| A randomized trial of computer kiosk-expedited management of cystitis in the emergency department. | |
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MedLine Citation:
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PMID: 21996070 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The objective was to assess the efficiency and safety of an interactive computer kiosk module for the management of uncomplicated urinary tract infections (UTI) in emergency departments (EDs). METHODS: This was a prospective unblinded randomized trial. Women age 18 to 64 years seeking care for suspected UTI in three urban EDs were referred to a computer kiosk after triage. The kiosk evaluated women for uncomplicated UTI (based on patient report of at least one irritable voiding symptom within 7 days and absence of complicating features), and eligible patients were randomized to expedited management or usual ED care. Expedited management consisted of a brief clinician encounter to confirm computer kiosk responses and selection of one of four standard antibiotic regimens. Study outcomes included urine culture results, duration of ED visit, time to illness resolution, return visits, and satisfaction with care. RESULTS: Seventeen percent (n = 103) of 624 participants with suspected UTI fulfilled uncomplicated criteria and were randomized. Sixty-nine percent of these women had a positive urine culture. Compared with the control group, the computer-expedited management group had lower median visit duration (89 minutes, interquartile range [IQR] = 65 to 150 minutes vs. 146 minutes, IQR = 105 to 216 minutes) for a decrease of 57 minutes (95% confidence interval [CI] = 27 to 87, p = 0.004). They had similar time to illness resolution, number of return visits, and satisfaction with care. CONCLUSIONS: An interactive computer kiosk accurately, efficiently, and safely expedited the management of women with uncomplicated UTI in a busy, urban ED. Expanding the use of this technology to other conditions could help to improve ED patient flow. |
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Authors:
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John C Stein; Bahar Navab; Brad Frazee; Kathleen Tebb; Gregory Hendey; Judy Maselli; Ralph Gonzales |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Volume: 18 ISSN: 1553-2712 ISO Abbreviation: Acad Emerg Med Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-14 Completed Date: 2012-02-24 Revised Date: 2012-04-26 |
Medline Journal Info:
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Nlm Unique ID: 9418450 Medline TA: Acad Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 1053-9 Citation Subset: IM |
Copyright Information:
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© 2011 by the Society for Academic Emergency Medicine. |
Affiliation:
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Department of Emergency Medicine, University of California, San Francisco, USA. jstein@medicine.ucsf.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Anti-Bacterial Agents / therapeutic use Computer Terminals* Cystitis / diagnosis*, drug therapy Efficiency, Organizational Emergency Service, Hospital / organization & administration* Female Humans Middle Aged Patient Satisfaction Prospective Studies Statistics, Nonparametric Treatment Outcome Triage / organization & administration* Urban Population |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents |
| Comments/Corrections | |
Comment In:
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Acad Emerg Med. 2012 Mar;19(3):365; author reply 366
[PMID:
22340153
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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