X-rays Trauma Request's by the Triage And Intake Nurse Intake and Referral Nurse:

NCT05669157 | Completed

• 1 other identifier: CHRO-2022-08
• Study Type: interventional
• Target: 400
• Locations: 1 country
• Sites: 1

Brief Summary

The number of consultations in emergency departments is increasing day by day, and the time to treat patients is getting longer. Different French studies have shown a significant reduction in the time spent in the emergency department after the implementation of the national protocol for the delegation of early radiography prescriptions. The investigators hypothesised that an early request for a standard X-ray by the intake and referral nurse in the case of isolated trauma to the extremities of a limb (from the knee to the toes and from the shoulder to the fingers) enables a reduction in medical management time and, consequently, in the time spent in the emergency department for the patient.

Conditions

Limb Injury

Keywords

Traumatology; Personnel delegation; Nurse specialists; Radiography; emergency department; intake and referral nurse

Outcome Measures

Primary Outcomes (1)

• Duration between triage and exit of emergency unit

  Total duration in minutes in the emergency department with or without anticipated request of X-ray

  immediatly after the procedure

Secondary Outcomes (6)

• Total duration of the stay

  immediatly after the procedure

• Number of additional X-ray prescribed by the physician after physician assessment.

  immediatly after the procedure

• Appropriateness of the X-rays requested by the IRN as per guidelines

  immediatly after the procedure

• IRN's feeling about the anticipated request for X-ray (assessed as per anonym Quality of Life at Work questionnaire)

  immediatly after the procedure

• X-ray technician's feeling about the anticipated request for X-ray (assessed as per anonym Quality of Life at Work questionnaire)

  immediatly after the procedure

Study Arms (2)

Current practice: radiography request by physician

EXPERIMENTAL

No interventions will be performed. There is no change in current practice.

Procedure: Radiography request by physician

Radiography request by the nurse

EXPERIMENTAL

the intake and referral nurse will request a radiography if required according to the local cooperation protocol

Procedure: Radiography request by nurse

Interventions

Radiography request by nurse PROCEDURE

Intervention group with radiography requested by the IRN instead of the physician. The radiography will be interpreted by the physician afterwards, according to current practice

Radiography request by the nurse

Radiography request by physician PROCEDURE

The physician prescribed the X-ray, the X-ray technician carries out the imagery and the physician interprets it afterwards

Current practice: radiography request by physician

Eligibility Criteria

• Age: 15 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Patient older than 15 years and 3 months admitted in adult emergency department of regional hospital center of ORLEANS with a simple and isolated trauma having occurred less than 48 hours prior to admission of a limb extremity (from the knee to the toes or from the shoulder to the fingers), and with no previous imagery assessment within 48 hours prior to admission in the emergency department.

You may not qualify if:

• Multiple trauma
• Patient with at least one Vittel criteria (except age)
• Patient refusing the protocol
• Hemodynamic instability and/or disorder of consciousness
• Sensory and/or vascular disorders downstream of the traumatized area
• Protected population (under guardianship or curators)
• Patient under court protection
• Pregnant or breastfeeding woman or one who declares herself to be pregnant or breastfeeding
• Patient with an expired blood alcohol level \> 0.4 mg/L and/or positive blood alcohol level
• Patient with diagnosed dementia
• Patient hospitalized after being taken in charge

Sponsors & Collaborators

• Centre Hospitalier Régional d'Orléans: lead

Study Sites (1)

CHR d'Orléans

Orléans, France

Location

Related Publications (1)

• Lindley-Jones M, Finlayson BJ. Triage nurse requested x rays--are they worthwhile? J Accid Emerg Med. 2000 Mar;17(2):103-7. doi: 10.1136/emj.17.2.103.

  PMID: 10718230 BACKGROUND

MeSH Terms

Conditions

Emergencies

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Vincent GARROUSTE, MD

  Regional Hospital center of ORLEANS

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 12, 2022
• First Posted: December 30, 2022
• Study Start: January 16, 2023
• Primary Completion: June 25, 2023
• Study Completion: June 25, 2023
• Last Updated: August 1, 2023

Record last verified: 2023-07

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)