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

NCT ID: NCT05765045

Last Updated: 2023-07-03

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 220 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-03-06
• Study Completion Date: 2023-04-23

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

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: DIAGNOSTIC
• Blinding Strategy: NONE

Study Groups

Nursing triage group

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

Group Type: EXPERIMENTAL

Nursing triage protocol

Intervention Type: 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.

Regular care group

Regular triage in the emergency department

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Nursing 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.

Intervention Type: DIAGNOSTIC_TEST

Eligibility Criteria

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

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Heilig Hartziekenhuis, Mol

UNKNOWN

Sponsor Role: collaborator

Universiteit Antwerpen

OTHER

Sponsor Role: lead

Responsible Party

Filip Haegdorens

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Filip Haegdorens, PhD

Role: PRINCIPAL_INVESTIGATOR

Universiteit Antwerpen

Locations

University of Antwerp

Wilrijk, Antwerp, Belgium

Countries

Belgium

Other Identifiers

TRINU-RX

Identifier Type: -

Identifier Source: org_study_id