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Investigating primary healthcare resource utilization, triage system awareness, and time expectations among patients presenting at emergency departments in Jordan: a cross-sectional study

This study aims to investigate patients' knowledge of the triage system, utilization of primary healthcare resources, and expectations for waiting times in Jordanian Emergency Departments (EDs). A descriptive, cross-sectional design was employed in the EDs in the largest public hospitals in Jordan. Convenient sampling resulted in 726 participants. A self-reported questionnaire included socio-demographic information and instruments assessing primary healthcare use, triage system awareness, and expected waiting times. Most participants (61.3%) lacked awareness of the triage system. The use of primary healthcare was influenced by age, education, marital status, current job, nationality, and location. Having a primary healthcare provider was associated with higher patient satisfaction. Significant variations in expected waiting times for diagnostic test results were noted based on gender, place of residence, education, current job, and marital status. Addressing patient awareness of the triage system is crucial for optimizing healthcare accessibility and quality in Jordanian EDs. Improving patient education, communication, and primary care utilization can enhance patient outcomes, reduce ED burden, and contribute to a more efficient healthcare system.

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Persistent cool extremities as an independent predictor of adverse clinical outcomes among critically ill patients: a single-center retrospective observational study

Cool extremities representing impaired skin perfusion are a classical sign of shock. We evaluated associations between the presence and persistence of subjective cool extremities observed by caring nurses and clinical outcomes. We conducted a retrospective observational study in an Intensive Care Unit (ICU) at a university hospital in Japan. Patients were divided into two groups based on the presence or absence of subjective cool extremities during the first 24 hours of their ICU stay. We compared their characteristics and outcomes. In total, 2956 patients were analyzed. Patients with cool extremities were older, had higher severity Acute Physiology and Chronic Health Evaluation (APACHE III) scores, had higher in-hospital mortality (4.1% vs 18%, p<0.001), and had a higher prevalence of acute kidney injury requiring renal replacement therapy (2.1% vs 10%, p<0.001) as compared to patients without nurse-reported cool extremities. Multivariable logistic regression showed cool extremities persisting for ≥12 hours were significantly associated with in-hospital death (adjusted Odds Ratio, OR, 1.64) and acute kidney injury requiring renal replacement therapy (adjusted OR 1.82). Patients with subjective cool extremities were more severely ill and had poorer outcomes. Subjective skin temperature assessment may be useful to detect high-risk patients.

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