May 2012  << Back  

Waiting room crowding and agitation in a dedicated psychiatric emergency service

Rif S. El-Mallakh, MD

Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA

Amanda Whiteley, MD

Seven Counties Services, Inc. Louisville, KY, USA

Tanya Wozniak, MD

River City Psychiatry, Louisville, KY, USA

McCray Ashby, MD

River City Psychiatry, Louisville, KY, USA

Shawn Brown, MD

Louisville Behavioral Health System, Louisville, KY, USA

Danya Colbert-Trowel, MD

Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA

Tammy Pennington, MD

River City Psychiatry, Louisville, KY, USA

Michael Thompson, MD

River City Psychiatry, Louisville, KY, USA

Rokeya Tasnin, MD

Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA

Christina L. Terrell, MD

Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA

BACKGROUND: Emergency department crowding is a growing problem that impacts patient care and safety. The effect of crowding has not been examined in emergency psychiatric services.

METHODS: The association between patient census and use of restraints, seclusion, and anti-agitation medications as needed was examined for 1 month.

RESULTS: A total of 689 patients were seen in 31 days. The average hourly census was 6.8±2.8 (range 0 to 18). There were 33 incidences of seclusion or restraint and an additional 15 instances of medications administered for agitation. The use of seclusion, restraint, or medication for agitation was significantly associated with census (r2=0.3, F=5.47, P=.036).

CONCLUSION: Crowding in emergency psychiatric waiting rooms may increase the need for seclusion, restraint, or medications for agitation.

ANNALS OF CLINICAL PSYCHIATRY 2012;24(2):140-142

CORRESPONDENCE Rif S. El-Mallakh, MD Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, MedCenter One, 501 East Broadway, Suite 340, Louisville, KY 40202 USA E-MAIL rselma01@louisville.edu
Annals of Clinical Psychiatry ©2012 Quadrant HealthCom Inc.

 
Read full article