Google
Trusted Resources: Evidence & Education
Scientific literature and patient education texts
Outcomes of an Emergency Department Observation Unit–Based Pathway for the Treatment of Uncomplicated Vaso-Occlusive Events in Sickle Cell Disease
source: Annals of Emergency Medicine
year: 2020
authors: Matthew Lyon, Lashon Sturgis, Richard Lottenberg, Marin E. Gibson, Jonathan Eck, Abdullah Kutlar, Robert W. Gibson
summary/abstract:Study objective:
This was a prospective, pre-post, 13-year observational study documenting the multiyear implementation of an observation unit sickle cell pathway for patients with uncomplicated vaso-occlusive events.
Methods:
The sickle cell pathway begins with rapid triage to identify patients with uncomplicated vaso-occlusive events for immediate transfer to the observation unit and initiation of patient-controlled analgesia followed by repeated evaluations of pain and identification of other complications. Data were abstracted from the electronic medical record or observation unit database. The sickle cell pathway was initiated in April 2006. Major revisions of it were carried out in June 2009 (physician evaluation occurs in sickle cell pathway and only patient-controlled analgesia administration of medications) and October 2010 (multidisciplinary management and individual dosing).
Results:
Annual ED visits ranged between 287 and 528. The preimplementation hospital admission rate was 33% (123/368), 3-day return rate 16% (60/368), and 30-day return rate 67% (248/368). Refinements to the sickle cell pathway have resulted in a decrease in admission rate to 20% (258/1276); 3-day return rate, to 3.6% (46/1,276); and 30-day return rate, to 41% (525/1,276) for the past 3 years.
Conclusion:
The use of a sickle cell pathway for the treatment of uncomplicated vaso-occlusive events has been effective in providing rapid treatment and reducing hospital admissions. However, it was not only the intervention and its refinement that made the sickle cell pathway successful. With the Consolidated Framework for Implementation Research, it was discerned that outer setting factors of organizational commitment to the care of patients with SCD, inner setting factors of learning climate and leadership engagement, individuals, and process contributed to the success of the sickle cell pathway.
DOI: 10.1016/j.annemergmed.2020.08.007
read more
+myBinderRelated Content
-
Low-molecular-weight heparins for managing vaso-occlusive crises in people with sickle cell diseaseBACKGROUND: Sickle cell disease is one ...
-
The role of carbon monoxide and heme oxygenase in the prevention of sickle cell disease vaso-occlusive crisesSickle Cell Disease (SCD) is a painful, ...
-
Crizanlizumab designated FDA breakthrough therapy for potential in vaso-occlusive crisis preventionCrizanlizumab (SEG101), Novartis‘ inve...
-
Finding the right sickle cell disease care teamChandra Wallace does not remember a time...
-
APS Scientific Meeting 2019The American Pain Society will hold its ...
-
My medical school lesson was tinged with racism. Did that affect how I treated a sickle cell patient years later?The young woman was curled up in a ball....
-
New Research Suggests SANGUINATE™ Reduces the Number of Sickled Red Blood Cells in Patients with Vaso-Occlusive Cr...SANGUINATE™, the only investigational ...
To improve your experience on this site, we use cookies. This includes cookies essential for the basic functioning of our website, cookies for analytics purposes, and cookies enabling us to personalize site content. By clicking on 'Accept' or any content on this site, you agree that cookies can be placed. You may adjust your browser's cookie settings to suit your preferences. More Information
The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.
Powered by
Support for this site is provided by
This platform is made possible through a partnership with the Sickle Cell Disease Association of America, Inc. (SCDAA) and its member organizations. SCDAA's mission is to advocate for people affected by sickle cell conditions and empower community-based organizations to maximize quality of life and raise public consciousness while advancing the search for a universal cure.