“Patients for days on a stretcher waiting for hospitalization”

Nursind data collected in hospitals. The guidelines of the Region indicate 2 hours. Exhibited in the prosecutor’s office in Turin and Ivrea. “The emergency is in difficult conditions”

IVREA. On paper, the time that should elapse from a patient’s hospitalization decision to actual hospitalization is two hours. So say the regional guidelines sent to all local health authorities and which are requested to incorporate the indications by 7 September. It must be said: these are not rules that come suddenly as it is since 2019 that the issue of overcrowding in the emergency room and patient management times has been addressed in various locations with different regulatory measures and the times should be those. The waves of pandemics that have followed one another since 2020, putting a strain on the resilience of the public health system, have highlighted potential and critical issues. Today, in terms of access to the emergency room, we have practically returned to the numbers prior to the pandemic, without, however, measures to strengthen local health care capable of producing any significant effect. With the emergency room situation that is cyclically reported. In addition, the Region, at the end of a work with all directions, binds the health companies to implement the guidelines on the times. But how is the situation in reality?

Nursind Piemonte tried to reconstruct the situation in the various hospitals. And the current times, between the decision to admit a patient and the actual admission, in the ASL / To4 hospitals are these: from three to seven days in Chivasso, from two to three days in Ivrea and Ciriè. Most hospitals in Piedmont have a time span of two to three days, with a minimum ranging from 30 to 40 hours at Molinette in Turin and a maximum in Chivasso and San Luigi di Orbassano, from three to six days.

For Nursind, the fact that in reality the situation is very different from that written on paper, poses a series of problems that generate negative consequences on the system.

Which? «For patients, delays in evaluation and treatment, increased hospitalization times, exposure to errors, worsening of outcomes – they underline -. For operators, increased stress and burnout, non-compliance with the guidelines of good clinical practice, increased aggression on the part of users ». There are also negative effects for the same structure ranging from the “inefficiency of the system, to the increase in hospitalization times, to the reduced attractiveness and increase in transfers and discharges of staff on duty in the emergency room”. Based on the data of its own monitoring, Nursind sent a complaint to the prosecutors of Ivrea and Turin. The complaint – it might seem paradoxical – does not have a sanctioning intent, but catalyzes attention on a system that, without interventions, has no possibility of articulating healthcare responses to patients in a different way than what it is doing. “The codes that have urgent characteristics – underlines Giuseppe Summa, Nursind territorial secretary – are respected, while the situation is different for the codes of lesser intensity, which numerically are the overwhelming majority”. To explain: the red codes do not wait, the orange ones must be taken over within a quarter of an hour. Going down the severity scale, there are the blue codes that provide a waiting time between registration and the first medical examination of a maximum of one hour, followed by the green ones that should be examined within two hours and finally the whites, within four hours. In addition, patients awaiting visit should be re-evaluated periodically. “But it’s complicated – adds Summa – if the emergency room is overcrowded. And unfortunately, the crowded conditions have become the norm ». A nurse takes care of the patient registration and classifies the clinical priority. «The number of nurses is calculated – adds Summa – on the basis of the number of accesses and not everywhere the number is congruous in all the shifts of service. Criticalities generate stress and increase the possibility of errors. Furthermore, this condition means that verbal or physical aggression against operators occurs every day in our hospitals. A sort of funnel has been created, users turn to the 118 system and first aid because they are an always open door to public health and there they look for an answer “. –