Usage of pediatric emergency department observation unit for children: observations in a university hospital Original Article

Year 2007, Volume: 42 Issue: 2, 61 - 64, 01.06.2007

Okşan Derinöz F. Sedef Tunaoğlu

Abstract

Aim: The evaluation of pediatric emergency department observation unit for the hospitalization of patients with frequently seen childhood disorders as an alternative to hospital wards Material and Method: Demographic features diagnoses hospital stay intervals of patients hospitalized in Gazi University Faculty of Medicine Pediatric Emergency Department Observation Unit between nbsp; January 1 st and nbsp; November 31 st 2006 were collected from the Pediatric Emergency Department records and patient files Results: Within one year 22286 patients were admitted Among them 535 patients were hospitalized in nbsp; The Pediatric Observation Unit while 919 patients were hospitalized in wards A total of 535 patients 243 girls 292 boys aged between 1 228 months were hospitalized in the Pediatric Emergency Unit Their diagnoses were trauma 164 535 intoxications 111 535 respiratory diseases 65 535 and neurologic diseases 61 535 Four hundred ninenty four of all cases were hospitalized for less than 24 hours 41 of them stayed more than 24 hours at the Observation Unit 439 82 of all cases were discharged from the pediatric observation unit 96 of all cases were transferred from the observation unit to the ward for continuation of medical treatment Conclusion: 535 subjects were hospitalized in the Emergency Pediatric Observation Unit and 82 of these subjects were discharged from the Emergency Pediatric Observation Unit This reality shows the benefits of this unit as prevention of unnecessary and over hospitalizations decreament in hospital stay intervals early diagnosis of clinically suspicious subjects prevention of delay in their treatment and increasing patient satisfaction by early discharge Pediatric emergency observation units are a must for the pediatric emergency services for the better evaluation and treatment of children Turk Arch Ped 2007; 42: 61 4 Key words: Children emergency department observation unit

Keywords

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Çocuk acil gözlem birimlerinin çocuk hastalar için kullanımı: bir üniversite hastanesinin izlenimleri Orijinal Araştırma

Abstract

Amaç: Sık görülen çocukluk çağı hastalıkları için yataklı servisler dışında bir seçenek olan acil gözlem birimlerinin nasıl kullanıldığını değerlendirmektir Gereç ve Yöntem: Gazi Üniversitesi Tıp Fakültesi Çocuk Acil Servis’inde yer alan Çocuk Acil Gözlem Birimi’ne 1 Ocak 31 Aralık 2006 tarihleri arasında yatan olguların demografik özellikleri tanıları hastanede kalış süreleri acil servis hasta kayıt defterinden ve hasta dosyalarından elde edilen veriler doğrultusunda geriye dönük olarak incelendi Bulgular: Bir yıl içinde Çocuk Acil Polikliniği’ne başvuran 22 286 olgudan 919’u 4 1 yataklı servislerde; yaşları 1 228 ay arasında değişen 243’ü kız 292’si erkek 535 2 4 hasta ise Acil Gözlem Birimi’nde izlendi Acil Gözlem Birimi’ne yatan hastaların yatış tanıları sırasıyla travma 164 535 zehirlenme 111 535 solunum sistemi hastalıkları 65 535 ve nörolojik hastalıklar 61 535 idi Tüm olguların 494’ü yirmidört saatten kısa 41’i yirmidört saatten daha uzun süre Acil Gözlem Birimi’nde izlendi Olguların 439’u 82 Çocuk Acil Gözlem Birimi’nden taburcu edilirken 96 olgu izlem ve tedavilerin devamı için ilgili servislere devredildi Çıkarımlar: Bir yıl içinde Acil Servis’ten yataklı servislere ve Acil Gözlem odalarına yatan hasta sayıları göz önüne alındığında Acil Gözlem Birimi’nde izlenen 535 olgunun 82’sinin Acil Gözlem Birimi’nden taburcu edilmiş olması yataklı servislere gereksiz hasta yatırılması ve gereksiz tetkik yapılmasını engellemede hastanede kalış süresini azaltmada klinik bulguları şüpheli olan olguların tanı ve tedavilerinin gecikmesini önlemede hastanın daha çabuk taburcu edilerek hasta memnuniyetini arttırmada önemlidir Bu nedenlerle acil gözlem birimleri çocuk hastaların belli durumlarda daha iyi değerlendirilmesini ve tedavilerinin yapılabilmesini sağlamak için çocuk acil servisleri içinde hastanelerin olanaklarına göre bulundurulması gereken alanlardır Türk Ped Arş 2007; 42: 61 4 Anahtar kelimeler: Acil servis çocuk gözlem birimi

Keywords

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References

• Graf LG, Radford MJ, Werne C. Probability of appendicitis befo- re and after observation. Ann Emerg Med 1991; 20:503-7.
• Erkan T, Çam H, Özkan HÇ, et al. Clinical spectrum of acute ab- dominal pain in Turkish pediatric patients: a prospective study. Pediatrics International 2004; 46:325-9.
• Lee TH, Juarez G, Cook EF, et al. Ruling out acute myocardial in- farction: a prospective multicenter validation of a 12-hour stra- tegy for patients at low risk. N Engl J Med 1991; 324:1239-46.
• Scribano PV, Wiley JF, Platt K. Use of an observation unit by a pediatric emergency department for common pediatric illnesses. Pediatr Emerg Care 2001; 17:321-3.
• Numa A, Oberklaid F. Can short hospital admissions be avoid- ed? A review of admissions of less than 24 hours’ duration in a pediatric teaching hospital. Med J Aust 1991; 155: 395-8.
• Dawson KP. A pediatric day unit: the first year’s experience. NZ Med J 1991; 104:185-7.
• Gouin S, Macarthur C, Parkin PC, et al. Effect of a pediatric ob- servation unit on the rate of hospitalization for asthma. Ann Emerg Med 1997; 29: 218-22.
• Mace SE. Pediatric observation medicine. Emerg Med Clin North Am 2001; 19: 239-54.
• Klein BL, Patterson M. Observation unit management of pediat- ric emergencies. Emerg Med Clin N Am 1991; 9: 669-76.
• Zebrack M, Kadish H, Nelson D. The pediatric hybrid observation unit: an analysis of 6477 consecutive patient encounters. Pediat- rics 2005; 115: 535-42.
• Holsti M, Kadish HA, Sill BL, Firth SD, Nelson DS. Pediatric closed head injuries treated in an observation unit. Pediatr Emerg Care 2005; 21: 639-44.
• Goldberg R, Chan L, Haley P, et al. Critical pathway for the emer- gency department management of acute asthma: effect on resource utilization. Ann Emerg Med 1998; 31: 562-7.
• Rydman RJ, Isola ML, Roberts RR, et al. Emergency department observation unit versus hospital inpatient care for a chronic asth- matic population. Med Care 1998; 36: 599-609.
• Zun L. Observation units: boom or bust for emergency medicine. J Emerg Med 1990; 8: 485-90.
• AAP Committee on Hospital Care. More data needed on short- stay units. AAP News 1999; 27.
• Leduc K, Haley-Andrews S, Rannie M. An observation unit in a pediatric emergency department: one children's hospital's ex- perience. J Emerg Nurs 2002; 28: 407-13.
• Beattie TF, Moir P. A paediatric accident and emergency short- stay ward: a 1-year audit. Arch Emerg Med 1993; 10:181-6.
• Wiley JF, Friday JH, Nowakowski T, et al. Observation unit: the role of an outpatient extend. Paed Emerg Care 1998; 14: 444-7.
• Brown GJ. A short stay or 23-hour ward in a general and acade- mic children’s hospital: are they effective? Pediatr Emerg Care 2000; 16: 223-9.
• Brown GL, Penna A. Short stay facilities: the future of efficient pediatric emergency services. Arch Dis Child 1996; 74: 309-13.
• Levett I, Berry K, Wacogne I. Review of a pediatric emergency department observation unit. Emerg Med J 2006; 23: 612-3.