EMERGENCY ROOM OVERCROWDING FACTORS AFFECTING TREATMENT MANAGEMENT OF SEPSIS PATIENTS IN DR. SAIFUL ANWAR PUBLIC HOSPITAL

Abstract

Emergency Room (ER) overcrowding is one of the world’s health problems in the last ten years. Overcrowding has adverse effects on ER services. Overcrowding obstructs therapeutic procedures, such as sepsis treatment. This study aimed to determine the relationship between the ER overcrowding and sepsis patients’ management based on the Hour-1 Sepsis Bundle. The study was an analytic observational study on 38 septic patients in critical emergency rooms. The observation recorded time until triage, occupancy rate, length of stay (LOS) in the emergency room, number of staff in the emergency room, boarding time, the percentage of boarders, and sepsis management’s suitability based on Hour-1 Sepsis Bundle. There was no significant relationship between ER overcrowding and suitability of Hour-1 Sepsis Bundle as a whole. However, based on the analysis between independent variables and each bundle component, there was a significant relationship between time until triage and blood culture examinations (p = 0.037). Besides, the occupancy rate has a significant relationship with the measurement of serum lactate levels (p = 0.023). Furthermore, there is a significant relationship between total ER staff and ER junior staff on antibiotics administration (p = 0.038 and p = 0.013). The time until triage influenced blood culture examinations, (p = 0.037), occupancy rate influenced the measurement of serum lactate levels, and the total ER staff and ER junior team influenced antibiotic administration.

Keywords

• overcrowding
• time until triage
• occupancy rate
• hour-1 sepsis bundle
• sepsis
• septic shock
• los
• boarding time
• boarders