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Nurse practitioners treating ankle and foot injuries using the Ottawa Ankle Rules: a comparative study in the emergency department

Lau, Lik Hui, Kerr, Debra, Law, Ian and Ritchie, Peter 2013, Nurse practitioners treating ankle and foot injuries using the Ottawa Ankle Rules: a comparative study in the emergency department, Australasian emergency nursing journal, vol. 16, no. 3, pp. 110-115, doi: 10.1016/j.aenj.2013.05.007.

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Title Nurse practitioners treating ankle and foot injuries using the Ottawa Ankle Rules: a comparative study in the emergency department
Author(s) Lau, Lik Hui
Kerr, DebraORCID iD for Kerr, Debra orcid.org/0000-0002-2956-2432
Law, Ian
Ritchie, Peter
Journal name Australasian emergency nursing journal
Volume number 16
Issue number 3
Start page 110
End page 115
Total pages 6
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2013-08
ISSN 1574-6267
Keyword(s) ankle
emergencies
nurse practitioner
x-rays
Summary BACKGROUND: Nurse practitioners (NPs) in the Emergency Department (ED) have been trained to assess a range of clinical problems and minor complaints such as acute ankle injury. This study compared assessment of suspected ankle and foot injuries using the Ottawa Ankle Rules (OAR) by NPs and ED medical doctors (ED-Drs).

METHODS: A prospective, comparative, observational study was undertaken in an Australian acute adult and paediatric urban district ED. NPs and ED-Drs recorded information for patients with acute ankle and/or mid-foot injuries on demographic characteristics, OAR features, use of X-ray and patient management. Outcome measures included X-ray rates and identification of fracture.

RESULTS: 174 patients were included in this study: 51 received NP and 123 received ED-Dr care. Assessed as requiring X-ray assessment (NP: 78.4%, ED-Dr: 88.6%; p=0.081), and detection of significant fracture (NP: 17.6%, ED-Dr: 22.8%; p=0.453) were similar. ED-based medical registrars were more likely to miss a fracture compared with NP (NP: 0%, ED-based Registrar: 28.6%, p=0.013). There were no significant differences in rates of OAR features for patients seen by NPs or ED-Drs.

CONCLUSION: This study suggests that NPs are less likely to miss significant fractures of the ankle and/or foot compared with ED-based medical registrars. Future research should focus on actual use of the OAR and accuracy of X-ray assessment by NPs.
Language eng
DOI 10.1016/j.aenj.2013.05.007
Field of Research 111099 Nursing not elsewhere classified
1110 Nursing
1117 Public Health And Health Services
Socio Economic Objective 920210 Nursing
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2013, College of Emergency Nursing Australasia
Persistent URL http://hdl.handle.net/10536/DRO/DU:30089854

Document type: Journal Article
Collection: School of Nursing and Midwifery
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