Factors associated with delayed order-to-administration time in the emergency department: a retrospective analysis

Timely medication administration in the emergency department (ED) is critical for improving patient outcomes. This study aimed to identify predictors of delayed order-to-administration (OTA) time, defined as exceeding 30 min for stat medications. A retrospective analysis was conducted in the ED of a...

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Published inBMC emergency medicine Vol. 25; no. 1; pp. 74 - 11
Main Authors Chen, Yen-Wen, Lee, Jian-Heng, Chiang, Cheng-Ying, Yeh, Ya-Ni, Lin, Jih-Chun, Tsai, Ming-Jen
Format Journal Article
LanguageEnglish
Published England BioMed Central Ltd 28.04.2025
BioMed Central
BMC
Subjects
Adult
Aged
Analgesics
Antibiotics
Blood
Clinical outcomes
Computed tomography
Drug administration
Efficiency
Electronic medical records
Emergency department
Emergency medical care
Emergency service
Emergency Service, Hospital - organization & administration
Emergency Service, Hospital - statistics & numerical data
Environmental factors
Female
Gynecology
Heart attacks
Hospitals
Humans
Intravenous administration
Male
Medical examination
Medical records
Medical referrals
Medical research
Medication administration
Medicine, Experimental
Middle Aged
Nursing
Obstetrics
Order-to-administration time
Otolaryngology
Patient safety
Patients
Pharmacy
Prescriptions
Radiography
Retrospective Studies
Time Factors
Treatment delay
Order-to-administration time
Treatment delay
Emergency department
Analgesics
Antibiotics
Medication administration
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Abstract Timely medication administration in the emergency department (ED) is critical for improving patient outcomes. This study aimed to identify predictors of delayed order-to-administration (OTA) time, defined as exceeding 30 min for stat medications. A retrospective analysis was conducted in the ED of a 1,000-bed tertiary hospital. Patients aged 20 years or older who received stat medications between June 1 and August 31, 2020, were included. Only the first stat medication order per patient was analyzed. Data on patient demographics, triage characteristics, environmental factors, prescription details, and OTA times were extracted from the hospital's electronic medical record and nursing information system. Multivariable logistic regression with backward elimination was used to identify predictors of OTA delays. Among the 11,429 patient visits included, 9.9% experienced OTA delays exceeding 30 min. Predictors of higher odds of delay included older age (adjusted odds ratio [aOR]: 1.01, 95% CI: 1.00-1.01), female sex (aOR: 1.49, 95% CI: 1.31-1.69), limited mobility (aOR: 1.38, 95% CI: 1.17-1.63 for ambulatory with assistance; aOR: 1.24, 95% CI: 1.03-1.48 for non-ambulatory patients), trauma (aOR: 1.35, 95% CI:1.09-1.66), hourly patient visits (aOR: 1.07, 95% CI: 1.05-1.10), concurrent intravenous fluid use (aOR:1.42, 95% CI:1.04-1.93), blood tests (aOR: 1.73, 95% CI: 1.30-2.30), radiography (aOR: 2.22, 95% CI: 1.87-2.64), and computed tomography (aOR: 1.57, 95% CI: 1.37-1.80). Reduced odds of delay were observed among patients with triage level 1 compared to level 3 (aOR 0.25, 95% CI:0.16-0.39), those arriving during night shifts compared to day shifts (aOR: 0.33, 95% CI: 0.18-0.63), and those receiving intramuscular medications compared to intravenous administration (aOR 0.71; 95% CI, 0.55-0.93). Several patient, environmental, and diagnostic-related factors were associated with OTA delays in stat medication administration. Understanding these predictors may help inform strategies to optimize ED workflows. Further research is warranted to validate these findings in other ED settings. Not applicable.
AbstractList Background Timely medication administration in the emergency department (ED) is critical for improving patient outcomes. This study aimed to identify predictors of delayed order-to-administration (OTA) time, defined as exceeding 30 min for stat medications. Methods A retrospective analysis was conducted in the ED of a 1,000-bed tertiary hospital. Patients aged 20 years or older who received stat medications between June 1 and August 31, 2020, were included. Only the first stat medication order per patient was analyzed. Data on patient demographics, triage characteristics, environmental factors, prescription details, and OTA times were extracted from the hospital's electronic medical record and nursing information system. Multivariable logistic regression with backward elimination was used to identify predictors of OTA delays. Results Among the 11,429 patient visits included, 9.9% experienced OTA delays exceeding 30 min. Predictors of higher odds of delay included older age (adjusted odds ratio [aOR]: 1.01, 95% CI: 1.00-1.01), female sex (aOR: 1.49, 95% CI: 1.31-1.69), limited mobility (aOR: 1.38, 95% CI: 1.17-1.63 for ambulatory with assistance; aOR: 1.24, 95% CI: 1.03-1.48 for non-ambulatory patients), trauma (aOR: 1.35, 95% CI:1.09-1.66), hourly patient visits (aOR: 1.07, 95% CI: 1.05-1.10), concurrent intravenous fluid use (aOR:1.42, 95% CI:1.04-1.93), blood tests (aOR: 1.73, 95% CI: 1.30-2.30), radiography (aOR: 2.22, 95% CI: 1.87-2.64), and computed tomography (aOR: 1.57, 95% CI: 1.37-1.80). Reduced odds of delay were observed among patients with triage level 1 compared to level 3 (aOR 0.25, 95% CI:0.16-0.39), those arriving during night shifts compared to day shifts (aOR: 0.33, 95% CI: 0.18-0.63), and those receiving intramuscular medications compared to intravenous administration (aOR 0.71; 95% CI, 0.55-0.93). Conclusions Several patient, environmental, and diagnostic-related factors were associated with OTA delays in stat medication administration. Understanding these predictors may help inform strategies to optimize ED workflows. Further research is warranted to validate these findings in other ED settings. Clinical trial number Not applicable. Keywords: Analgesics, Antibiotics, Emergency department, Medication administration, Order-to-administration time, Treatment delay
Abstract Background Timely medication administration in the emergency department (ED) is critical for improving patient outcomes. This study aimed to identify predictors of delayed order-to-administration (OTA) time, defined as exceeding 30 min for stat medications. Methods A retrospective analysis was conducted in the ED of a 1,000-bed tertiary hospital. Patients aged 20 years or older who received stat medications between June 1 and August 31, 2020, were included. Only the first stat medication order per patient was analyzed. Data on patient demographics, triage characteristics, environmental factors, prescription details, and OTA times were extracted from the hospital’s electronic medical record and nursing information system. Multivariable logistic regression with backward elimination was used to identify predictors of OTA delays. Results Among the 11,429 patient visits included, 9.9% experienced OTA delays exceeding 30 min. Predictors of higher odds of delay included older age (adjusted odds ratio [aOR]: 1.01, 95% CI: 1.00–1.01), female sex (aOR: 1.49, 95% CI: 1.31–1.69), limited mobility (aOR: 1.38, 95% CI: 1.17–1.63 for ambulatory with assistance; aOR: 1.24, 95% CI: 1.03–1.48 for non-ambulatory patients), trauma (aOR: 1.35, 95% CI:1.09–1.66), hourly patient visits (aOR: 1.07, 95% CI: 1.05–1.10), concurrent intravenous fluid use (aOR:1.42, 95% CI:1.04–1.93), blood tests (aOR: 1.73, 95% CI: 1.30–2.30), radiography (aOR: 2.22, 95% CI: 1.87–2.64), and computed tomography (aOR: 1.57, 95% CI: 1.37–1.80). Reduced odds of delay were observed among patients with triage level 1 compared to level 3 (aOR 0.25, 95% CI:0.16–0.39), those arriving during night shifts compared to day shifts (aOR: 0.33, 95% CI: 0.18–0.63), and those receiving intramuscular medications compared to intravenous administration (aOR 0.71; 95% CI, 0.55–0.93). Conclusions Several patient, environmental, and diagnostic-related factors were associated with OTA delays in stat medication administration. Understanding these predictors may help inform strategies to optimize ED workflows. Further research is warranted to validate these findings in other ED settings. Clinical trial number Not applicable.
BackgroundTimely medication administration in the emergency department (ED) is critical for improving patient outcomes. This study aimed to identify predictors of delayed order-to-administration (OTA) time, defined as exceeding 30 min for stat medications.MethodsA retrospective analysis was conducted in the ED of a 1,000-bed tertiary hospital. Patients aged 20 years or older who received stat medications between June 1 and August 31, 2020, were included. Only the first stat medication order per patient was analyzed. Data on patient demographics, triage characteristics, environmental factors, prescription details, and OTA times were extracted from the hospital’s electronic medical record and nursing information system. Multivariable logistic regression with backward elimination was used to identify predictors of OTA delays.ResultsAmong the 11,429 patient visits included, 9.9% experienced OTA delays exceeding 30 min. Predictors of higher odds of delay included older age (adjusted odds ratio [aOR]: 1.01, 95% CI: 1.00–1.01), female sex (aOR: 1.49, 95% CI: 1.31–1.69), limited mobility (aOR: 1.38, 95% CI: 1.17–1.63 for ambulatory with assistance; aOR: 1.24, 95% CI: 1.03–1.48 for non-ambulatory patients), trauma (aOR: 1.35, 95% CI:1.09–1.66), hourly patient visits (aOR: 1.07, 95% CI: 1.05–1.10), concurrent intravenous fluid use (aOR:1.42, 95% CI:1.04–1.93), blood tests (aOR: 1.73, 95% CI: 1.30–2.30), radiography (aOR: 2.22, 95% CI: 1.87–2.64), and computed tomography (aOR: 1.57, 95% CI: 1.37–1.80). Reduced odds of delay were observed among patients with triage level 1 compared to level 3 (aOR 0.25, 95% CI:0.16–0.39), those arriving during night shifts compared to day shifts (aOR: 0.33, 95% CI: 0.18–0.63), and those receiving intramuscular medications compared to intravenous administration (aOR 0.71; 95% CI, 0.55–0.93).ConclusionsSeveral patient, environmental, and diagnostic-related factors were associated with OTA delays in stat medication administration. Understanding these predictors may help inform strategies to optimize ED workflows. Further research is warranted to validate these findings in other ED settings.Clinical trial numberNot applicable.
Timely medication administration in the emergency department (ED) is critical for improving patient outcomes. This study aimed to identify predictors of delayed order-to-administration (OTA) time, defined as exceeding 30 min for stat medications.BACKGROUNDTimely medication administration in the emergency department (ED) is critical for improving patient outcomes. This study aimed to identify predictors of delayed order-to-administration (OTA) time, defined as exceeding 30 min for stat medications.A retrospective analysis was conducted in the ED of a 1,000-bed tertiary hospital. Patients aged 20 years or older who received stat medications between June 1 and August 31, 2020, were included. Only the first stat medication order per patient was analyzed. Data on patient demographics, triage characteristics, environmental factors, prescription details, and OTA times were extracted from the hospital's electronic medical record and nursing information system. Multivariable logistic regression with backward elimination was used to identify predictors of OTA delays.METHODSA retrospective analysis was conducted in the ED of a 1,000-bed tertiary hospital. Patients aged 20 years or older who received stat medications between June 1 and August 31, 2020, were included. Only the first stat medication order per patient was analyzed. Data on patient demographics, triage characteristics, environmental factors, prescription details, and OTA times were extracted from the hospital's electronic medical record and nursing information system. Multivariable logistic regression with backward elimination was used to identify predictors of OTA delays.Among the 11,429 patient visits included, 9.9% experienced OTA delays exceeding 30 min. Predictors of higher odds of delay included older age (adjusted odds ratio [aOR]: 1.01, 95% CI: 1.00-1.01), female sex (aOR: 1.49, 95% CI: 1.31-1.69), limited mobility (aOR: 1.38, 95% CI: 1.17-1.63 for ambulatory with assistance; aOR: 1.24, 95% CI: 1.03-1.48 for non-ambulatory patients), trauma (aOR: 1.35, 95% CI:1.09-1.66), hourly patient visits (aOR: 1.07, 95% CI: 1.05-1.10), concurrent intravenous fluid use (aOR:1.42, 95% CI:1.04-1.93), blood tests (aOR: 1.73, 95% CI: 1.30-2.30), radiography (aOR: 2.22, 95% CI: 1.87-2.64), and computed tomography (aOR: 1.57, 95% CI: 1.37-1.80). Reduced odds of delay were observed among patients with triage level 1 compared to level 3 (aOR 0.25, 95% CI:0.16-0.39), those arriving during night shifts compared to day shifts (aOR: 0.33, 95% CI: 0.18-0.63), and those receiving intramuscular medications compared to intravenous administration (aOR 0.71; 95% CI, 0.55-0.93).RESULTSAmong the 11,429 patient visits included, 9.9% experienced OTA delays exceeding 30 min. Predictors of higher odds of delay included older age (adjusted odds ratio [aOR]: 1.01, 95% CI: 1.00-1.01), female sex (aOR: 1.49, 95% CI: 1.31-1.69), limited mobility (aOR: 1.38, 95% CI: 1.17-1.63 for ambulatory with assistance; aOR: 1.24, 95% CI: 1.03-1.48 for non-ambulatory patients), trauma (aOR: 1.35, 95% CI:1.09-1.66), hourly patient visits (aOR: 1.07, 95% CI: 1.05-1.10), concurrent intravenous fluid use (aOR:1.42, 95% CI:1.04-1.93), blood tests (aOR: 1.73, 95% CI: 1.30-2.30), radiography (aOR: 2.22, 95% CI: 1.87-2.64), and computed tomography (aOR: 1.57, 95% CI: 1.37-1.80). Reduced odds of delay were observed among patients with triage level 1 compared to level 3 (aOR 0.25, 95% CI:0.16-0.39), those arriving during night shifts compared to day shifts (aOR: 0.33, 95% CI: 0.18-0.63), and those receiving intramuscular medications compared to intravenous administration (aOR 0.71; 95% CI, 0.55-0.93).Several patient, environmental, and diagnostic-related factors were associated with OTA delays in stat medication administration. Understanding these predictors may help inform strategies to optimize ED workflows. Further research is warranted to validate these findings in other ED settings.CONCLUSIONSSeveral patient, environmental, and diagnostic-related factors were associated with OTA delays in stat medication administration. Understanding these predictors may help inform strategies to optimize ED workflows. Further research is warranted to validate these findings in other ED settings.Not applicable.CLINICAL TRIAL NUMBERNot applicable.
Timely medication administration in the emergency department (ED) is critical for improving patient outcomes. This study aimed to identify predictors of delayed order-to-administration (OTA) time, defined as exceeding 30 min for stat medications. A retrospective analysis was conducted in the ED of a 1,000-bed tertiary hospital. Patients aged 20 years or older who received stat medications between June 1 and August 31, 2020, were included. Only the first stat medication order per patient was analyzed. Data on patient demographics, triage characteristics, environmental factors, prescription details, and OTA times were extracted from the hospital's electronic medical record and nursing information system. Multivariable logistic regression with backward elimination was used to identify predictors of OTA delays. Among the 11,429 patient visits included, 9.9% experienced OTA delays exceeding 30 min. Predictors of higher odds of delay included older age (adjusted odds ratio [aOR]: 1.01, 95% CI: 1.00-1.01), female sex (aOR: 1.49, 95% CI: 1.31-1.69), limited mobility (aOR: 1.38, 95% CI: 1.17-1.63 for ambulatory with assistance; aOR: 1.24, 95% CI: 1.03-1.48 for non-ambulatory patients), trauma (aOR: 1.35, 95% CI:1.09-1.66), hourly patient visits (aOR: 1.07, 95% CI: 1.05-1.10), concurrent intravenous fluid use (aOR:1.42, 95% CI:1.04-1.93), blood tests (aOR: 1.73, 95% CI: 1.30-2.30), radiography (aOR: 2.22, 95% CI: 1.87-2.64), and computed tomography (aOR: 1.57, 95% CI: 1.37-1.80). Reduced odds of delay were observed among patients with triage level 1 compared to level 3 (aOR 0.25, 95% CI:0.16-0.39), those arriving during night shifts compared to day shifts (aOR: 0.33, 95% CI: 0.18-0.63), and those receiving intramuscular medications compared to intravenous administration (aOR 0.71; 95% CI, 0.55-0.93). Several patient, environmental, and diagnostic-related factors were associated with OTA delays in stat medication administration. Understanding these predictors may help inform strategies to optimize ED workflows. Further research is warranted to validate these findings in other ED settings.
Timely medication administration in the emergency department (ED) is critical for improving patient outcomes. This study aimed to identify predictors of delayed order-to-administration (OTA) time, defined as exceeding 30 min for stat medications. A retrospective analysis was conducted in the ED of a 1,000-bed tertiary hospital. Patients aged 20 years or older who received stat medications between June 1 and August 31, 2020, were included. Only the first stat medication order per patient was analyzed. Data on patient demographics, triage characteristics, environmental factors, prescription details, and OTA times were extracted from the hospital's electronic medical record and nursing information system. Multivariable logistic regression with backward elimination was used to identify predictors of OTA delays. Among the 11,429 patient visits included, 9.9% experienced OTA delays exceeding 30 min. Predictors of higher odds of delay included older age (adjusted odds ratio [aOR]: 1.01, 95% CI: 1.00-1.01), female sex (aOR: 1.49, 95% CI: 1.31-1.69), limited mobility (aOR: 1.38, 95% CI: 1.17-1.63 for ambulatory with assistance; aOR: 1.24, 95% CI: 1.03-1.48 for non-ambulatory patients), trauma (aOR: 1.35, 95% CI:1.09-1.66), hourly patient visits (aOR: 1.07, 95% CI: 1.05-1.10), concurrent intravenous fluid use (aOR:1.42, 95% CI:1.04-1.93), blood tests (aOR: 1.73, 95% CI: 1.30-2.30), radiography (aOR: 2.22, 95% CI: 1.87-2.64), and computed tomography (aOR: 1.57, 95% CI: 1.37-1.80). Reduced odds of delay were observed among patients with triage level 1 compared to level 3 (aOR 0.25, 95% CI:0.16-0.39), those arriving during night shifts compared to day shifts (aOR: 0.33, 95% CI: 0.18-0.63), and those receiving intramuscular medications compared to intravenous administration (aOR 0.71; 95% CI, 0.55-0.93). Several patient, environmental, and diagnostic-related factors were associated with OTA delays in stat medication administration. Understanding these predictors may help inform strategies to optimize ED workflows. Further research is warranted to validate these findings in other ED settings. Not applicable.
ArticleNumber 74
Audience Academic
Author Yeh, Ya-Ni
Lee, Jian-Heng
Lin, Jih-Chun
Chen, Yen-Wen
Chiang, Cheng-Ying
Tsai, Ming-Jen
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Issue 1
Keywords Order-to-administration time
Treatment delay
Emergency department
Analgesics
Antibiotics
Medication administration
Language English
License 2025. The Author(s).
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Snippet Timely medication administration in the emergency department (ED) is critical for improving patient outcomes. This study aimed to identify predictors of...
Background Timely medication administration in the emergency department (ED) is critical for improving patient outcomes. This study aimed to identify...
BackgroundTimely medication administration in the emergency department (ED) is critical for improving patient outcomes. This study aimed to identify predictors...
Abstract Background Timely medication administration in the emergency department (ED) is critical for improving patient outcomes. This study aimed to identify...
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SubjectTerms Adult
Aged
Analgesics
Antibiotics
Blood
Clinical outcomes
Computed tomography
Drug administration
Efficiency
Electronic medical records
Emergency department
Emergency medical care
Emergency service
Emergency Service, Hospital - organization & administration
Emergency Service, Hospital - statistics & numerical data
Environmental factors
Female
Gynecology
Heart attacks
Hospitals
Humans
Intravenous administration
Male
Medical examination
Medical records
Medical referrals
Medical research
Medication administration
Medicine, Experimental
Middle Aged
Nursing
Obstetrics
Order-to-administration time
Otolaryngology
Patient safety
Patients
Pharmacy
Prescriptions
Radiography
Retrospective Studies
Time Factors
Treatment delay
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Title Factors associated with delayed order-to-administration time in the emergency department: a retrospective analysis
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