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Requesting wrist radiographs in emergency department triage: developing a training program and diagnostic algorithm.
Joanna Streppa1, Valerie Schneidman, Alain D Biron
1School of Nursing, McGill University (Ms Streppa and Dr Biron); and Emergency Department, Jewish General Hospital (Ms Schneidman), Montreal, Quebec, Canada.
Advanced Emergency Nursing Journal
|February 4, 2014
Summary
Emergency department (ED) crowding in Canada leads to long waits for wrist injuries. A new protocol allows triage nurses to request wrist radiographs, improving efficiency and patient satisfaction.
Area of Science:
- Emergency Medicine
- Radiography
- Nursing Practice
Background:
- Canadian emergency departments face significant crowding, leading to increased patient wait times, particularly for less severe injuries like wrist fractures.
- Wrist fractures are a common injury, especially in individuals under 65 years old.
- Nurses in emergency departments often request wrist radiographs as part of their standard practice.
Purpose of the Study:
- To evaluate the benefits of implementing a triage nurse-requested radiographic protocol for wrist injuries.
- To assess the impact of this protocol on emergency department length of stay, patient satisfaction, and staff satisfaction.
- To determine if nurses can appropriately request wrist radiographs based on a standardized protocol.
Main Methods:
- Development of a training program for emergency nurses covering wrist anatomy, injuries, assessment, and radiographic imaging.
- Creation of a diagnostic algorithm to guide nurses in clinical decision-making for requesting wrist radiographs.
- Implementation and evaluation of the protocol in emergency department settings.
Main Results:
- Patients experienced a significant time-saving of 36% in emergency department length of stay when nurses initiated radiographs.
- The protocol demonstrated potential for increased patient and staff satisfaction without compromising the quality of radiographic requests or services.
- Nurses were shown to be capable of requesting appropriate radiographs based on the developed protocol and educational materials.
Conclusions:
- Implementing a triage nurse-requested radiographic protocol for suspected wrist fractures can significantly reduce emergency department wait times.
- This initiative enhances nursing competency in assessing and requesting radiographs, leading to better patient outcomes.
- The protocol promotes efficient resource utilization and improves overall patient and staff satisfaction within emergency departments.
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