L'impact de la consultation de tri sur l'hospitalisation en urgence chirurgicale - ETUDE PROSPECTIVE- L’Etablissement Publique Hospitalière MOHAMMED BOUDIAF OUARGLA

Abstract

Introduction :Emergency general surgery constitutes 11% of all hospital admissions but represents half (50%) of all surgical mortality. The objective of our study is to evaluate the impact of the triage consultation on surgical emergency hospitalizations at the Mohammed Boudiaf Ouargla hospital.

Method :Our study is a prospective descriptive study carried out in the surgical emergency services of the public health establishment (EPH Mohammed Boudiaf-Ouargla) onregisters of patients consulted for the management of a visceral surgical emergency within those services during the extended period from 01/02/2023 to 30/04/2023.

Results :general emergencies constituted 1.35% of total emergency room admissions. No patient had contacted a reception and orientation nurse (IAO).52.34%, had exceeded 5 minutes in the box, while 50.48%, had not had a clinical examination longer than 5 minutes. 85.05% of patients had performed complementary examinations. For the exit mode there was 74.76% that they had passed to the observation room. Among the patients who had been passed directly to the observation room (22 patients), 50% had represented an ETG of 2 and 22.72% had represented an ETG of 3. The waiting time for a specialist opinion had been around 110 minutes, this delay had been directly linked to the delay in the complementary examinations in 79.52% of the cases. The time between admission and hospitalization was more than 2 hours in 79.74% of cases. The average time between hospitalization and the operation was around 5 hours, of which 92.41% of the patients had undergone an immediate emergency operation.

Conclusion :Time studies provide useful process data to identify system inefficiencies. Triage here turns out to be a key process in the proper functioning of any emergency service.

Introduction :Emergency general surgery constitutes 11% of all hospital admissions but represents half (50%) of all surgical mortality. The objective of our study is to evaluate the impact of the triage consultation on surgical emergency hospitalizations at the Mohammed Boudiaf Ouargla hospital.

Method :Our study is a prospective descriptive study carried out in the surgical emergency services of the public health establishment (EPH Mohammed Boudiaf-Ouargla) onregisters of patients consulted for the management of a visceral surgical emergency within those services during the extended period from 01/02/2023 to 30/04/2023.

Results :general emergencies constituted 1.35% of total emergency room admissions. No patient had contacted a reception and orientation nurse (IAO).52.34%, had exceeded 5 minutes in the box, while 50.48%, had not had a clinical examination longer than 5 minutes. 85.05% of patients had performed complementary examinations. For the exit mode there was 74.76% that they had passed to the observation room. Among the patients who had been passed directly to the observation room (22 patients), 50% had represented an ETG of 2 and 22.72% had represented an ETG of 3. The waiting time for a specialist opinion had been around 110 minutes, this delay had been directly linked to the delay in the complementary examinations in 79.52% of the cases. The time between admission and hospitalization was more than 2 hours in 79.74% of cases. The average time between hospitalization and the operation was around 5 hours, of which 92.41% of the patients had undergone an immediate emergency operation.

Conclusion :Time studies provide useful process data to identify system inefficiencies. Triage here turns out to be a key process in the proper functioning of any emergency service.

مقدمة :تشكل الجراحة العامة الطارئة 11٪ من جميع حالات دخول المستشفيات، لكنها تمثل النصف (50٪) من إجمالي الوفيات الجراحية. الهدف من دراستنا هو تقييم تأثير استشارة الفرز على الاستشفاء الجراحي الطارئ في مستشفى محمد بوضياف ورقلة.

الطريقة :عملنا عبارة عن دراسة وصفية بأثر تقدمي تم إجراؤها في مصلحة الطوارئ الجراحية لمؤسسة الصحة العامة (محمد بوضياف –ورقلة-) انطلاقا من سجلات المرضى الذين أتوا لأخذ الاستشارة فيما يخص الطوارئ الجراحية العامة على مستوى هذه المصلحة خلال الفترة الممتدة من 01/02/2023 إلى 30/04/2023.

النتائج :حالات الطوارئ العامة تشكل 1.35٪ من إجمالي حالات دخول غرفة الطوارئ.لم يتصل أي مريض بـالممرضة منظمة الاستقبال.52.34٪، تجاوزوا 5 دقائق في غرفة الفرز، في حين أن 50.48٪، لم يخضعوا لفحص سريري تزيد مدته عن 5 دقائق. 85.05٪ من المرضى أجروا فحوصات إضافية. بالنسبة لنمط الخروج كان هناك 74.76٪ من مروا إلى غرفة المراقبة. من بين المرضى الذين تم نقلهم مباشرة إلى غرفة المراقبة (22مريض)، 50٪ كانوا مصنفين كETG من المستوى 2 و22.72٪ مصنفين كETG من المستوى 3. وكان وقت الانتظار للحصول على رأي متخصص حوالي 110 دقيقة، وكان هذا التأخير مرتبطًا بشكل مباشر بالتأخير في نتائج الفحوصات الإضافية في 79.52٪ من الحالات. كانت المدة بين الدخول إلى المستشفى والاستشفاء أكثر من ساعتين في 79.74٪ من الحالات. كان متوسط الوقت بين الاستشفاء والعملية حوالي 5 ساعات،حيث خضع 92.41٪ من المرضى لعملية طارئة فورية.

الاستنتاج :توفر دراسات الوقت بيانات مفيدة لتحديد أوجه القصور في النظام. يثبت الفرز هنا أنه عملية رئيسية في الأداء السليم لأي قسم للطوارئ.