Factors associated with disposition of patients transferred to an emergency department in a district hospital in Botswana

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing Pub Date : 2025-05-28 DOI:10.1016/j.ienj.2025.101624

Tebogo T. Mamalelala , William Holzemer , Mabona E. Maleho , Ditebogo J. Mokone

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Abstract

Background

The Emergency Department (ED) at the district hospital or primary hospital serves as a point of entry for patients with various medical needs from health posts and community clinics. A delayed or inaccurate disposition can result in a transfer to a lower level of care and a possible return to the health system. The study aimed to investigate the factors associated with disposition of patients from district hospital ED.

Methods

A retrospective descriptive study using 1,565 triage charts and admitting medical records was conducted for the period June through December 2020. A binomial logistic regression investigated patient and facility factors related to patient disposition. The moderated mediation model evaluated the effect of patients’ urgency on the disposition of the patients from the ED.

Results

Referring facility, HIV status, patient-level of acuity, length of stay in the ED, and the waiting time for the doctor were predictors of the disposition of the patients from the ED (p = 0000). Waiting time for a doctor’s consultation is positively and significantly associated with length of stay in the ED (p < 0.001).

Conclusion

The findings highlight the need for an efficient triage system, as delays in care can adversely affect patient outcomes. Addressing challenges related to prolonged length of stay (LOS) and doctors waiting time are also essential for optimizing patient flow. Enhancing triage processes and conducting further research are crucial for improving emergency care efficiency and safety.

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博茨瓦纳一家地区医院转到急诊科的病人处置的相关因素

背景地区医院或初级医院的急诊科是来自卫生站和社区诊所有不同医疗需求的病人的入口。延误或不准确的处置可能导致转移到较低护理水平，并可能返回卫生系统。本研究旨在探讨与区医院ed患者处置相关的因素。方法对2020年6月至12月期间1565份分诊图和入院病历进行回顾性描述性研究。二项逻辑回归研究了患者和设施因素与患者处置的关系。经调节的中介模型评估了急症患者对急症患者处置的影响。结果：转诊设施、HIV感染状况、患者的视力水平、急症患者的住院时间和等待时间是急症患者处置的预测因子（p = 0000）。等待医生咨询的时间与急诊科的住院时间呈显著正相关(p <；0.001)。结论研究结果强调需要一个有效的分诊系统，因为延误护理会对患者的预后产生不利影响。解决与延长住院时间（LOS）和医生等待时间相关的挑战对于优化患者流程也至关重要。加强分诊过程和开展进一步研究对于提高急诊护理效率和安全性至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Emergency Nursing NURSING-

CiteScore

3.20

自引率

11.10%

发文量

期刊介绍： International Emergency Nursing is a peer-reviewed journal devoted to nurses and other professionals involved in emergency care. It aims to promote excellence through dissemination of high quality research findings, specialist knowledge and discussion of professional issues that reflect the diversity of this field. With an international readership and authorship, it provides a platform for practitioners worldwide to communicate and enhance the evidence-base of emergency care. The journal publishes a broad range of papers, from personal reflection to primary research findings, created by first-time through to reputable authors from a number of disciplines. It brings together research from practice, education, theory, and operational management, relevant to all levels of staff working in emergency care settings worldwide.