Quality of hospital emergency department care for patients with COVID-19 during the first wave in 2020: the CALUR-COVID-19 study
Por:
Jimenez, S, Miro, O, Alquezar-Arbe, A, Pinera, P, Jacob, J, Llorenss, P, Garcia-Lamberechts, EJ, Martin-Sanchez, FJ, Del Castillo, JG, Burillo-Putze, G
Publicada:
1 oct 2022
Resumen:
Objectives. To define quality of care indicators and care process standards for treating patients with COVID-19 in hospital emergency departments (EDs), to determine the level of adherence to standards during the first wave in 2020, and to detect factors associated with different levels of adherence.
Methods. We selected care indicators and standards by applying the Delphi method. We then analyzed the level of adherence in the SIESTA cohort (registered by the Spanish Investigators in Emergency Situations Team). This cohort was comprised of patients with COVID-19 treated in 62 Spanish hospitals in Maid and April 2020. Adherence was compared according to pandemic-related ED caseload pressure, time periods during the wave (earlier and later), and age groups.
Results. Fourteen quality indicators were identified. Three were adhered to in less than 50% of the patients. Polymerase chain reaction testing for SARS-CoV-2 infection was the indicator most often disregarded, in 29% of patients when the caseload was high vs 40% at other times (P < .001) and in 30% of patients in the later period vs 37% in the earlier period (P = .04). Adherence to the following indicators was better in the later part of the wave: monitoring of oxygen saturation (100% vs 99%, P = .035), electrocardiogram monitoring in patients treated with hydroxychloroquine (87% vs 65%, P < .001), and avoiding of lopinavir/ritonavir treatment in patients with diarrhea (79% vs 53%, P < .001). No differences related to age groups were found.
Conclusions. Adherence to certain quality indicators deteriorated during ED treatment of patients with COVID-19 during the first wave of the pandemic. Pressure from high caseloads may have exacerbated this deterioration. A learning effect led to improvement. No differences related to patient age were detected.
Filiaciones:
Jimenez, S:
Univ Barcelona, Hosp Clin, IDIBAPS, Serv Urgencias, Barcelona, Spain
Miro, O:
Univ Barcelona, Hosp Clin, IDIBAPS, Serv Urgencias, Barcelona, Spain
Alquezar-Arbe, A:
Hosp Santa Creu & Sant Pau, Serv Urgencias, Barcelona, Spain
Pinera, P:
Hosp Gen Univ Reina Sofia, Serv Urgencias, Murcia, Spain
Jacob, J:
Hosp Univ Bellvitge, Serv Urgencias, Barcelona, Spain
Llorenss, P:
Univ Miguel Hernandez, Hosp Gen Univ Alicante, Serv Urgencias, Inst Invest Sanitaria & Biomed Alicante ISABIAL, Alicante, Spain
Garcia-Lamberechts, EJ:
Univ Complutense, Hosp Clin San Carlos, Serv Urgencias, IDISSC, Madrid, Spain
Martin-Sanchez, FJ:
Univ Complutense, Hosp Clin San Carlos, Serv Urgencias, IDISSC, Madrid, Spain
Del Castillo, JG:
Univ Complutense, Hosp Clin San Carlos, Serv Urgencias, IDISSC, Madrid, Spain
Burillo-Putze, G:
Hosp Univ Canarias, Serv Urgencias, Tenerife, Spain
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