Biomedical subjects

D Justham

Publications and source records attributed to D Justham.

7 recordsLinked to original sources

PubMed2000

Nurse practitioners and the Ottawa Ankle Rules: comparisons with medical staff in requesting X-rays for ankle injured patients.

This paper reports on part of a study of 354 consecutive attendances to an Accident and Emergency (A&E) department by patients with ankle injuries. The aim of this study was to examine the percentage of X-ray photographs requested by nurse practitioners compared to those requested by medical practitioners. The study took place in an A&E department where nurse practitioners have the authority to request X-rays photographs for ankle injuries, either at triage assessment or at the subsequent treatment stage. Nurse practitioners applied the Ottawa Ankle Rules (OAR) in 187 patients. The results show that nurse practitioners requested X-rays for 61.5% of patients assessed using the OAR. This is compared with 80.4% for patients assessed by medical practitioners. The difference is highly significant. Detection rates show that fractures were identified in 29.6% of patients sent for X-ray by nurse practitioners compared with 22.8% in patients seen by medical practitioners, although this difference is not significant. Although nurse practitioners applied the OAR appropriately in all 187 cases, four patients who were assessed by nurse practitioners and judged not to need an X-ray photograph were subsequently found to have a fracture.

Ankle Injuries↗

PubMed2000

A case-control study of the transit times through an accident and emergency department of ankle injured patients assessed using the Ottawa Ankle Rules.

This paper reports part of a larger study of 354 consecutive attendances to an Accident and Emergency department by patients with ankle injuries. One hundred and ninety-nine patients met the criteria for inclusion in this study. The case study group (n =79) were those patients assessed by a nurse practitioner who had been trained in, and had authority to use of the Ottawa Ankle Rules (OAR) and were referred for radiographs from triage assessment. The control group (initially 120) consisted of those patients who were assessed by nurses who were not trained to be nurse practitioners and were not empowered to use the OAR but were sent for radiographs when assessed at the treatment stage. Sixteen patients were excluded from the study due to missing time data, reducing the control group to 104 patients. Previous studies have suggested that reductions in transit times through the department can be achieved by empowering nurses to request radiographs at the time of initial assessment, although these studies did not look specifically at the application of the OAR. Significant reductions in transit time are demonstrated for those patients who are required to have an X-ray to confirm a diagnosis if this is requested at the time of the triage assessment by nurse practitioners.

Adolescent↗

PubMed1985