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NCT Number: NCT07782892

Impact of an Emergency Advanced Practice Nurse on Complications After Home Discharge of Oxygen-Dependent Patients Managed in the Emergency Department: A Quantitative and Qualitative Study

Since the COVID-19 pandemic, discharging patients home on low-flow oxygen therapy has proven to be a safe and effective alternative to hospitalization, helping to relieve overcrowded hospitals while ensuring continuity of care. At the investigating emergency department, a dedicated care pathway ("Oxy-Urg") already allows selected oxygen-dependent patients to return home with a home-care provider, regardless of the cause of their breathlessness, once their condition is stable.

This study evaluates whether managing these patients with a team combining an emergency advanced practice nurse (APN) and an emergency physician, rather than a physician alone, improves the organization of care and reduces complications after home discharge.

Adult oxygen-dependent patients eligible for the Oxy-Urg pathway are randomly assigned (1:1) to management by an APN-physician team (intervention group) or by a physician alone (control group). Both groups then receive the usual Oxy-Urg pathway (home oxygen therapy, provider tele-monitoring, community nurse and general practitioner follow-up).

The main goal is to compare the number of organizational adverse events occurring between inclusion and Day 28 between the two groups. The study also assesses clinical deterioration after discharge, the time professionals spend setting up the pathway, and, through interviews and a focus group, the experience of patients and professionals. The hypothesis is that the APN-physician team allows a more efficient organization and improves the patient experience, supporting the sustainability and wider use of this pathway.

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Key information

Conditions

Acute Respiratory Conditions Requiring Oxygen Therapy Advanced Practice Nursing Disease Attributes Emergencies Emergency Service, Hospital Home Care Services Home Oxygen Therapy Pathologic Processes Pathological Conditions, Signs and Symptoms Patient Discharge

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adult patient (>= 18 years)
  • Affiliated to a social health insurance scheme
  • Able to understand the objectives and risks of the research and to give dated, signed informed consent
  • Oxygen-dependent patient eligible for the Oxy-Urg pathway, meeting all of the following:
  • Stable for more than 12 hours on oxygen therapy in the emergency department
  • Oxygen requirement <= 2 L/min (no upward change for 12 hours)
  • Not socially isolated (relatives able to readily help the patient, living geographically close)
  • Residing within the provider's geographical area (Bas-Rhin department)
  • No known pregnancy at inclusion

Exclusion criteria

  • Clinical condition requiring hospitalization (decided by the senior physician, per standard of care)
  • Patient's refusal to enter the pathway
  • Patient managed outside the emergency APN's working hours
  • End-of-life patient
  • Unable to give informed consent (including insufficient understanding of French)
  • Subject in an exclusion period
  • Subject under legal protection
  • Subject under guardianship or curatorship

Treatment and study plan

APN-physician team management of the Oxy-Urg pathway

Other

Organizational intervention: the emergency advanced practice nurse and the emergency physician jointly manage the inclusion of the patient in the Oxy-Urg pathway and the organization of the home discharge on oxygen.

Usual care: physician-alone management of the Oxy-Urg pathway

Other

Usual care

Primary outcomes

  1. Proportion of patients with at least one organizational adverse event related to home discharge on oxygen

    Time frame: From inclusion (Day 0) to Day 28

    At least one of the following organizational adverse events: (1) total pathway inclusion time greater than 20 minutes; (2) administrative error or omission regarding prescriptions, the liaison file or handover; (3) time to home oxygen availability exceeding the protocol target; (4) initial technical difficulty of the equipment requiring corrective action by the provider; (5) non-compliance with instructions given to home caregivers, evidenced by a documented non-conformity; (6) nurse visit not compliant with the prescription, observed and recorded.

Study contacts

Contact information is provided by the study sponsor or research team.

Aline CHENOU

CONTACT

[email protected]

0033369551460

Sponsors and collaborators

Lead sponsor

University Hospital, Strasbourg, France

Other

Registry information

Official study title

Impact of the Advanced Practice Nurse (Emergency Care Specialty) on Complications Related to the Home Discharge of Patients on Oxygen Therapy After Management in the Emergency Department: A Quantitative and Qualitative Study

Acronym: OXYURG-IPA

Important dates

Study start
2026
Primary completion
2028
Study completion
2028
First posted
Aug 24, 2026
Registry last updated
Aug 24, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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