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Completed

NCT Number: NCT05669157

X-rays Trauma Request's by the Triage And Intake Nurse Intake and Referral Nurse:

The number of consultations in emergency departments is increasing day by day, and the time to treat patients is getting longer. Different French studies have shown a significant reduction in the time spent in the emergency department after the implementation of the national protocol for the delegation of early radiography prescriptions. The investigators hypothesised that an early request for a standard X-ray by the intake and referral nurse in the case of isolated trauma to the extremities of a limb (from the knee to the toes and from the shoulder to the fingers) enables a reduction in medical management time and, consequently, in the time spent in the emergency department for the patient.

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Key information

Age range

15 year–80 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

CHR d'Orléans

Orléans, France

About this study

This study is divided into two steps to three month.

  • The first step of the study corresponds to the current standard of care (SoC) in the emergency department of Orléans. In this first step, the intake and Referral Nurse (IRN) will carry out the usual triage and refer the participant to the appropriate emergency department before being appointed by the physician. The radiography will be requested after the medical consultation.
  • In the second step, the intake and referral nurse will carry out the usual triage and then request one, or more, radiography(ies) depending on the standard protocol. This ensures that the physician has access to the imaging before the consultation with the patient. If necessary, the X-ray technician is authorized to refuse the exams or complete the request, the choice of the incidence is up to him/her according to the intake and referral nurse.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Patient older than 15 years and 3 months admitted in adult emergency department of regional hospital center of ORLEANS with a simple and isolated trauma having occurred less than 48 hours prior to admission of a limb extremity (from the knee to the toes or from the shoulder to the fingers), and with no previous imagery assessment within 48 hours prior to admission in the emergency department.

Exclusion criteria

  • Multiple trauma
  • Patient with at least one Vittel criteria (except age)
  • Patient refusing the protocol
  • Hemodynamic instability and/or disorder of consciousness
  • Sensory and/or vascular disorders downstream of the traumatized area
  • Protected population (under guardianship or curators)
  • Patient under court protection
  • Pregnant or breastfeeding woman or one who declares herself to be pregnant or breastfeeding
  • Patient with an expired blood alcohol level > 0.4 mg/L and/or positive blood alcohol level
  • Patient with diagnosed dementia
  • Patient hospitalized after being taken in charge

Treatment and study plan

Radiography request by nurse

Procedure

Intervention group with radiography requested by the IRN instead of the physician. The radiography will be interpreted by the physician afterwards, according to current practice

Radiography request by physician

Procedure

The physician prescribed the X-ray, the X-ray technician carries out the imagery and the physician interprets it afterwards

Primary outcomes

  1. Duration between triage and exit of emergency unit

    Time frame: immediatly after the procedure

    Total duration in minutes in the emergency department with or without anticipated request of X-ray

Secondary outcomes

  1. Total duration of the stay

    Time frame: immediatly after the procedure

    Total duration in minutes in the emergency department

  2. Number of additional X-ray prescribed by the physician after physician assessment.

    Time frame: immediatly after the procedure

    Number of new X-ray images taken after physician assessment.

  3. Appropriateness of the X-rays requested by the IRN as per guidelines

    Time frame: immediatly after the procedure

    Number of new X-ray images taken after physician assessment.

  4. IRN's feeling about the anticipated request for X-ray (assessed as per anonym Quality of Life at Work questionnaire)

    Time frame: immediatly after the procedure

    Quality of life questionnaire. Min: not satisfied; max : satisfied

  5. X-ray technician's feeling about the anticipated request for X-ray (assessed as per anonym Quality of Life at Work questionnaire)

    Time frame: immediatly after the procedure

    Quality of life questionnaire. Min: not satisfied; max : satisfied

  6. Physician's feeling about the anticipated request for X-ray (assessed as per anonym Quality of Life at Work questionnaire) Physician's feeling about the anticipated request for X-ray (assessed as per anonym Quality of Life at Work questionnaire)

    Time frame: immediatly after the procedure

    Quality of life questionnaire. Min: not satisfied; max : satisfied

Sponsors and collaborators

Lead sponsor

Centre Hospitalier Régional d'Orléans

Other

Registry information

Official study title

X-rays Trauma Request's by the Triage And Intake Nurse Intake and Referral Nurse: X-TRAIN Study

Acronym: DARIO

Important dates

Study start
2023
Primary completion
2023
Study completion
2023
First posted
Dec 30, 2022
Registry last updated
Aug 1, 2023

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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