The association between a prolonged stay in the emergency department and adverse events in older patients admitted to hospital: a retrospective cohort study

Ackroyd‐Stolarz, Stacy; Guernsey, Judith Read; MacKinnon, Neil J.; Kovács, George

doi:10.1136/bmjqs.2009.034926

Cited by 137 publications

(104 citation statements)

References 20 publications

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“…These factors play an important role in the interaction between the patients and the healthcare providers (12). Such factors, on the whole, lead to an increase in the waiting time and the patients' stay and, ultimately, reduce the healthcare services quality (56,57). In another study, Deirkavand referred to the role of language and dialectal barriers in the establishment of relationships between nurses and patients and their impacts on patient satisfaction (22); Taylor also emphasized this role in his study (58).…”

Section: Discussionmentioning

confidence: 99%

Patients’ Satisfaction with Medical Emergency Services in Iran from 2000 to 2017: A Systematic Review and Meta-Analysis

Ravaghi

Salemi

Behzadifar

et al. 2018

Iran Red Crescent Med J

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Context: Emergency department is the first place in the hospital that patients refer to receive services, and patients often experience an emergency referral in their lives. Emergency care and paraclinical services are provided to patients in this department. The current study aimed at evaluating the patients' satisfaction with emergency department in Iran through a systematic review and meta-analysis. Evidence Acquisition: The databases including Web of Science (WOS), Embase, PubMed, Scopus, Ovid, as well as the Iranian databases such as Irandoc and Magiran in the Persian and English languages were searched from 2000 to 2017. The STROBE (strengthening the reporting of observational studies in epidemiology) checklist was used to assess the quality of the research methodologies. The random model was used to determine the mean value of satisfaction and the results were reported with the confidence interval (CI) of 95%. Also, sensitivity analysis, subgroup and meta-regression were conducted. The Egger test was used to investigate the publication bias in the studies. Results: Based on the random model, the mean of satisfaction with emergency services in Iran was 70.52% (95% CI: 63.81 -77.23).The results of sensitivity analysis showed no change before and after the analysis of the results. Highest and lowest rates of patient satisfaction were reported in the Eastern (79.17%) and Northern regions (67.15%) of Iran, respectively. Conclusions: The current study findings showed that patients' satisfaction with emergency services in Iran was high compared with the neighboring countries. Health policymakers should increase patients' satisfaction through appropriate training, information, and increased human resources.

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Section: Discussionmentioning

confidence: 99%

Patients’ Satisfaction with Medical Emergency Services in Iran from 2000 to 2017: A Systematic Review and Meta-Analysis

Ravaghi

Salemi

Behzadifar

et al. 2018

Iran Red Crescent Med J

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“…La hospitalización no está exenta de algunos problemas potenciales; riesgo de infección nosocomial, riesgo de desorientación, riesgo de pérdida de autonomía, riesgo de caídas intrahospitalarias. A mayor tiempo de estancia, mayor riesgo de presentar complicaciones nosocomiales 37,38 .…”

Section: Alta Precoz Y Reducción De Las Estancias Mediasunclassified

Consideraciones éticas en la gestión enfermera: una revisión actual

Udina

Almenara

2012

Nursing (Ed. española)

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Consideraciones éticas en una revisión actualIntroducción Las decisiones de gestión configuran una parte muy importante del contexto organizativo para la prestación de cuidados. En la literatura científica se encuentran evidencias del impacto del contexto organizativo y de la pericia de los profesionales en los resultados clínicos de los enfermos y en los resultados de productividad de los centros 1,2 .Aunque tradicionalmente la gestión enfermera se asocia principalmente a la gestión de recursos, en especial a la gestión de recursos humanos, existen múltiples estudios que demuestran que la gestión enfermera, a nivel directivo y también a nivel asistencial (supervisión), incluye otras áreas diferenciadas e igualmente importantes.En el desarrollo del proyecto COM_VA © , de definición y evaluación de las competencias enfermeras en el ámbito hospitalario, se definen siete ámbitos de responsabilidad enfermera en la gestión directiva:1. Dirigir la prestación y la gestión de cuidados en los centros. 2. Construir redes relacionales productivas. 3. Gestionar el conocimiento. 4. Liderar y contribuir a consolidar proyectos. 5. Potenciar la autonomía responsable de los profesionales. 6. Mantener el equilibrio entre los valores y las prioridades. 7. Gestionar los recursos. ResumenIntroducción. Las decisiones de gestión configuran una parte importante del contexto organizativo para la prestación de cuidados. En la literatura científica se encuentran evidencias del impacto del contexto organizativo y de la pericia de los profesionales en los resultados. Puesto que el contexto organizativo está influido por las decisiones de gestión y la toma de decisiones está directamente relacionada con el nivel de competencia de cada profesional, es de esperar que en la práctica existan múltiples visiones sobre una misma situación, que precipiten dilemas éticos en los que la enfermera gestora deberá actuar. Objetivo. Presentar una revisión reflexiva sobre los aspectos éticos de actualidad en la gestión enfermera como herramienta esencial en el desarrollo de pericia para la toma de decisiones. Método. Revisión interpretativa y discusión de la literatura científica actual sobre las cuestiones ético-morales en el ámbito de la gestión asistencial y directiva enfermera: conflictos de valores, dilemas éticos, competencia ética, sufrimiento moral, redes relacionales, whistleblowing y comportamientos negativos. Resultados y conclusiones. Gestionar el equilibrio entre los valores y las prioridades, en el marco del cumplimiento de los principios empresariales de eficiencia, efectividad y productividad puede chocar con los valores profesionales de respeto a la dignidad, equidad, beneficencia, calidad y seguridad, por lo que se requieren enfermeras gestoras con un grado elevado de competencia ética, capaces de abordar la emergencia de los dilemas que surgen en la práctica. Los directivos de las empresas sanitarias no deberían obviar la promoción de redes relacionales positivas y las políticas de gestión de los comportamientos negativos y abordar las cu...

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“…Hospitals are still of course essential in any future vision of healthcare but will increasingly focus on investigations and procedures that require a very high level of expertise and sophisticated technology. The proportion of beds devoted to high dependency and intensive care will increase while the overall number of beds will reduce (Ackroyd-Stolarz et al 2011 ).…”

Section: The Changing Nature Of Healthcarementioning

confidence: 99%

New Challenges for Patient Safety

Vincent

Amalberti

2016

Safer Healthcare

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The developments described in the previous chapters are required because our present vision of safety is not adequate for the challenges we face. Our arguments for these developments rest on analyses of the nature of safety in healthcare as it is delivered today. However, as is well known, healthcare is changing rapidly and there are many new opportunities, pressures and challenges. We believe that these coming changes will have further implications for how safety is understood and practiced which will increase the urgency and importance of the transition to a broader vision.In this chapter we briefl y summarise some of the recent and forthcoming developments in healthcare. These have been widely discussed and we are only concerned to summarise some key points. The primary purpose of the chapter is to consider the implications for patient safety and for the strategies and practices we set out in the remainder of the book. The Changing Nature of HealthcareThe problems faced by healthcare, and many of the challenges for patient safety, arise in part from the very success of modern medicine in combating disease. Because of improvements in diet, nutrition, medicine and environment many people are living longer but also living with one or more chronic conditions such as diabetes, cardiovascular disease and cancer. Diseases which were once fatal are now becoming chronic conditions.The survival rate for cancers, infections and AIDS, strokes, cardiovascular disease and many other previously fatal diseases have improved signifi cantly even in the last decade. For instance a recent French study of 427,000 new adult cancer cases diagnosed between 1989 and 2004, showed signifi cant improvements in 5 year survival for most cancers, especially prostate cancer (Grosclaude et al. 2013 ).In the French population of 65 million people over 320,000 new cancers are diagnosed every year; of these 150,000 are designated as 'cured' within the same 130 year and a further 150,000 can expect to survive at least 5 years. Similar improvements in survival and quality of life in AIDS patients have been seen in developed countries with the introduction of HAART therapies (Highly Active Antiretroviral Therapy) (Borrell et al. 2006 ). Most people treated for chronic conditions are going back to work, family and home, with the personal ambition of leading as healthy life as possible. These developments present huge challenges for healthcare systems in providing care and yet remaining affordable.The traditional hospital cannot remain the main provider of care and core of the medical system simply because it would be unaffordable. Hospitals are still of course essential in any future vision of healthcare but will increasingly focus on investigations and procedures that require a very high level of expertise and sophisticated technology. The proportion of beds devoted to high dependency and intensive care will increase while the overall number of beds will reduce (Ackroyd-Stolarz et al. 2011 ).Medical innovations have lead progressively to shorter h...

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The association between a prolonged stay in the emergency department and adverse events in older patients admitted to hospital: a retrospective cohort study

Abstract: A prolonged ED stay for older admitted patients is associated with an increased risk of an in-hospital AE. The longer hospital LOS associated with AEs further reduces the availability of acute care beds, thus exacerbating ED crowding.

Cited by 137 publications

References 20 publications

Patients’ Satisfaction with Medical Emergency Services in Iran from 2000 to 2017: A Systematic Review and Meta-Analysis

Patients’ Satisfaction with Medical Emergency Services in Iran from 2000 to 2017: A Systematic Review and Meta-Analysis

Consideraciones éticas en la gestión enfermera: una revisión actual

New Challenges for Patient Safety

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