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ED triage pain protocol reduces time to receiving analgesics in patients with painful conditions. | LitMetric

AI Article Synopsis

  • - The study investigates how a triage pain protocol in the emergency department can speed up the delivery of pain medications to patients.
  • - Researchers analyzed data from over 23,000 adult patients and found a significant decrease in the average time it took to receive analgesics after the protocol was implemented, dropping from 238 minutes to 168 minutes.
  • - Results indicate that the new pain protocol effectively reduced wait times for pain relief without being influenced by factors like gender, race, or insurance type.

Article Abstract

Background: Studies suggest that collaborative nursing protocols initiated in triage improve emergency department (ED) throughput and decrease time to treatment.

Objective: The objective of the study is to determine if an ED triage pain protocol improves time to provision of analgesics.

Methods: Retrospective data abstracted via electronic medical record of patients at a safety net facility with 67 000 annual adult visits. Patients older than 18 years who presented to the ED between March 1, 2011, and May 31, 2013, with 1 of 6 conditions were included: back pain, dental pain, extremity trauma, sore throat, ear pain, or pain from an abscess. A 3-month orientation to an ED nurse-initiated pain protocol began on March 1, 2012. Nurses administered oral analgesics per protocol, beginning with acetaminophen or ibuprofen and progressing to oxycodone. Preimplementation and postimplementation analyses examined differences in time to analgesics. Multivariable analysis modeled time to analgesics as a function of patient factors.

Results: Over a 27-month period, 23 409 patients were included: 13 112 received pain medications and 10 297 did not. A total of 12 240 (52%) were male, 12 578 (54%) were African American, and 7953 (34%) were white, with a mean (SD) age of 39 years (13 years). The pain protocol was used in 1002 patients. There was a significant change in mean time (minutes) to provision of analgesics between preimplementation (238) and postimplementation (168) (P < .0001). Linear regression showed the protocol-delivered medications to younger patients and of lower acuity in a reduced time. Variables not related to time to provision of medication included sex, payer, and race.

Conclusion: Emergency department triage pain protocol decreased time to provision of pain medications and did so without respect to payer category, sex, or race.

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Source
http://dx.doi.org/10.1016/j.ajem.2016.08.051DOI Listing

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