Journal review
Sobie JM, Gaves D, Tringali A. ED "hold" patients: Is their care also being held? J Emerg Nurs 2000; 26:549-553.
Patients who are "held" in the ED because of an unavailable inpatient bed had their blood pressure, pulse, respiratory rate, and oxygen saturation recorded with greater frequency than patients who were directly admitted, according to this study from William Beaumont Hospital in Troy, MI, and St. John’s Hospital in Detroit. The researchers audited 104 medical records of patients with pneumonia to compare the care received by "ED hold" patients and 52 "ED direct admit" patients. Here are key findings:
- Directly admitted patients had their intake, output and temperature noted with greater frequency.
- A higher percentage of ED hold patients (30.8%) did not have a temperature recorded than the direct admit group (1.9%).
- More hold patients (36.5%) did not have breath sounds assessed, compared with 1.9% of the direct admit group.
ED nurses did not adhere to the standard of recording temperature and breath sounds, but assessment was more timely in hold patients compared with direct admits, which surprised the researchers. "We expected that the prioritization of care for newly arrived patients in the emergency department would supersede the care of patients who had already been admitted and were waiting for a bed," they write. "As a result, we thought the care of the patients being held would be less timely."
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