Adherence to low back pain clinical guidelines in Australian hospital emergency departments: A public and private comparison

IF 2.1 4区 医学 Q2 EMERGENCY MEDICINE
Claire L. Samanna , Paul Buntine , Daniel L. Belavy , Ron V. Sultana , Clint T. Miller , Vasilios (Bill) Nimorakiotakis , Patrick J. Owen
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引用次数: 0

Abstract

Managing LBP via clinical practice guidelines in healthcare settings is recommended, yet burgeoning evidence suggests adherence is suboptimal in emergency department settings. Whether adherence differs between public and private settings is unknown. A retrospective audit of two Australian emergency departments matched 86 private patients to 86 public patients by age ( ± 5 years), sex (male/female) and LBP duration (first time/history of LBP). Patient charts were reviewed according to the Australian clinical guidelines for the management of LBP. Guidelines were considered individually and via a collective guideline adherence score (GAS). Management GAS was lower in private patients compared to public patients (d [95 %CI]: −0.67 [−0.98, −0.36], P < 0.001). Public patients were more likely to have documentation of guideline-based advice (OR [95 %CI]: 4.4 [2.4, 8.4], P < 0.001) and less likely to be sent for imaging (OR [95 %CI]: 5.0 [2.6, 9.4], P < 0.001). Private patients were more likely to have documented screening for psychosocial risk factors (OR [95 %CI]: 21.8 [9.1, 52.1], P < 0.001) and more likely to receive guideline-based medication prescriptions at patient discharge (OR [95 %CI]: 2.2 [1.2, 4.2], P = 0.013). Differences exist in public and private hospital emergency department guideline adherence. Exploring barriers and facilitators underpinning these differences will assist in guiding future implementation science approaches.
澳大利亚医院急诊科对腰背痛临床指南的遵守情况:公立和私立医院的比较。
人们建议在医疗机构中通过临床实践指南来管理腰背痛,但大量证据表明,在急诊科环境中遵守指南的情况并不理想。公立医院和私立医院在遵守指南方面是否存在差异尚不清楚。对澳大利亚两家急诊科进行的一项回顾性审计将86名私立医院患者和86名公立医院患者按年龄(±5岁)、性别(男/女)和枸杞痛持续时间(首次/有枸杞痛病史)进行了配对。根据澳大利亚枸杞痛治疗临床指南对患者病历进行了审查。对指南进行了单独考量,并通过指南遵守情况集体评分(GAS)进行考量。与公立医院患者相比,私立医院患者的管理 GAS 较低(d [95 %CI]:-0.67 [-0.98, -0.36],P.
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来源期刊
Australasian Emergency Care
Australasian Emergency Care Nursing-Emergency Nursing
CiteScore
3.30
自引率
5.60%
发文量
82
审稿时长
37 days
期刊介绍: Australasian Emergency Care is an international peer-reviewed journal dedicated to supporting emergency nurses, physicians, paramedics and other professionals in advancing the science and practice of emergency care, wherever it is delivered. As the official journal of the College of Emergency Nursing Australasia (CENA), Australasian Emergency Care is a conduit for clinical, applied, and theoretical research and knowledge that advances the science and practice of emergency care in original, innovative and challenging ways. The journal serves as a leading voice for the emergency care community, reflecting its inter-professional diversity, and the importance of collaboration and shared decision-making to achieve quality patient outcomes. It is strongly focussed on advancing the patient experience and quality of care across the emergency care continuum, spanning the pre-hospital, hospital and post-hospital settings within Australasia and beyond.
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