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

Universiteit Antwerpen

Status: Completed

Conditions: Trauma Injury

Treatments: Diagnostic Test: Nursing triage protocol

Study type: Interventional

Funder types: Other

Identifiers

NCT05765045

TRINU-RX

Details and patient eligibility

About

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).

Enrollment: 220 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

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

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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220 participants in 2 patient groups

Nursing triage group

Experimental group

Description:

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

Treatment:

Diagnostic Test: Nursing triage protocol

Regular care group

No Intervention group

Description:

Regular triage in the emergency department