Browsing by Author "Gezahegn Demmelash"

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    Magnitude of Emergency Surgical Interventions Delay for Acute Abdomen and its Associated Patient and Hospital-Related Factors in Tikur Anbessa Specialized Hospital
    (Addis Ababa University, 2024-01-11) Solomon Edom; Gezahegn Demmelash
    Background: Acute abdomen surgeries require immediate attention and treatment. Delay of emergency surgical interventions results in increased mortality rates and healthcare costs, prolonged hospital stays, and poor patient outcomes. Understanding the magnitude and related factors of this delay in management can help in improving patients’ outcomes, shorten the length of stay, and minimize the burden in emergency rooms. Objectives: To identify the magnitude, and assess the associated patient and hospital-related factors for the delay of emergency surgery for acute abdomen in the TASH emergency department. Methods: Single-center, prospective, cross-sectional study done among acute abdomen cases in the TASH emergency department with a total of 97 patients selected from September 1- December 4, 2023. Data was gathered through chart review and operation room documentation logbook utilizing a standardized questionnaire adapted from prior research with few modifications. The data was coded, cleaned, and loaded into the SPSS version 26 software program for further analysis. Descriptive statistics, and bivariate, and multivariate analysis were performed to evaluate the outcome and associated factors. The odd ratio was employed to estimate relative risk and P values < 0.05 were considered significant. Results: The overall prevalence and magnitude of the delay in emergency surgical intervention for acute abdomen were 40.2%. The age group 35-45 had the highest frequency of delay, with an AOR of 27.067 (95% CI = 2.516-291.187, P=0.007). This study data also demonstrated that a prolonged duration of stay in an emergency (> 24 hours) is substantially associated with delays in surgical care, compared to less than 24 hours stays (AOR=4.551 (95% CI=1.355-15.283, P=0.014). Conclusion: Acute abdomen is a surgical emergency that most commonly affects men and young adults. Patients aged 35-45 and who spent more than 24 hours in the emergency department were more likely to be delayed. This study indicated a considerable incidence of 40.2% delayed emergency surgical management for acute abdomen, above prior studies. Emergency surgical care at our hospital is frequently delayed due to a shortage of physical resources, delays in decision-making to operate, and the surgical team's preoccupation with other emergency cases
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    Pain Treatment Practice and Its Impact on Patient Satisfaction in Emergency Department: Experience From Tikur Anbessa Specialized Hospital, Ethiopia, 2019.
    (Addis Abeba University, 2019-08) Gezahegn Demmelash; Azazh Aklilu ; Zewdu Tigist
    Background: Undertreatment of pain is common in emergency department. The major reasons are lack of staff training in recognition, measurement and adequate pain treatment. Despite the global attention being given over the years, undertreatment of pain in the clinical practice is still an issue. Objective: The general objective of this study is to assess the pain treatment practice and its impact on patient satisfaction in the emergency department of Tikur Anbessa Specialized Hospital, July 15-19, 2019 Addis Ababa Ethiopia. Methodology: Single cantered, prospective, observational study for a continuous 24 hours of 5 days was conducted on total of 106 patients with history of recent pain. Numeric Rating Scale was used to assess patient’s severity of pain. Each patient was evaluated twice, initially at triage and 2-4 hours after arrival. The desire for analgesics was assessed at triage and Patient’s level of satisfaction was also assessed during the second evaluation. Data was analysed with SPSS version 21 Results: Out of 106 patients male account for 57.5% with M:F ratio of 1.3. The mean age of participants was 42.53years, with SD =16.3 years. The majority of patients were having medial emergencyfollowed by oncologic emergency and trauma. The mean initial numeric rating scale was 5.88(SD=2.09) measured out of 10. The proportion of patients who did not receive analgesics priorto emergency department were 77.4% (n=82), despite the fact that 57.5% (n=61) of them were referred by primary care taker. Desire for analgesics was found to be significantly associated with initial numeric rating scale. Despite the fact that 80.2% (n=85) of the patients desired analgesia, it was prescribed only for 51%(n=54) patients and actually taken by only 41.5%(n=44). Asking for analgesics and patient presentation during day time were significantly associated (p<0.05) with physician analgesics prescription. The overall satisfaction with pain treatment was reported in 68.87% (n=73) patients, despite the presence of undertreatment in 54% (n=52). Coming at day time and lower repeat numeric repeat scale has statistically significant association with over all emergency department in pain treatment satisfaction. Conclusion: There was a significant undertreatment of pain in the emergency department of Tikur Anbessa Specialized Hospital. Under recognition of pain by physicians and decision not to prescribe was the major reason patients didn’t take analgesics. Despite that, patient satisfaction was good and repeat mean numeric rating scale was also decreased.