Clinical monitoring and care complexity of patients in the Department of Emergency and Acceptance (DEA): care and organisational issues
DOI:
https://doi.org/10.54103/dn/17506Keywords:
complexity of care, emergency department, acceptance, emergency room, DEAAbstract
BACKGROUND:
The analysis of care complexity has proved necessary in order to better respond to the needs for patient care and assistance at the level of the emergency department; hence the need to monitor care complexity in the Department of Emergency and Acceptance, as there are no studies or tools that deal with this subject in this context.
AIMS:
To map the care complexity of patients admitted to the Department of Emergency and Acceptance at the San Paolo hospital in Milan, verifying the applicability of the tool and methods already used for the study in the emergency department, possibly adapting them to the context under study. To this end, the paper presents a validation of an instrument for detecting the care complexity of patients in this unit, discussing its implications for nursing practice.
METHODS:
Prospective, single-centre, convenience-sample observational study with enrolment of all patients aged ≥ 18 years, admitted within the DEA and coming from the emergency department of the St Paul's hospital.
RESULTS:
203 patients were recruited. The proposed instrument showed satisfactory internal consistency (0.71). Statistical analysis also made it possible to see the most compromised needs of the patients examined, according to access diagnosis and comorbidities.
CONCLUSIONS:
The proposed tool can therefore be used to monitor the complexity of care in the Department of Emergency and Acceptance with integration by the nurse, of assessments that emerge during contact with the person assisted.
References
Marmo G, Molinar Min M, Montanaro A, Rossetto P. Complessità assistenziale: un metodo per orientarsi. Santarcangelo di Romagna (Rimini) : Maggioli Editore; 2016.
Cavaliere B. Misurare la complessità assistenziale: strumenti operativi per le professioni sanitarie. Santarcangelo di Romagna (Rimini): Maggioli, 2009.
Moiset C, Vanzetta M, Vallicella F. Misurare l’assistenza- Un modello di sistema informativo della performance infermieristica. Milano: McGraw.Hill; 2003.
Gruppo Formazione Triage. Triage infermieristico. Milano, McGraw-Hill, 2010.
Benci L. Aspetti normativi e responsabilità nel triage. In GFT Triage infermieristico. 3a ed. Milano: MCGraw-Hill. 2010.
Zagra M. L’infermiere di Triage e la gestione dell’attesa: le insidie medico-legali. Italian Journal of Emergency Medicine. marzo 2016.
Ministero della Sanità. Gazzetta Ufficiale N. 114 Serie Generale del 17 maggio19 "Atto di intesa tra Stato e regioni di approvazione delle linee guida sul sistema di emergenza sanitaria in applicazione del decreto del Presidente della Repubblica 27 marzo 1992. 1992.
Pennini A. Modelli Organizzativi in Ambito ospedaliero. McGraw-Hill 2015.
Marchetti R, Romigi G, Stievano A. Lavorare in area critica: l’assistenza in ospedale e sul territorio. Roma: Carocci Faber; 2005.
Mangiacavalli B. Validazione di uno strumento per l’organizzazione dell’assistenza infermieristica. XVI congresso Federazione Nazionale e Collegi Ipasvi Bologna 2012.
15° Censimento generale della popolazione e delle abitazioni. Struttura demografica della popolazione, dati definitivi. Sistema Statistico Nazionale Istituto Nazionale di Statistica 2011. Consultato su www.istat.it il 5/09/2017.
Safford MM, Allison JJ, Kiefe CI. Patient complexity: more than comorbidity. The vector model of complexity. J Gen Intern Med. dicembre 2007;22 Suppl 3:382–90.
Sommaruga M. Comunicare con il paziente: la consapevolezza della relazione nella professione infermieristica. Roma: Carocci Faber, 2012.
Gallant MH, Beaulieu MC, Carnevale FA. “Partnership: An Analysis of the Concept within the Nurse-Client Relationship.” Journal of Advanced Nursing 40, no. 2 (October 2002): 149–57.
Tsveti M, Broome, B. “Effective Communication and Delivery of Culturally Competent Health Care.” Urologic Nursing 27, no. 3 (June 2007): 239–42.
Li Hui T, Hegney D, Ang, E. “Factors Affecting Effective Communication between Registered Nurses and Adult Cancer Patients in an Inpatient Setting: A Systematic Review.” International Journal of Evidence-Based Healthcare 9, no. 2 (June 2011): 151–64.
Cavallo D, Re LG, Lusignani M. Caratteristiche Ed Efficacia Della Relazione Terapeutica Tra Infermiere E Utente: Una Revisione Della Letteratura. L’ Infermiere, 57(4), e99-e109. Vol. 57, 2013.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Erika Trionfetti, Giovanni Di Pietro
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Accepted 2022-06-15
Published 2022-07-29
