To measure the effectiveness of Emergency nurse practitioners on service and quality of patient care outcomes for patients in the Emergency department compared with standard emergency medical care.

For patients presenting to the emergency department with Pain, following collection of baseline data and the eligibility of the patient is confirmed; consenting patents in series will be randomly assigned to either the intervention or the control group by a computer-generated program. The intervention to be evaluated in this research will be emergency nurse practitioner (E-NP) service. The emergency nurse practitioner model of care specifically includes assessment and management of patients using critical decision-making skills, referring directly to other health care providers, prescribing medications, performing interventions, ordering and interpreting diagnostic investigations and admission/discharging autonomy. The E-NP will assess the next available patient within their scope of practice according to time waiting to be seen as per usual ED policy. After this initial assessment the E-NP will commence management of the patient and complete the episode of care. The duration of the intervention will be from initial patient assessment until discharge from the ED. The service is geographically located in the Fast track area of the ED and the E-NP manages patients presenting with ATS categories 2-5 (Australian College of Emergency Medicine, 2012).