Fatema H Al Abri1, Joshua K Muliira2, Huda Al Awaisi3. 1. Diwan Health Complex, Diwan Royal Courts, Sultan Qaboos University, Muscat, Oman. 2. Department of Adult Health & Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman. 3. Directorate of Nursing, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman.
Abstract
AIM: Ankle injuries are commonly seen in the emergency department (ED) and contribute to overcrowding. In Oman, injuries are a leading cause of years of life lost, disability-adjusted life years, and pose a burden to the healthcare system. This study aimed to evaluate the effectiveness of ED triage nurse-led application of the Ottawa Ankle Rules (OARs) toward improving the healthcare outcomes of ankle injury patients. METHODS: A quasi-experimental design was used to collect data (demographic characteristics, waiting time, length of stay, and number of radiographic tests) from 96 patients. The intervention group (n = 46) received ED triage nurse-led assessment and initiation of radiographic tests based on the OARs. The control group (n = 50) received usual care. RESULTS: The participants' mean age was 26.4 ± 7.90 years. The main causes of ankle injuries were football (36%), falls (31%) and twisting while walking (24%). There was a significant difference in number of ankle X-rays (t = 6.19; p < .001); length of stay (U = 549; p < .001); and waiting time (U = 167; p < .001) between the control and intervention group. The intervention reduced the mean waiting time and length of stay by 25.09 and 41.01 min, respectively. CONCLUSION: Application of the OARs by the ED triage nurse can decrease the number of unnecessary radiographic tests, waiting time and length of stay in the ED. Nurses' utilization of evidence-based clinical decision-making tools can improve ED care outcomes of common acute conditions such as ankle injuries.
RCT Entities:
AIM: Ankle injuries are commonly seen in the emergency department (ED) and contribute to overcrowding. In Oman, injuries are a leading cause of years of life lost, disability-adjusted life years, and pose a burden to the healthcare system. This study aimed to evaluate the effectiveness of ED triage nurse-led application of the Ottawa Ankle Rules (OARs) toward improving the healthcare outcomes of ankle injurypatients. METHODS: A quasi-experimental design was used to collect data (demographic characteristics, waiting time, length of stay, and number of radiographic tests) from 96 patients. The intervention group (n = 46) received ED triage nurse-led assessment and initiation of radiographic tests based on the OARs. The control group (n = 50) received usual care. RESULTS: The participants' mean age was 26.4 ± 7.90 years. The main causes of ankle injuries were football (36%), falls (31%) and twisting while walking (24%). There was a significant difference in number of ankle X-rays (t = 6.19; p < .001); length of stay (U = 549; p < .001); and waiting time (U = 167; p < .001) between the control and intervention group. The intervention reduced the mean waiting time and length of stay by 25.09 and 41.01 min, respectively. CONCLUSION: Application of the OARs by the ED triage nurse can decrease the number of unnecessary radiographic tests, waiting time and length of stay in the ED. Nurses' utilization of evidence-based clinical decision-making tools can improve ED care outcomes of common acute conditions such as ankle injuries.
Authors: Maya M Jeyaraman; Rachel N Alder; Leslie Copstein; Nameer Al-Yousif; Roger Suss; Ryan Zarychanski; Malcolm B Doupe; Simon Berthelot; Jean Mireault; Patrick Tardif; Nicole Askin; Tamara Buchel; Rasheda Rabbani; Thomas Beaudry; Melissa Hartwell; Carolyn Shimmin; Jeanette Edwards; Gayle Halas; William Sevcik; Andrea C Tricco; Alecs Chochinov; Brian H Rowe; Ahmed M Abou-Setta Journal: BMJ Open Date: 2022-04-20 Impact factor: 3.006