masterThesis
Impacto de la valoración por especialista en medicina de emergencias de pacientes adultos en el servicio de urgencias de un Hospital de IV Nivel en Bogotá
Autor
Buitrago Gómez, Mónica Paola
López Rivera, Sindy Janneth
Melón Mateus, Laura Pilar
Institución
Resumen
Objective: Evaluate the impact on the opportunity in the initial evaluation, definition and use of resources, when implementing the assessment with emergency medicine specialist of adult patients classified as triage two. Methods: Observational, cross-sectional, retrospective study, performed in the emergency department of a highly complex university hospital, which attends approximately 5.000 patients monthly and has 5-level-triage classification system (ESI). 130 patients assessed by general practitioners in 2019 and 130 patients assessed by emergency medicine specialist in 2020 were included. Selected by random sampling, and comparing demographic and clinical variables, care times and resources used. Results: No statistically significant differences were found (p = 0.975) in the waiting time for initial evaluation between patients assessed by general practitioners (median = 19 minutes, IQR = 10-29) and those assessed with emergency medicine specialist (median = 19 minutes, IQR = 9-34). In contrast, there were differences (p = 0.014) in the median total definition time, 9 hours (IQR 7-12) and 8 hours (IQR 5-11), respectively, as well as in the percentage of hospitalization (p <0.001 ) which was higher in 2020 (61.5%) compared to 2019 (43.8%). Conclusions: Accompaniment by emergency medicine specialist in the evaluation of patients classified as triage 2, reduce definition times, especially those who require hospitalization, maintain the opportunity in the initial evaluation, without significant differences in the request of paraclinical studies, which can impact the quality and safety of care.