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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, gcumming@ualberta.ca

Abstract

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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

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