Length of stay in the emergency department and its associated factors among pediatric patients attending Wolaita Sodo University Teaching and Referral Hospital, Southern, Ethiopia

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Globally, there is an increase in the need for emergency department visits, which is exceptionally high in pediatric patients, resulting in longer lengths of stay, which is a global challenge and a hospital bottleneck that increases the risk of patient morbidity and mortality while also lowering satisfaction.

Objective

This study aimed to assess the length of stay and associated factors in the pediatric emergency department at Wolaita Sodo University Hospital in 2021.

Methods

An institution-based cross-sectional investigation was undertaken from March 15 to May 15, 2021. The 422 study participants were chosen using a systematic sampling procedure. The data were collected using semi-structured interviewer-administered questionnaires and chart reviews. Epi Data version 4.6 was used to enter the data, while SPSS version 26 was used to analyze it. With a 95% confidence interval, descriptive statistics were used to describe the prevalence, pediatrics, and emergency department duration of stay. The factors related to the length of stay were identified using bivariable and multivariable logistic regression analysis. On the AOR, a significant level was proclaimed when the p-value was less than 0.05, and the confidence interval was less than 95%.

Results

The proportion of prolonged pediatric emergency department length of stay was 79.70% (95% CI; 75.7, 83.6). Nighttime arrival [AOR = 3.19, 95% CI (1.14, 8.98)], weekend arrival [AOR = 4.25, 95% CI (1.49, 5.35)], not receiving ordered medication in the hospital [AOR = 2.05, 95% CI (1.04, 4.03)], orange triage category [AOR = 4.01, 95% CI (1.60, 10.05)], and duration of pain 13–24 h [AOR = 0.29, 95% CI (0.89,0.98)], were significantly associated with length of stay.

Conclusion

The percentage of children who stayed in the pediatric emergency department for an extended period was high. Policymakers should implement evidence-based care, maximize existing resources, provide equal access to care and high-quality care, and make pediatric emergency departments more accessible and operationally efficient.

Related collections

Most cited references 31

Record: found
Abstract: found
Article: found

Is Open Access

Emergency department crowding: A systematic review of causes, consequences and solutions

Claire Morley, Maria Unwin, Gregory M. Peterson … (2018)

Background Emergency department crowding is a major global healthcare issue. There is much debate as to the causes of the phenomenon, leading to difficulties in developing successful, targeted solutions. Aim The aim of this systematic review was to critically analyse and summarise the findings of peer-reviewed research studies investigating the causes and consequences of, and solutions to, emergency department crowding. Method The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A structured search of four databases (Medline, CINAHL, EMBASE and Web of Science) was undertaken to identify peer-reviewed research publications aimed at investigating the causes or consequences of, or solutions to, emergency department crowding, published between January 2000 and June 2018. Two reviewers used validated critical appraisal tools to independently assess the quality of the studies. The study protocol was registered with the International prospective register of systematic reviews (PROSPERO 2017: CRD42017073439). Results From 4,131 identified studies and 162 full text reviews, 102 studies met the inclusion criteria. The majority were retrospective cohort studies, with the greatest proportion (51%) trialling or modelling potential solutions to emergency department crowding. Fourteen studies examined causes and 40 investigated consequences. Two studies looked at both causes and consequences, and two investigated causes and solutions. Conclusions The negative consequences of ED crowding are well established, including poorer patient outcomes and the inability of staff to adhere to guideline-recommended treatment. This review identified a mismatch between causes and solutions. The majority of identified causes related to the number and type of people attending ED and timely discharge from ED, while reported solutions focused on efficient patient flow within the ED. Solutions aimed at the introduction of whole-of-system initiatives to meet timed patient disposition targets, as well as extended hours of primary care, demonstrated promising outcomes. While the review identified increased presentations by the elderly with complex and chronic conditions as an emerging and widespread driver of crowding, more research is required to isolate the precise local factors leading to ED crowding, with system-wide solutions tailored to address identified causes.

0 comments Cited 294 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Prolonged length of stay in the emergency department and increased risk of hospital mortality in patients with sepsis requiring ICU admission.

Zhongheng Zhang, Faran Bokhari, Yizhan Guo … (2019)

Delayed patient admission to the intensive care unit (ICU) from the ED is common in China. Patients with severe sepsis or septic shock requiring ICU admission are in need of specialised monitoring and tailored treatment. Delayed admission to the ICU might be associated with adverse clinical outcomes for patients with sepsis.

0 comments Cited 44 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Effect of Population Lockdown on Pediatric Emergency Room Demands in the Era of COVID-19

Francesco Valitutti, Letizia Zenzeri, Angela Mauro … (2020)

Objectives: The aim of this study was to assess the impact of the COVID-19 pandemic and population lockdown on pediatric ED consultations. Methods: A cross-sectional study on pediatric emergency department consultations before and during the current COVID-19 pandemic (March–May 2019 vs. March–May 2020) was performed in two hospitals in the Campania region (Southern Italy) [i.e., Salerno University Hospital (Salerno) and Pediatric Regional Referral Emergency Hub “AORN Santobono-Pausillipon” (Naples)]. Results: 29,368 consecutive ED pediatric patients (13,430 females; mean age ± SD = 5.4 ± 4.7 years) were seen in March–May 2019 and 9,133 (4,494 females; mean age ± SD = 5.9 ± 4.2 years) in March–May 2020. Resuscitation/emergency and urgent care pediatric ED consultations were 1,388 (4.7%, 95% CI 4.5–4.9) in the 2019 trimester, while they were 648 (7.1%, 95% CI 6.6–7.6) in the 2020 trimester (p < 0.01). Mean pediatric ED daily consultations were 326.3 (95% CI 299.9–352.7) in the considered period of 2019 and 101.4 (95%CI 77.9–124.9) in the same period of 2020 (p < 0.001). COVID-19 nasal swabs were performed for 385 children; of those, six resulted positive and four of them were hospitalized. Conclusions: This work provides a unique snapshot of the pediatric EDs demands in the era of COVID-19. We witnessed a significant reduction of non-urgent health care demands during the pandemic but an increase of more severe urgent cases. The COVID-19 pandemic and the following lockdown unveiled the inappropriateness of the majority of pediatric ED consultations. Nevertheless, the current scenario highlighted the need for appropriate and timely clinical evaluations in the pediatric primary care to tackle late and more severe diagnoses in EDs.

0 comments Cited 30 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Bewuketu Terefe:

ORCID: https://orcid.org/0000-0002-0063-0999

woldeabwomariam@gmail.com

Journal

Journal ID (nlm-ta): BMC Emerg Med

Journal ID (iso-abbrev): BMC Emerg Med

Title: BMC Emergency Medicine

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-227X

Publication date (Electronic): 13 December 2022

Publication date PMC-release: 13 December 2022

Publication date Collection: 2022

Volume: 22

Electronic Location Identifier: 203

Affiliations

[1 ]GRID grid.494633.f, ISNI 0000 0004 4901 9060, School of Nursing Department of pediatrics and neonatology, , Wolaita Sodo University, ; Wolaita Sodo, Ethiopia

[2 ]GRID grid.59547.3a, ISNI 0000 0000 8539 4635, Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, , University of Gondar, ; Gondar, Ethiopia

[3 ]GRID grid.494633.f, ISNI 0000 0004 4901 9060, School of Nursing Department of emergency and critical care nursing, , Wolaita Sodo University, ; Wolaita Sodo, Ethiopia

[4 ]GRID grid.59547.3a, ISNI 0000 0000 8539 4635, Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, , University of Gondar, ; Gondar, Ethiopia

Author information

Bewuketu Terefe https://orcid.org/0000-0002-0063-0999

Article

Publisher ID: 740

DOI: 10.1186/s12873-022-00740-3

PMC ID: 9746184

PubMed ID: 36510156

SO-VID: 3a771790-0fc7-4c95-a704-7715c70f39c0

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.