A Nursing Triage Protocol for Minor Orthopedic Traumata: the Effect on Flow Time, Quality of Care and Patient Satisfaction in an Emergency Department

NCT05765045 | Completed

• 1 other identifier: TRINU-RX
• Study Type: interventional
• Target: 220
• Locations: 1 country
• Sites: 1

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).

Conditions

Trauma Injury

Outcome Measures

Primary Outcomes (1)

• TLOS

  Total length of stay

  6-8 weeks

Secondary Outcomes (2)

• Patient satisfaction

  6-8 weeks

• Treatment efficiency

  6-8 weeks

Study Arms (2)

Nursing triage group

EXPERIMENTAL

Using a triage protocol for medical imaging conducted by a triage nurse in the emergency department

Diagnostic Test: Nursing triage protocol

Regular care group

NO INTERVENTION

Regular triage in the emergency department

Interventions

Nursing triage protocol DIAGNOSTIC_TEST

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.

Nursing triage group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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)

You may not qualify if:

• 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

Sponsors & Collaborators

• Universiteit Antwerpen: lead
• Heilig Hartziekenhuis, Mol: collaborator

Study Sites (1)

University of Antwerp

Wilrijk, Antwerp, 2610, Belgium

Location

MeSH Terms

Conditions

Accidental Injuries

Condition Hierarchy (Ancestors)

Wounds and Injuries

Study Officials

• Filip Haegdorens, PhD

  Universiteit Antwerpen

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: Intervention group and control group

Study Record Dates

• First Submitted: February 9, 2023
• First Posted: March 13, 2023
• Study Start: March 6, 2023
• Primary Completion: April 23, 2023
• Study Completion: April 23, 2023
• Last Updated: July 3, 2023

Record last verified: 2023-06

Data Sharing

• IPD Sharing: Will not share

Locations

BE (1)