Purpose : The purpose of this study is to analyze general characteristics, hospital visit-related characteristics, clinical characteristics and nursing interventions of adult patients with abdominal pain in the emergency room of a tertiary hospital.
Methods : A retrospective study was conducted to analyze medical records of 1,822 adult patients aged 18 or above, who visited the emergency room of a tertiary hospital for abdominal pain, nursing interventions were classified using NIC (Nursing Interventions Classification). Data were collected from patients with abdominal pain that visited the hospital in the even month from January 1st to December 31st 2015 and for data analysis, SPSS 21. program was applied and descriptive statistics and χ2- test were conducted.
Results : In relation to general characteristics, 53.8% of the subjects were female patients, the average age was 51.7 years old, 71.7% of them visited the hospital directly, 11.9% of them used an 119 ambulance, the average time required for visiting the emergency room was 55.99±103.50(hr), 38.9% of them were hospitalized, the average time required for deciding hospitalization was 13.42±54.06(hr), 13.1% of them underwent an operation, the average time required for deciding an operation was 5.01±3.80 and the average length of stay in the emergency room was 8.40±10.00(hr). In relation to clinical characteristics, 63.7% of the subjects had abdominal pain in the whole abdomen, 12.4% of them had RUQ (Right Upper Quadrant), the pain intensity was 3 and above 4 in 50.6% and 25.2% of them respectively, 92.9% of them felt sharp pain and 75.0% of them showed an intermittent frequency. The average time required for initial pain assessment of nurses was 2.15±7.95(min) and the average time required for injecting a painkiller was 57.84±90.54(min). Accompanying symptoms were vomiting and diarrhea in 33.7% and 26.2% of the subjects respectively, 79.5% of them were diagnosed with diseases of the digestive system finally and especially, 20.5% of them had biliary tract and pancreatic diseases. Among general characteristics of the subjects, gender, age, accompanying symptoms and pain regions showed significant differences in diagnostic classification (p<.05) and medical outcomes showed significant differences depending on gender, age, operation, the route of emergency department access, the means of transportation to hospital, the time required for visiting the hospital and the length of stay in the emergency room (p<.05). Pain regions displayed significant differences depending on gender and age and pain intensity showed significant differences depending on age (p<.05). According to the nursing intervention classification, there were 6 domains, 24 classes and 117 interventions. In domains, safety and health system (99.9%), physiological: basics (99.8%) and behavioral (99.6%) were performed most frequently, in classes, risk management and health system mediation (99.9%), physical comfort promotion (99.8%) and patient education (99.6%) were performed most frequently and in interventions, pain management (99.8%), fall prevention (99.7%), admission care (99.7%), teaching: individual (99.5%), patient identification (99.2%) and teaching: prescribed medication (92.4%) were performed most frequently.
Conclusion : The study finding showed that age of the patients in the emergency room the time required for visiting the medical institution after symptoms occurred were related to medical outcomes and diagnosis varied depending on the regions of abdominal pain. 117 nursing interventions were provided and especially, pain management was provided most frequently. But there was a lack of diarrhea management, gastrointestinal tube care and psychological support. Therefore, a standardized nursing intervention. which take abdominal pain characteristics of patients in the emergency room or diagnoses into account, needs to be developed.