Date of Award

2011

Document Type

Thesis

Degree Name

Master of Science in Nursing (MSN)

First Advisor

Mary Alice Hodge

Abstract

The purpose of the study was to identify the effects of the emergency department length of stay on clinical outcomes for critically ill or injured patients in the regional referral community hospital. Delays in transfer have been associated with increased mortality rates, prolonged length of stays, and poor outcomes. Emergency departments are designed to respond to immediate life or limb threatening emergencies.

A quantitative, descriptive, retrospective design was used in this study. Data was collected from APACHE II, trauma databases, and ED logs. The study was conducted in a 752 bed hospital in the western North Carolina. Data was analyzed from 1520 patients.

Critically ill or injured patients who stayed in the ED greater than 3 hours and less than 6 hours were more likely to die in the critical care unit (n = 46, p = 0.033). Five patients developed a ventilator associated pneumonia (p = 0.042).

The study results suggest significant effects on mortality when transfer to the critical care unit is delayed 3-6 hours. The delay in implementing best clinical practices affects the patient outcomes as suggested from the significance of the ventilator associated pneumonia rates.

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