Factors associated with delayed order-to-administration time in the emergency department: a retrospective analysis
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...
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2025-04-01
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| Series: | BMC Emergency Medicine |
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| Online Access: | https://doi.org/10.1186/s12873-025-01229-5 |
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| author | Yen-Wen Chen Jian-Heng Lee Cheng-Ying Chiang Ya-Ni Yeh Jih-Chun Lin Ming-Jen Tsai |
| author_facet | Yen-Wen Chen Jian-Heng Lee Cheng-Ying Chiang Ya-Ni Yeh Jih-Chun Lin Ming-Jen Tsai |
| author_sort | Yen-Wen Chen |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-8dad4992a8be4ababf2c830eabfcd741 |
| institution | DOAJ |
| issn | 1471-227X |
| language | English |
| publishDate | 2025-04-01 |
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| series | BMC Emergency Medicine |
| spelling | doaj-art-8dad4992a8be4ababf2c830eabfcd7412025-08-20T02:55:31ZengBMCBMC Emergency Medicine1471-227X2025-04-0125111110.1186/s12873-025-01229-5Factors associated with delayed order-to-administration time in the emergency department: a retrospective analysisYen-Wen Chen0Jian-Heng Lee1Cheng-Ying Chiang2Ya-Ni Yeh3Jih-Chun Lin4Ming-Jen Tsai5Department of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian HospitalDepartment of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian HospitalDepartment of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian HospitalDepartment of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian HospitalDepartment of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian HospitalDepartment of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian HospitalAbstract 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.https://doi.org/10.1186/s12873-025-01229-5AnalgesicsAntibioticsEmergency departmentMedication administrationOrder-to-administration timeTreatment delay |
| spellingShingle | Yen-Wen Chen Jian-Heng Lee Cheng-Ying Chiang Ya-Ni Yeh Jih-Chun Lin Ming-Jen Tsai Factors associated with delayed order-to-administration time in the emergency department: a retrospective analysis BMC Emergency Medicine Analgesics Antibiotics Emergency department Medication administration Order-to-administration time Treatment delay |
| title | Factors associated with delayed order-to-administration time in the emergency department: a retrospective analysis |
| title_full | Factors associated with delayed order-to-administration time in the emergency department: a retrospective analysis |
| title_fullStr | Factors associated with delayed order-to-administration time in the emergency department: a retrospective analysis |
| title_full_unstemmed | Factors associated with delayed order-to-administration time in the emergency department: a retrospective analysis |
| title_short | Factors associated with delayed order-to-administration time in the emergency department: a retrospective analysis |
| title_sort | factors associated with delayed order to administration time in the emergency department a retrospective analysis |
| topic | Analgesics Antibiotics Emergency department Medication administration Order-to-administration time Treatment delay |
| url | https://doi.org/10.1186/s12873-025-01229-5 |
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