Knapman M, Bonner A. International Journal of Nursing Practice 2010; 16: 310–317
Overcrowding in medium-volume emergency departments: Effects of aged patients in emergency departments on wait times for non-emergent triage-level patients
This study aims to examine patient wait times from triaging to physician assessment in the emergency department (ED) for non-emergent patients, and to see whether patient flow and process (triage) are impacted by aged patients. A retrospective study method was used to analyse 185 patients in three age groups. Key data recorded were triage level, wait time to physician assessment and ED census. Multiple linear regression analysis was used to determine the strength of association with increased wait time. A longer average wait time for all patients occurred when there was an increase in the number of patients aged ≥ 65 years in the ED. Further analysis showed 12.1% of the variation extending ED wait time associated with the triage process was explained by the number of patients aged ≥ 65 years. In addition, extended wait time, overcrowding and numbers of those who left without being seen were strongly associated (P < 0.05) with the number of aged patients in the ED. The effects of aged patients on ED structure and process have significant implications for nursing. Nursing process and practice sets clear responsibilities for nursing to ensure patient safety. However, the impact of factors associated with aged patients in ED, nursing's role and ED process can negatively impact performance expectations and requires further investigation.