Abstract
ABSTRACTObjective:to check the association of the proposed priorities of the institutional protocol of risk classification with the outcomes and evaluate the profile of the care provided in an emergency unit. Method:observational epidemiological study based on data from the computerized files of a Reference Emergency Unit. Care provided to adults was evaluated regarding risk classification and outcomes (death, hospitalization and hospital discharge) based on the information recorded in the emergency bulletin. Results:the mean age of the 97,099 registered patients was 43.4 years; 81.5% cases were spontaneous demand; 41.2% had been classified as green, 15.3% yellow, 3.7% blue, 3% red and 36.and 9% had not received a classification; 90.2% of the patients had been discharged, 9.4% hospitalized and 0.4% had died. Among patients who were discharged, 14.7% had been classified as yellow or red, 13.6% green or blue, and 1.8% as blue or green. Conclusion:the protocol of risk classification showed good sensitivity to predict serious situations that can progress to death or hospitalization.
Highlights
Overcrowding of emergency services, defined as the situation in which attention to urgencies is compromised by the excessive demand in relation to the available resources, represents a relevant public health problem in several countries
This study aimed to associate the service priorities proposed by the institutional protocol with the outcomes of the care provided in the emergency unit and its ability to predict patient severity, as well as to evaluate the profile of the care provided in the emergency unit
A total of 71,907 (74.3%) patients remained in the Emergency Unit less than one day, 79,133 (81.5%) came by spontaneous demand and 78,175 (90.2%) had hospital discharge as outcome
Summary
Overcrowding of emergency services, defined as the situation in which attention to urgencies is compromised by the excessive demand in relation to the available resources, represents a relevant public health problem in several countries. Scholars devise strategies to reduce the known negative effects of these events, such as increased mortality, prolonged hospitalization time and increased readmissions. Patient evaluation by nurses using risk classification protocols represents an essential strategy to minimize these problems[1]. Protocols have been developed and published to assist nursing professionals in this evaluation. Studies in several countries have demonstrated the validity and effectiveness of these protocols as important tools for the organization of emergency services[3,4,5,6]
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