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Splint Quality Assessment and Improvement Among Emergency Department Staff.

Jason Cucchiara1, Julie Thompson, Michael Zychowicz

  • 1School of Nursing, Duke University, Durham, North Carolina (Drs Cucchiara, Thompson, and Zychowicz); Northern Orthopaedics, Mount Airy, North Carolina (Drs Cucchiara and Williamson); and Mount Airy Emergency Physicians, Mount Airy, North Carolina (Dr McHone).

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|July 28, 2023
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Summary

This quality improvement project enhanced emergency department (ED) splinting, increasing correct applications from 50% to 95%. Staff confidence in splint application also significantly improved, benefiting all patients, especially vulnerable populations.

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Area of Science:

  • Emergency Medicine
  • Quality Improvement
  • Orthopedic Care

Background:

  • High turnover and inadequate training in Emergency Departments (EDs) contribute to suboptimal splint application.
  • Poor splinting can result in patient injuries such as pain, edema, and skin complications.
  • Consistent, high-quality splint application is crucial for fracture stabilization and preventing further harm.

Purpose of the Study:

  • To evaluate and enhance the quality of splint application within the ED setting.
  • To assess and improve the confidence levels of ED staff regarding splint application.
  • To investigate the impact of improved splinting practices on patient outcomes, particularly for high-risk and marginalized populations.

Main Methods:

  • A quality improvement project utilizing a Likert-based analysis of 20 ED-applied splints.
  • Implementation of targeted training courses to improve ED staff splinting techniques.
  • Post-training analysis of 20 splints and assessment of staff confidence levels before and after the educational intervention.

Main Results:

  • Statistically significant improvements were observed in both splint application quality and staff confidence.
  • The rate of correct splint applications rose from 50% to 95% following the training sessions.
  • Emergency department staff confidence in splint application increased from 35% to 77.1%.

Conclusions:

  • Educational interventions effectively improve the quality of splint application and staff confidence in the ED.
  • Enhanced splinting practices positively impact patient care, reducing potential injuries and complications.
  • The project demonstrated a positive effect on a vulnerable patient population with limited resources and higher comorbidity risks.