Determining the factors affecting the satisfaction of patient and physician insedoanalgesia due to distal radius fracture in emergency department

Introduction: The first place of admission for distal radius fracture is emergency departments frequently. Reduction, followed by short arm plaster/ splint application, accompanying with procedural sedation and analgesia (PSA) are also frequently performed in the emergency. In this study, it was aimed to determine the factors affecting the satisfaction in patients undergoing PSA due to distal radius fracture in adult emergency room Method: 70 patients over 18 years of age were included to our observational, descriptive, prospective, cross-sectional study for distal radius fracture and whose PSA procedure were decided by their primary physician between 01.08.2019-01.01.2020 who were applied to Dokuz Eylül University Emergency Department. The socio-demographic data of the patients, comorbid diseases, the type of the fracture and whether there had additional injuries, information and level of satisfaction regarding the PSA procedure, the characteristics of the physicians who applied PSA procedure and the reduction and the features related to the area where the procedure was performed were recorded in the data form. The patients were grouped as those who were satisfied with the PSA procedure and those who were not. Factors thought to affect satisfaction were compared in both groups. P <0.05 was considered significant. Results: 52 (74.3%) were female and 18 (25.7%) were male of the 70 patients included in the study. The average age was 57.5 ± 15.7 (range: 26-94) and the median was 58.5 (IQR: 49.5- 67). Satisfaction levels of the patients were evaluated with a five-point Likert scale included in the study the median value was found to be 4 (IQR 4-5). 59 (84.3%) of the patients were satisfied with the PSA procedure, 11 (15.7%) were not satisfied. The satisfaction of the patients who were satisfied with the PSA procedure, and their satisfaction with the given information about PSA procedure and the cleanliness of the area where the procedure was performed were higher than those who were not satisfied with the PSA procedure (p = 0.014 and p = 0.007, respectively). In addition, as the residency period of the physician who applied PSA procedure increased, the satisfaction of the patients also increased (p = 0.025). There was no relationship between the satisfaction of the physician who applied the reduction and the patient satisfaction 10 (p = 0.272). When patients who are and are not satisfied with GSA are compared; there was no significant difference between the groups in terms of age, gender, educational status, comorbidities, fracture type, additional injury, analgesic type applied, sedative type applied, RASS score median, and complication in the procedure (p> 0.05). No complications were observed in 64 (91.4%) of the patients. Conclusion: According to the results of our study: the residency period of the physician who performed the PSA procedure in patients who underwent PSA due to the distal radius fracture in the emergency room, satisfaction with the given information about PSA procedure and the cleanliness of the area where the PSA procedure was performed affects the patient satisfaction. PSA is a procedure that can be performed safely in the emergency room and increases patient and physician satisfaction. Keywords: procedural sedation analgesia, emergency department, distal radius fracture, patient satisfaction, physician satisfaction, richmond agitation sedation scale