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.
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.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
400
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
The physician prescribed the X-ray, the X-ray technician carries out the imagery and the physician interprets it afterwards
CHR d'Orléans
Orléans, France
Duration between triage and exit of emergency unit
Total duration in minutes in the emergency department with or without anticipated request of X-ray
Time frame: immediatly after the procedure
Total duration of the stay
Total duration in minutes in the emergency department
Time frame: immediatly after the procedure
Number of additional X-ray prescribed by the physician after physician assessment.
Number of new X-ray images taken after physician assessment.
Time frame: immediatly after the procedure
Appropriateness of the X-rays requested by the IRN as per guidelines
Number of new X-ray images taken after physician assessment.
Time frame: immediatly after the procedure
IRN's feeling about the anticipated request for X-ray (assessed as per anonym Quality of Life at Work questionnaire)
Quality of life questionnaire. Min: not satisfied; max : satisfied
Time frame: immediatly after the procedure
X-ray technician's feeling about the anticipated request for X-ray (assessed as per anonym Quality of Life at Work questionnaire)
Quality of life questionnaire. Min: not satisfied; max : satisfied
Time frame: immediatly after the procedure
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)
Quality of life questionnaire. Min: not satisfied; max : satisfied
Time frame: immediatly after the procedure
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