Specialized emergency nurses treating ankle and foot injuries: a randomized controlled trial.
OBJECTIVE
To cope with emergency departments (EDs) being progressively overcrowded, the concept of specialized emergency nurses (SENs) was conceived. In this study, the ability of SENs to treat ankle/foot injuries was assessed.


METHODS
Regular emergency nurses were trained in a 2-day session that addressed all aspects of ankle/foot injuries. A randomized controlled trial was set up in which the diagnostic accuracy of SENs was compared with that of house officers (HOs). Secondary outcome parameter was patient satisfaction measured by a standardized questionnaire.


RESULTS
In total, 512 consecutive patients were included. The sensitivity of SENs was 0.94 (95% confidence interval [CI], 0.78-0.99) compared with 0.78 (95% CI, 0.57-0.91) of HOs. Specificity was 0.94 (95% CI, 0.90-0.97) for SENs compared with 0.95 (95% CI, 0.91-0.98) for HOs. The delivered care by SENs was found to be significantly better and the median waiting time at the ED was significantly reduced (21 minutes for SENs vs 32 minutes for HOs).


CONCLUSIONS
Specialized emergency nurses are capable of assessing and treating ankle/foot injuries accurately with excellent patient satisfaction and with a reduction of waiting times. Other injury-specific courses are now developed for this approach.
Derksen
Robert Jan
RJ
Department of Surgery/Traumatology, VU University Medical Center Amsterdam, 1007 MB Amsterdam, The Netherlands. rj.derksen@vumc.nl
Bakker
Fred C
FC
de Lange-de Klerk
Elly S M
ES
Spaans
Irma M
IM
Heilbron
Emil A
EA
Veenings
Bart
B
Haarman
Henk J Th M
HJ
D000328:Adult; D016512:Ankle Injuries / Q000175:diagnosis* / Q000451:nursing*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000175:diagnosis* / Q000451:nursing*; D006801:Humans; D008297:Male; D009738:Nursing Service, Hospital; D017060:Patient Satisfaction; D011237:Predictive Value of Tests; D013997:Time Factors; D016896:Treatment Outcome