Implementation of advanced practice nursing for orthopaedic patients in the emergency care context – A study protocol for outcome studies

Abstract

Aim To evaluate the implementation of advanced practice nursing in emergency care in Norway for patients with orthopaedic injuries, including hip fractures. The outcomes relate to quality of care and patient trust. Design A non‐inferiority study comparing an advanced practice nursing care model with a standard (physician‐led) care model. Methods Data will be collected from patient records and through the Patient Trust Questionnaire, completed by patients. The data will be analysed by descriptive and inferential statistics. Funding for the research was granted in 2015 and the regional ethical committee approved the current study in February 2019. Discussion In Norway and the other Nordic countries, advanced practice nursing is still in its infancy, especially in the emergency care context. This study will evaluate advanced practice nursing in this new context. Impact The study will add to knowledge on the quality of care provided for orthopaedic patients with minor orthopaedic injuries or hip fractures as delivered by advanced practice nurses and physicians, respectively. It will also evaluate how well‐advanced practice nursing is accepted by patients in this new context.

Using the PEPPA framework to develop the nurse practitioner role in emergency care: Critical reflections

“…A protocol for outcome studies has also been set up. 13 While we have demonstrated the applicability of the PEPPA framework, we conclude that the process has not been straightforward. It is noted that to communicate and establish the new role in a setting as demanding as an emergency department takes time.…”

“…To help resolve this problem, it was decided that NPs would care for a specific group of non-urgent conditions, defined in the project as patients with minor orthopaedic injuries (injuries in the elbow or distal of the elbow, or distal of the knee; more specified in Boman et al. 13 ). The goal was for wait times for non-urgent patients to decrease without compromising patient safety.…”

Challenges faced by nursing in the emergency room for the care of trauma victims: an integrative literature review

“…In emergency sectors, the demand of trauma victims at different levels of severity and the lack of beds in hospitals lead nurses to provide care throughout different stages of the health-disease process, going beyond initial emergency care. However, the overcrowding of hospitals and the routine of traumas, such as gunshot wounds or motorcycle accidents, can result in standardized and less individualized treatment for patients, which can compromise the provision of humanized care (Boman et al, 2020;Rabelo et al, 2020;Corrêa et al, 2020).…”

“…The Fugulin Scale is a care instrument used to size personnel according to the patient's degree of dependency, but its isolated application may be impracticable due to the variability and unpredictability of demand. It is advisable to ensure additional staff to ensure proper care and care for patients (Santos, 2018;Boman et al, 2020;Rabelo et al, 2020;Oliveira et al, 2022).…”

“…It is essential that the emergency care team not only have access to a complete and adapted structure, but also be composed of distinguished professionals, capable of acting effectively and precisely, with technical and managerial skills. (Santos, 2018;Ferreira et al, 2020;Boman et al,2020;Rabelo et al;2020) However, in many emergency services, the same team that cares for patients in the red room (critical care) is responsible for caring for other patients hospitalized in the sector, which can lead to care failures at some point. The high demand of patients in the emergency room demands more time from professionals, leading to a lack of attention to other patients.…”