An evaluation of the care of patients with minor injuries in emergency settings.

This paper describes a study which evaluated three models of emergency care for patients with minor injuries; a traditional Accident and Emergency (A&E) department where patients with minor injuries were seen by senior house officers and nurses working together; a Minor Accident Treatment Service (MATS) unit, located in a main A&E, where patients with minor injuries were seen by Emergency Nurse Practitioners (ENPs) and a nurse-led Minor Injuries Unit (MIU), where patients with minor injuries were also seen by ENPs. Information about waiting times and length of stay was recorded by the researchers and patients were asked to complete a satisfaction questionnaire at the end of their stay. A sample of 181 patients were included in the study (57 in the traditional A&E, 57 in the MATS unit and 67 in the nurse-led MIU). Patients in the traditional A&E waited significantly longer to be seen than patients seen by an ENP, by an average of 40 minutes, and spent an average of 33 minutes longer in the department. ENPs spent an average of 12 minutes longer than doctors undertaking the first consultation where patients' needs were assessed and documented. Patients were very satisfied with care given by all health professionals. Those seen by ENPs were significantly more likely to have been given health advice and information, written instructions on discharge and told who to contact if they needed further advice. They were found to be subsequently significantly less worried about their health than patients seen in the traditional A&E. It is suggested that although ENPs spent longer with patients, this resulted in an improvement in the quality and depth of information and advice provided. Copyright 2000 Harcourt Publishers Ltd.