Trauma Injury
Conditions
Brief summary
In 2019, nearly half of all hospital contacts in Belgium took place through the emergency department, and more than a third of patients arrived after an accident or trauma. In instances of overcrowding, patients with minor orthopedic injuries face prolonged waiting times. Previous studies have shown that implementing triage protocols for medical imaging conducted by a triage nurse can reduce the Total Length of Stay (TLOS) for this patient group. This is a single-center, unblinded, randomized, controlled trial that aims to evaluate the impact of a nurse triage protocol on turnaround time (primary outcome), quality of care, and patient satisfaction. The study population consists of adults who present with minor orthopedic injuries below the elbow or knee and have an Emergency Severity Index (ESI) of 4 or 5. Participants are randomly assigned to either the 'nurse triage protocol' group (n=110) or the 'usual care' group (n=110).
Interventions
DIAGNOSTIC_TESTNursing triage protocol
Medically approved and supervised standing order that allows trained ER nurses to start medical imaging (RX) for adult patients with minor traumata to the limbs.
Sponsors
Heilig Hartziekenhuis, Mol
Universiteit Antwerpen
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Intervention model description
Intervention group and control group
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Adults (18 years old) * ESI 4 or ESI 5 Recent trauma (\< 10 days after trauma) * Accidental trauma mechanism * Trauma below the elbow (forearm, wrist, hand, finger) * Trauma below the knee (lower leg, ankle, foot, toe)
Exclusion criteria
* ESI 1 or ESI 2 or ESI 3 * Return visit after previous emergency department contact for the same injury (e.g. increased pain, tight cast, ...) * Trauma resulting from underlying somatic pathology (e.g. syncope, epileptic attack, vertigo, vasovagal collapse, ...) * Atraumatic (pain) complaints (e.g. pain in the calf, toe, foot, wrist, ... without a clear trauma mechanism) * Additional, non-orthopedic injuries (e.g. laceration, signs of cerebral commotion, ...) * Pregnancy or a suspicion of pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| TLOS | 6-8 weeks | Total length of stay |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient satisfaction | 6-8 weeks | Patient satisfaction measured by a 10-point Likert scale at discharge using a questionnaire |
| Treatment efficiency | 6-8 weeks | Measurement if the patient diagnosis and/or treatment was correctly initiated at the Emergency Department. Yes = no additional diagnosis or treatments were necessary; No = within 14 days after discharge a change in treatment or new diagnosis was done. Data will be collected using the hospital's patient records or by calling patients if no information is found in the record. |
Countries
Belgium
Outcome results
None listed