad. Emerg. Med. 2006 13 : 140 7.
11. Raftery KA, Smith-Coggins R, Chen AHM. Gender-associated differences in emergency department pain management. Ann. Emerg. Med. 1995 26 : 414 21.
12. Jones JS, Johnson K, McNinch M. Age as a risk factor for inadequate emergency department analgesia. Am. J. Emerg. Med. 1996 14 : 157 60.
13. Dunn R. Reduced access block causes shorter emergency department waiting times: an historical control observational study. Emerg. Med. Australas. 2003 15 : 232 8.
14. Bindman AB, Grumbach K, Keane D et al. Consequences of queuing for care at a public hospital emergency department. JAMA 1991 266 : 1091 6.
15. Baker DW, Stevens CD, Brook RH. Patients who leave a public hospital emergency department without being seen by a physician. Causes and consequences. JAMA 1991 266 : 1085 90.
16. Green RA, Wyer PC, Giglio J. ED walk-out rate correlated with ED length of stay but not with ED volume or hospital census [Abstract Acad. Emerg. Med. 2002 9 : 514.
17. Schull MJ, Morrison LJ, Vermeulen M et al. Emergency department overcrowding and ambulance transport delays for patients with chest pain. CMAJ 2003 168 : 277 83.
18. Schull MJ, Lazier K, Vermeulen M et al. Emergency department contributors to ambulance diversion: a quantitative analysis. Ann. Emerg. Med. 2003 41 : 467 76.
19. Fatovich DM, Hirsch RL. Entry overload, emergency department overcrowding, and ambulance bypass. Emerg. Med. J. 2003 20 : 406 9.
20. Richardson DB. The access-block effect: relationship between delay to reaching an inpatient bed and inpatient length of stay. Med. J. Aust. 2002 177 : 492 5.
21. Liew D, Liew D, Kennedy MP. Emergency department length of stay independently predicts excess inpatient length of stay. Med. J. Aust. 2003 179 : 524 6.
22. Richardson DB. Increase in patient mortality at 10 days associated with emergency department overcrowding. Med. J. Aust. 2006 184 : 213 16.
23. Sprivulis PC, Da Silva JA, Jacobs IG et al. The association between hospital overcrowding and mortality among patients admitted via Western Australian emergency departments. Med. J. Aust. 2006 184 : 208 12.
24. Schull MJ, Vermeulen M, Slaughter G et al. Emergency department crowding and thrombolysis delays in acute myocardial infarction. Ann. Emerg. Med. 2004 44 : 577 85.
25. Hwang U, Richardson LD, Sonuyi TO et al. The effect of emergency department crowding on the management of pain in older adults with hip fracture. J. Am. Geriatr. Soc. 2006 54 : 270 5.
26. Richardson DB. Relationship between total daily patient care time and performance as a measure of emergency department efficiency. Acad. Emerg. Med. 2003 10 : 527.
27. Richardson DB. Prospective confirmation that total daily patient care time can measure emergency department overcrowding. Acad. Emerg. Med. 2003 10 : 526.
28. Australian Council on Healthcare Standards. ACHS Clinical Indicator Survey. Sydney : Australian Council on Healthcare Standards, 2004.
29. Pines JM, Hollander JE. Emergency department crowding is associated with poor care for patients with severe pain. Ann. Emerg. Med. 2008 51 : 1 5.
30. Kelly AM, Brumby C, Barnes C. Nurse-initiated, titrated intravenous opioid analgesia reduces time to analgesia for selected painful conditions. CJEM 2005 7 : 149 54.
31. National Institute of Clinical Studies. Emergency Care Community of Practice Pain Initiative Report to Footscray Hospital: Western Health. Melbourne : National Health and Medical Research Council, 2007.
32. Green LV, Soares J, Giglio JF et al. Using queuing theory to increase the effectiveness of emergency department provider staffing. Acad. Emerg. Med. 2006 13 : 61 8.
33. de Bruin AM, Koole GM, Visser MC. Bottleneck analysis of emergency cardiac in-patient flow in a university setting: an application of queuing theory. Clin. Invest. Med. 2005 28 : 316 17.
34. Bagust A, Place M, Posnett JW. Dynamics of bed use in accommodating emergency admissions: stochastic simulation model. BMJ 1999 319 : 155 8.
35. Shabbir J, Ridgway PF, Lynch K et al. Administration of analgesia for acute abdominal pain sufferers in the accident and emergency setting. Eur. J. Emerg. Med. 2004 11 : 309 12.
36. Todd KH et al. Ethnicity as a risk factor for inadequate emergency department analgesia. JAMA 1993 269 : 1537 9.
37. Choi DM, Yate P, Coats T et al. Ethnicity and prescription of analgesia in an accident and emergency department: cross sectional study. BMJ 2000 320 : 980 1.
38. Fuentes EF, Kohn MA, Neighbor ML. Lack of association between patient ethnicity or race and fracture analgesia. Acad. Emerg. Med. 2002 9 : 910 15.