Early lessons from <scp>COVID</scp>‐19 that may reduce future emergency department crowding

Mazurik, Laurie; Javidan, Arshia; Higginson, Ian; Judkins, Simon; Petrie, David; Graham, Colin A.; Bonning, John; Hansen, Kim; Lang, Eddy

doi:10.1111/1742-6723.13612

Cited by 16 publications

(28 citation statements)

References 7 publications

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“…These strategies included dedicated COVID-19 task forces, hospitals, community facilities, emergency centres, and cohorting and treating patients with respiratory symptoms away from those without any. Other suggestions have included the establishment of fever and isolation zones and increased access to telehealth [53] .…”

Section: Discussionmentioning

confidence: 99%

Emergency clinicians’ knowledge, preparedness and experiences of managing COVID-19 during the 2020 global pandemic in Australian healthcare settings

Sotomayor-Castillo

Nahidi

et al. 2021

Australasian Emergency Care

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Background Emergency clinicians have a crucial role during public health emergencies and have been at the frontline during the COVID-19 pandemic. This study examined the knowledge, preparedness and experiences of Australian emergency nurses, emergency physicians and paramedics in managing COVID-19. Methods A voluntary cross-sectional study of members of the College of Emergency Nursing Australasia, the Australasian College for Emergency Medicine, and the Australasian College of Paramedicine was conducted using an online survey (June-September 2020). Results Of the 159 emergency nurses, 110 emergency physicians and 161 paramedics, 67.3-78% from each group indicated that their current knowledge of COVID-19 was ‘good to very good’. The most frequently accessed source of COVID-19 information was from state department of health websites. Most of the respondents in each group (77.6-86.4%) received COVID-19 specific training and education, including personal protective equipment (PPE) usage. One-third of paramedics reported that their workload ‘had lessened’ while 36.4-40% of emergency nurses and physicians stated that their workload had ‘considerably increased’. Common concerns raised included disease transmission to family, public complacency, and PPE availability. Conclusions Extensive training and education and adequate support helped prepare emergency clinicians to manage COVID-19 patients. Challenges included inconsistent and rapidly changing communications and availability of PPE.

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Section: Discussionmentioning

confidence: 99%

Emergency clinicians’ knowledge, preparedness and experiences of managing COVID-19 during the 2020 global pandemic in Australian healthcare settings

Sotomayor-Castillo

Nahidi

et al. 2021

Australasian Emergency Care

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“…The burden of suspected COVID‐19 cases is significant and is likely to contribute to prolonged ED length of stay 1 . This has the potential to precipitate overcrowding, exacerbate access block and delay definitive care 1,24,25 . Prolonged test turnaround times contribute to this burden because patients spend a longer period of time in isolation while awaiting test results.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and clinical features of emergency department patients with suspected and confirmed COVID‐19: A multisite report from the COVID‐19 Emergency Department Quality Improvement Project for July 2020 (COVED‐3)

O’Reilly

Mitchell

Mitra

et al. 2020

Emerg Medicine Australasia

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Objective The aim of this study was to describe the epidemiology and clinical features of patients presenting to the emergency department (ED) with suspected and confirmed COVID‐19. Methods The COVID‐19 Emergency Department (COVED) Project is an ongoing prospective cohort study in Australian EDs. This analysis presents data from eight sites across Victoria and Tasmania for July 2020 (during Australia's ‘second wave’). All adult patients who met criteria for ‘suspected COVID‐19’ and underwent testing for SARS‐CoV‐2 in the ED were eligible for inclusion. Study outcomes included a positive SARS‐CoV‐2 test result and mechanical ventilation. Results In the period 1 to 31 July 2020, there were 30 378 presentations to the participating EDs and 2917 (9.6%; 95% CI: 9.3–9.9) underwent testing for SARS‐CoV‐2. Of these, 50 (2%) patients returned a positive result. Among positive cases, two (4%) received mechanical ventilation during their hospital admission compared to 45 (2%) of the SARS‐CoV‐2 negative patients (OR 1.7 [95% CI: 0.4–7.3], p = 0.47). Two (4%) SARS‐CoV‐2 positive patients died in hospital compared to 46 (2%) of the SARS‐CoV‐2 negative patients (OR 1.7 [0.4–7.1] p = 0.49). Strong clinical predictors of a positive result included self‐reported fever, non‐smoking status, bilateral infiltrates on CXR, and absence of a leucocytosis on first ED blood tests (p < 0.05). Conclusions In this prospective multi‐site study from July 2020, a substantial proportion of ED patients required SARS‐CoV‐2 testing, isolation and enhanced infection prevention and control precautions. Presence of SARS‐CoV‐2 on nasopharyngeal swab was not associated with death or mechanical ventilation. This article is protected by copyright. All rights reserved.

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“…Vorliegende Studien aus Patientenperspektive zeigen bereits, dass neben Terminaspekten bei Haus-oder Fachärzten und zeitlicher Flexibilität vor allem die in der Notaufnahme erwartete qualitativ höherwertige und multidisziplinäre Versorgung als Motiv genannt wird, ebenso wie Unsicherheit und Angst über den eigenen Gesundheitszustand [18,20,21,23]. Die Coronapandemie hat diesen Trend im Bereich der Selbsteinweisungen durch Patienten mit niedriger Behandlungsdringlichkeit umgekehrt [2, 10,14,24,27]. Viele Patienten verzichten derzeit eher auf eine Selbsteinweisung in der Notaufnahme aus Angst vor einer Ansteckung mit dem Coronavirus oder möglichen Versorgungsengpässen [14].…”

Section: Gesundheitskompetenz Und Notfallverhaltenunclassified

“…Ängste und Unsicherheiten über die eigene Gesundheit scheinen damit in beiden Entwicklungen eine relevante Rolle für das Notfallverhalten bei Patienten mit nichtdringlichem Versorgungsbedarf einzunehmen. Da wenig Zweifel daran besteht, dass nach dem Ende der Coronapandemie wieder mit einem Zuwachs nichtdringlicher Patienten zu rechnen ist [10,13], erscheint eine genauere Untersuchung, die über die Nennung von Motiven hinausgeht, dringend erforderlich. Dies gilt umso mehr, da die geplante Strukturreform durch die Coronapandemie vorerst gebremst ist [3].…”

Section: Gesundheitskompetenz Und Notfallverhaltenunclassified

Gesundheitskompetenz und Notfallverhalten

Wehler

Kalch

Bilandzić

et al. 2021

Notfall Rettungsmed

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Zusammenfassung Hintergrund Die Anzahl an Patienten in Notaufnahmen steigt seit Jahren an. Im Besonderen wächst der Anteil an Patienten mit einem nichtdringlichen Behandlungsbedarf. Bislang ist unklar, ob dies in Deutschland auch auf eine eingeschränkte Gesundheitskompetenz zurückgeführt werden kann. Ziel der Arbeit Ziel der Studie war es, die Gesundheitskompetenz (GK) von Notfallpatienten mit nichtdringlichem Behandlungsbedarf zu erfassen, mit allgemeinen Bevölkerungsdaten zur GK zu vergleichen und Zusammenhänge mit der subjektiv empfundenen notfallmedizinischen Versorgung zu betrachten. Material und Methode Es wurde eine Querschnittsbefragung in der zentralen Notaufnahme und der angeschlossenen kassenärztlichen Bereitschaftspraxis (KVB-Praxis) des Universitätsklinikums Augsburg durchgeführt. Insgesamt wurden 448 Patienten mit nichtdringlichem Versorgungsbedarf befragt. Ergebnisse Es zeigt sich, dass die GK der Notfallpatienten schlechter ausfällt als die der deutschen Gesamtpopulation. Patienten mit niedriger GK nehmen eine höhere subjektive Behandlungsdringlichkeit wahr, kennen signifikant seltener alternative Anlaufstellen zur Behandlung und möchten nach hausärztlicher Versorgung häufiger in der Notaufnahme oder der KVB-Praxis eine zweite Meinung einholen. Diskussion Die Ergebnisse zeigen einen Handlungsbedarf für eine Verbesserung der Gesundheitskompetenz auf. Dabei sind insbesondere die aktuellen strukturellen Veränderungen der Notfallversorgung in Deutschland zu berücksichtigen.

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Early lessons from COVID‐19 that may reduce future emergency department crowding

Cited by 16 publications

References 7 publications

Emergency clinicians’ knowledge, preparedness and experiences of managing COVID-19 during the 2020 global pandemic in Australian healthcare settings

Emergency clinicians’ knowledge, preparedness and experiences of managing COVID-19 during the 2020 global pandemic in Australian healthcare settings

Epidemiology and clinical features of emergency department patients with suspected and confirmed COVID‐19: A multisite report from the COVID‐19 Emergency Department Quality Improvement Project for July 2020 (COVED‐3)

Gesundheitskompetenz und Notfallverhalten

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