Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-23T00:17:58.707Z Has data issue: false hasContentIssue false
  • English
  • Français

Health promotion and disease prevention in the emergency department: a feasibility study

Published online by Cambridge University Press:  21 May 2015

Garnet Edward Cummings ,
Louis Hugo Francescutti ,
Gerald Predy  and
Greta Cummings
Garnet Edward Cummings*
Affiliation:
Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.
Louis Hugo Francescutti
Affiliation:
Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta.
Gerald Predy
Affiliation:
Capital Health, Edmonton, Alta.
Greta Cummings
Affiliation:
Faculty of Nursing, University of Alberta, Edmonton, Alta.
*
Department of Emergency Medicine, Faculty of Medicine, University of Alberta, 10240 Kingsway Ave., Edmonton AB T5H 3V9; 780 735-5374, [email protected]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

Health promotion and disease prevention have been increasingly recognized as activities that may be within the scope of emergency medicine. The purpose of this feasibility study was to identify health risks and offer immediate interventions to adult patients who have drug and/or alcohol problems, incomplete immunization, are overdue for a Pap (Papanicolaou) smear, and/or are smokers.

Methods:

The study took place in a busy tertiary Emergency Department (ED) serving an inner-city population with a significant proportion of patients who are homeless, substance abusers, working poor, and/or recent immigrants. A convenience sample of patients completed a computer-based health-risk survey. Trained health promotion nurses offered appropriate interventions to patients following review and discussion of their self-reported data. Interventions included counseling for problem drinking, substance abuse, and smoking cessation, screening for cervical cancer, and immunization.

Results:

From October 20, 2000 to June 30, 2003, we enrolled 2366 patients. One thousand and eleven subjects (43%) reported substance abuse and 1095 (46%) were smokers. Of the 158 smokers contacted in follow-up, 19 (12%) had quit, 63 (40%) had reduced the number of cigarettes/day and 76 (48%) reported no change. Of 1248 women surveyed, 307 (25%) were overdue for a Pap smear and 54 (18%) received this intervention. Forty-four percent of subjects were overdue for at least one immunization and of those, 414 (40%) were immunized in the ED.

Conclusion:

At-risk patients can be identified using a computer-based screening tool, and appropriate interventions can be given to a proportion of these patients in a busy inner city ED without increasing wait time.

Keywords

disease preventionhealth promotion
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 8 , Issue 2 , March 2006 , pp. 100 - 105
Copyright
Copyright © Canadian Association of Emergency Physicians 2006

References

1.American University National Center for Health Fitness. Definition of Health Promotion. Available: www.american.edu /academic.depts/cas/health/nchf/nchfhpdef.html (accessed 9 Feb 2006).Google Scholar
2.World Health Organization. Ottawa Charter for Health Promotion. First International Conference on Health Promotion, Nov 17–21, 1986, Ottawa. Geneva: the Organization; 1986.Google Scholar
3.Bensberg, M, Kennedy, M.A framework for health promoting emergency departments. Health Promot Int 2002;17:179–88.Google Scholar
4.Alberta Health and Wellness. Health Innovation Fund: Prevention in the Emergency Department (RAH). HIF #64. Edmonton; 2003.Google Scholar
5.Predy, GN, Lightfoot, P, Edwards, J, et al. How healthy are we? A Report of the Medical Officer of Health, November 2004. Edmonton: Capital Health Authority; 2004. Available: www.capital health.ca (accessed 9 Feb 2006).Google Scholar
6.Estey, A, Ness, K, Saunders, LD, et al. Understanding the causes of overcrowding in emergency departments in the Capital Health Region in Alberta: a focus group study. Can J Emerg Med 2003;5(2):87–94.Google Scholar
7.Tyrrell, L, Dauphinee, D, on behalf of the Canadian Medical Forum Task Force. Task Force on Physician Supply in Canada. Canadian Medical Forum; 1999.Google Scholar
8.SoRelle, R.Blending passion with data yields a valuable public health message. Emerg Med News 1999;61.Google Scholar
9.Page, D.Treating and streeting patients misses an opportunity for preventive care. Emerg Med News 1999.Google Scholar
10.Clancy, CM, Eisenberg, JM.Emergency medicine in population-based systems of care. Ann Emerg Med 1997;30:800–3.Google Scholar
11.Rhodes, KV, Lauderdale, DS, Stocking, CB, et al. Better health while you wait: a control trial of a computer based intervention for screening and health promotion in the emergency department. Ann Emerg Med 2001;37:284–91.CrossRefGoogle Scholar
12.Rhodes, K, Gordon, J, Lowe, R.Preventive care in the emergency department, Part 1: Clinical preventive services – Are they relevant to emergency medicine? Acad Emerg Med 2000;7:1036–41.Google Scholar
13.Babcock, I, Wyer, P, Gerson, L.Preventive care in the emergency department, Part 2: Clinical preventive services – An emergency medicine evidence-based review. Acad Emerg Med 2000;7:1042–54.Google Scholar
14.Murray, M, Bullard, M, Grafstein, E; for the CTAS and CEDIS National Working Groups. Revisions to the Canadian Emergency Department Triage and Acuity Scale Implementation Guidelines. Can J Emerg Med 2004;6(6):421–7.Google Scholar
15.Hayward, RSA, Hogeterp, JA, Langton, KB.A computer-assisted design tool for the development and analysis of evidence-based automated questionnaires. Medinfo 1995;2:934–7.Google Scholar
16.Hunt, DL, Haynes, RB, Hayward, RS, et al. Patient-specific evidence-based care recommendations for diabetes mellitus: development and initial clinic experience with a computerized decision support system. Int J Med Inform 1998;51:127–35.Google Scholar
17.Weingarten, S, Stone, E, Hayward, R, et al. The adoption of preventive care practice guidelines by primary care physicians: Do actions match intentions? J Gen Intern Med 1995;10(3):138–44.CrossRefGoogle ScholarPubMed
18.Helzlsouer, KJ, Ford, DE, Hayward, RSA, et al. Perceived risk of cancer and practice of cancer prevention behaviours among employees in an oncology center. Prev Med 1994;23:302–8.Google Scholar
19.Roizen, MF, Coalson, D, Hayward, RS, et al. Can patients use an automated questionnaire to define their current health status? Med Care 1992;30(5 suppl):MS74-84.CrossRefGoogle ScholarPubMed
20.Hayward, RS, Steinberg, EP, Ford, DE, et al. Preventive care guidelines in 1990. In: Eddy, DM, editor. Common screening tests. Philadephia: American College of Physicians; 1991. p. 326–93. [Updated in 1997].Google Scholar
21.Ewing, JA.Detecting alcoholism. The CAGE questionnaire. JAMA 1984;252:1905–7.CrossRefGoogle ScholarPubMed
22.Prochaska, JO, DiClemente, CC, Norecross, JC.In search of how people change: application to addictive behaviors. Am Psychol 1992;47:1102–14.Google Scholar
23.Minister of Health Advisory Committee on Immunization. Canadian Immunization Guide, 5th ed. Ottawa: Public Health Agency of Canada; 1998. p. 1–228.Google Scholar
24.Canadian Task Force on Preventive Health Care. Screening for cervical cancer. 1994. Available: www.ctfphc.org (modified 27 Mar 1998; accessed 9 Feb 2006).Google Scholar
25.Cummings, G, Voaklander, D, Vincenten, J, et al. Emergency staff survey on their role in pediatric injury prevention education: a pilot study. J Emerg Med 2000;18:299–303.Google Scholar