Pub Date : 2020-09-02DOI: 10.1002/9781119057840.ch90
Gillian A. Corbett, T. McGuigan
To the Editor: In their survey of patient satisfaction with intravenous PCA or epidural morphine, Egan and Ready conclude that satisfaction is very high with both modalities, but the perceived advantages and disadvantages differ, t While I share the authors' enthusiasm for both techniques, I feel there are some methodological concerns which may limit the validity of the conclusions. The authors reported differences between the two patient groups with respect to advantages, disadvantages and patient satisfaction. I question if such comparisons are valid when the demographics of the two groups studied are so clearly different; the PCA group was, on average, nine years younger than the epidural group, and presumably represented a different case mix. Although not reported, it is reasonable to assume that the patients undergoing more serious surgery were also more likely to receive epidural narcotics postoperatively. Within each group the authors have identified relative advantages and disadvantages perceived by the patients. However, on the basis of the very considerable demographic differences, I would argue that no valid between-group comparisons of PCA versus epidural narcotics are possible. The authors also state that" ... patients converted from one form of therapy to the other for any reason were excluded." This would seem to bias the reported satisfaction scores, since the only obvious reason for a change in therapy is patient or physician dissatisfaction. It would be useful to know how often this occurred. Quite tightly, Egan and Ready point out that, "Although patients willingly offer (satisfaction) ratings, it is by no means clear what such ratings represent." This is further illustrated in a randomized prospective study of PCA versus im morphine in patients following hip arthroplasty. 2 In both groups, the patients reported satisfaction scores of approximately nine out of ten, yet pain control assessed using visual analogue scores for both intensity and distress was often inadequate. In fact, the highest satisfaction score was coincident with the worst reported pain. Barring the most egregious errors, one suspects that if your patient likes you, reported satisfaction will be high.
{"title":"Patient satisfaction.","authors":"Gillian A. Corbett, T. McGuigan","doi":"10.1002/9781119057840.ch90","DOIUrl":"https://doi.org/10.1002/9781119057840.ch90","url":null,"abstract":"To the Editor: In their survey of patient satisfaction with intravenous PCA or epidural morphine, Egan and Ready conclude that satisfaction is very high with both modalities, but the perceived advantages and disadvantages differ, t While I share the authors' enthusiasm for both techniques, I feel there are some methodological concerns which may limit the validity of the conclusions. The authors reported differences between the two patient groups with respect to advantages, disadvantages and patient satisfaction. I question if such comparisons are valid when the demographics of the two groups studied are so clearly different; the PCA group was, on average, nine years younger than the epidural group, and presumably represented a different case mix. Although not reported, it is reasonable to assume that the patients undergoing more serious surgery were also more likely to receive epidural narcotics postoperatively. Within each group the authors have identified relative advantages and disadvantages perceived by the patients. However, on the basis of the very considerable demographic differences, I would argue that no valid between-group comparisons of PCA versus epidural narcotics are possible. The authors also state that\" ... patients converted from one form of therapy to the other for any reason were excluded.\" This would seem to bias the reported satisfaction scores, since the only obvious reason for a change in therapy is patient or physician dissatisfaction. It would be useful to know how often this occurred. Quite tightly, Egan and Ready point out that, \"Although patients willingly offer (satisfaction) ratings, it is by no means clear what such ratings represent.\" This is further illustrated in a randomized prospective study of PCA versus im morphine in patients following hip arthroplasty. 2 In both groups, the patients reported satisfaction scores of approximately nine out of ten, yet pain control assessed using visual analogue scores for both intensity and distress was often inadequate. In fact, the highest satisfaction score was coincident with the worst reported pain. Barring the most egregious errors, one suspects that if your patient likes you, reported satisfaction will be high.","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81839108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-10Epub Date: 2020-02-04DOI: 10.7748/en.2020.e1993
Stephen McGhee, Juan Gonzalez, Catherine Nadeau, Johis Ortega
Cutaneous leishmaniasis is endemic in more than 70 countries worldwide. It is a non-fatal disease caused by the Leishmania parasite that is transmitted to humans via bites of infected female sandflies. Cutaneous leishmaniasis causes skin lesions on areas of exposed skin, such as the face and limbs, which often produce scarring and atrophy. If untreated, cutaneous leishmaniasis can develop into mucocutaneous leishmaniasis, which is potentially life-threatening. Furthermore, patients with cutaneous leishmaniasis commonly experience psychosocial issues such as anxiety, distress, stigma and rejection. Cutaneous leishmaniasis is spreading outside of its traditional endemic areas because of the effects of environmental changes such as urbanisation and climate change. In the UK, healthcare professionals may encounter the disease in migrants from endemic areas, members of the armed forces, tourists and expatriates. Therefore, emergency nurses need to be able to assess and support patients who present with symptoms suggestive of cutaneous leishmaniasis. This article provides an overview of the epidemiology, aetiology, pathophysiology, clinical presentation, diagnosis, treatment and prevention of the disease.
{"title":"Assessment and treatment of cutaneous leishmaniasis in the emergency department.","authors":"Stephen McGhee, Juan Gonzalez, Catherine Nadeau, Johis Ortega","doi":"10.7748/en.2020.e1993","DOIUrl":"10.7748/en.2020.e1993","url":null,"abstract":"<p><p>Cutaneous leishmaniasis is endemic in more than 70 countries worldwide. It is a non-fatal disease caused by the Leishmania parasite that is transmitted to humans via bites of infected female sandflies. Cutaneous leishmaniasis causes skin lesions on areas of exposed skin, such as the face and limbs, which often produce scarring and atrophy. If untreated, cutaneous leishmaniasis can develop into mucocutaneous leishmaniasis, which is potentially life-threatening. Furthermore, patients with cutaneous leishmaniasis commonly experience psychosocial issues such as anxiety, distress, stigma and rejection. Cutaneous leishmaniasis is spreading outside of its traditional endemic areas because of the effects of environmental changes such as urbanisation and climate change. In the UK, healthcare professionals may encounter the disease in migrants from endemic areas, members of the armed forces, tourists and expatriates. Therefore, emergency nurses need to be able to assess and support patients who present with symptoms suggestive of cutaneous leishmaniasis. This article provides an overview of the epidemiology, aetiology, pathophysiology, clinical presentation, diagnosis, treatment and prevention of the disease.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88441873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The site of the Surgical Materials Testing Laboratory, at www.smtl.co.uk , holds frequentlyupdated, comprehensive information on wound products.
外科材料测试实验室的网站，www.smtl.co.uk，经常更新，关于伤口产品的全面信息。
{"title":"Materials testing.","authors":"K. Ambrose","doi":"10.7748/en.13.1.6.s10","DOIUrl":"https://doi.org/10.7748/en.13.1.6.s10","url":null,"abstract":"The site of the Surgical Materials Testing Laboratory, at www.smtl.co.uk , holds frequentlyupdated, comprehensive information on wound products.","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84402889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-31DOI: 10.1525/9780520939554-008
D. Fox
Here’s the right way to get oxygen to your muscles. By Terry Laughlin The rules of breathing are simple in sports like cycling or running. You need a breath? You take a breath. You need more? You take more. Oxygen is there for the asking. A regular no-brainer. And then there is for swimming, where it sometimes seems, to frustrated novices and crosstrainers, that the simple act of getting oxygen to your muscles is a monumental task. And the stakes are high. Wiped out by just a few laps? It might not be your conditioning that’s at fault. It might be your lack of breathing technique that gets in the way of a good workout or discourages you from swimming altogether.
{"title":"Breathing easy.","authors":"D. Fox","doi":"10.1525/9780520939554-008","DOIUrl":"https://doi.org/10.1525/9780520939554-008","url":null,"abstract":"Here’s the right way to get oxygen to your muscles. By Terry Laughlin The rules of breathing are simple in sports like cycling or running. You need a breath? You take a breath. You need more? You take more. Oxygen is there for the asking. A regular no-brainer. And then there is for swimming, where it sometimes seems, to frustrated novices and crosstrainers, that the simple act of getting oxygen to your muscles is a monumental task. And the stakes are high. Wiped out by just a few laps? It might not be your conditioning that’s at fault. It might be your lack of breathing technique that gets in the way of a good workout or discourages you from swimming altogether.","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86865880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The phrase 'cut the Gordian knot' describes a bold and direct solution to a complicated problem. Nursing presence has been defined as nurses' ability to pay attention to patients and make them feel that their needs have been considered. In the emergency department (ED), nursing presence can be adversely affected by factors such as fatigue, workplace bullying, moral distress and inadequate staffing levels, which could lead to suboptimal patient outcomes and compromise the goals of nursing. Nursing presence is also important for nurses' job satisfaction and therefore for staff retention. This article explores the combined effects of fatigue, workplace bullying, moral distress and inadequate staffing levels on emergency nurses. To cut the Gordian knot it also provides recommendations for mitigating these issues in EDs through safe staffing decisions that consider patient acuity and skill mix.
cut The Gordian knot这个短语描述的是对一个复杂问题大胆而直接的解决方案。护理存在被定义为护士关注病人的能力，并使他们感到他们的需求得到了考虑。在急诊科(ED)，护理存在可能会受到疲劳，工作场所欺凌，道德困扰和人员配备不足等因素的不利影响，这可能导致患者预后不佳并损害护理目标。护理存在对护士的工作满意度也很重要，因此对员工留任也很重要。本文探讨了疲劳、职场欺凌、道德困扰和人员配备不足对急诊护士的综合影响。为了解决棘手的问题，它还提供了建议，通过考虑患者敏锐度和技能组合的安全人员配置决策来减轻急诊科的这些问题。
{"title":"How safe staffing can improve emergency nursing: time to cut the Gordian knot.","authors":"L. Wolf","doi":"10.7748/en.2019.e1928","DOIUrl":"https://doi.org/10.7748/en.2019.e1928","url":null,"abstract":"The phrase 'cut the Gordian knot' describes a bold and direct solution to a complicated problem. Nursing presence has been defined as nurses' ability to pay attention to patients and make them feel that their needs have been considered. In the emergency department (ED), nursing presence can be adversely affected by factors such as fatigue, workplace bullying, moral distress and inadequate staffing levels, which could lead to suboptimal patient outcomes and compromise the goals of nursing. Nursing presence is also important for nurses' job satisfaction and therefore for staff retention. This article explores the combined effects of fatigue, workplace bullying, moral distress and inadequate staffing levels on emergency nurses. To cut the Gordian knot it also provides recommendations for mitigating these issues in EDs through safe staffing decisions that consider patient acuity and skill mix.","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89659539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephen McGhee, Juan Manuel Gonzalez, Carmen Rosa Presti, Robert Hare
Decompression sickness (DCS) is commonly associated with diving or occupational exposure to compressed air, and is a life-threatening condition if left untreated. This article provides an overview of the pathophysiology and types of DCS. It also explains the principles of care for people presenting to the emergency department with DCS that emergency nurses must be familiar with, including the recognition of its signs and symptoms and the initial management required. It is important that emergency nurses are aware of the optimal treatment protocol for DCS, which involves its early recognition, prompt administration of high-flow oxygen and referral to the nearest hyperbaric chamber for recompression.
{"title":"Decompression sickness: a guide for emergency nurses.","authors":"Stephen McGhee, Juan Manuel Gonzalez, Carmen Rosa Presti, Robert Hare","doi":"10.7748/en.2019.e1989","DOIUrl":"10.7748/en.2019.e1989","url":null,"abstract":"<p><p>Decompression sickness (DCS) is commonly associated with diving or occupational exposure to compressed air, and is a life-threatening condition if left untreated. This article provides an overview of the pathophysiology and types of DCS. It also explains the principles of care for people presenting to the emergency department with DCS that emergency nurses must be familiar with, including the recognition of its signs and symptoms and the initial management required. It is important that emergency nurses are aware of the optimal treatment protocol for DCS, which involves its early recognition, prompt administration of high-flow oxygen and referral to the nearest hyperbaric chamber for recompression.</p>","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78626643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In 2016, definitions of sepsis and septic shock were updated to focus on organ dysfunction rather than systemic inflammatory response as the identifying trait. This article aims to compare and evaluate the effectiveness of systemic inflammatory response syndrome (SIRS) and quick Sequential Organ Failure Assessment (qSOFA) in detecting sepsis in emergency department (ED) patients. A systematic search of the literature was undertaken using four databases. A total of 307 articles was identified. After the selection process, 13 articles met the inclusion criteria for the review. Five themes emerged from the meta-analysis: SIRS; qSOFA; timeliness and simplicity; sensitivity versus specificity; and adding lacate. SIRS offered users greater sensitivity when assessing for sepsis. However, qSOFA is a simple bedside tool with greater specificity, which does not require any blood test results. The author created a new qSOFA screening tool, which incorporated the use of point-of-care serum lactate measurement. He found that qSOFA outperforms SIRS as an ED sepsis screening tool with its strengths of efficacy, efficiency and ease. It was also found to differentiate better between uncomplicated infection and sepsis, which can commonly cause trigger fatigue in EDs.
{"title":"Screening for sepsis: SIRS or qSOFA? A literature review.","authors":"Benjamin Feist","doi":"10.7748/en.2019.e1939","DOIUrl":"https://doi.org/10.7748/en.2019.e1939","url":null,"abstract":"In 2016, definitions of sepsis and septic shock were updated to focus on organ dysfunction rather than systemic inflammatory response as the identifying trait. This article aims to compare and evaluate the effectiveness of systemic inflammatory response syndrome (SIRS) and quick Sequential Organ Failure Assessment (qSOFA) in detecting sepsis in emergency department (ED) patients. A systematic search of the literature was undertaken using four databases. A total of 307 articles was identified. After the selection process, 13 articles met the inclusion criteria for the review. Five themes emerged from the meta-analysis: SIRS; qSOFA; timeliness and simplicity; sensitivity versus specificity; and adding lacate. SIRS offered users greater sensitivity when assessing for sepsis. However, qSOFA is a simple bedside tool with greater specificity, which does not require any blood test results. The author created a new qSOFA screening tool, which incorporated the use of point-of-care serum lactate measurement. He found that qSOFA outperforms SIRS as an ED sepsis screening tool with its strengths of efficacy, efficiency and ease. It was also found to differentiate better between uncomplicated infection and sepsis, which can commonly cause trigger fatigue in EDs.","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82076472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tibial plateau fractures are complex injuries and relatively common presentations in emergency departments (EDs), yet the diagnosis is not always obvious. Patients with this injury are managed increasingly in EDs by registered advanced nurse practitioners (RANPs), who are recognised in Ireland as senior clinical decision-makers. RANPs are broadening their scope of practice to maximise their responses to current and emerging challenges in healthcare services. They use a range of skills, including taking comprehensive health histories, problem solving, clinical decision-making and using their expert judgement to diagnose and create management plans for patients who attend EDs. In Ireland, RANP is a protected title and practitioners work within an agreed scope of practice, meeting criteria set by the Nursing and Midwifery Board of Ireland to register. RANPs ensure continuity of care, improve the quality of care, provide a quick response to patient care, reduce waiting times and improve flow of patients through EDs. The main scope of RANPs' practice in emergency care includes management of patients with non-life-threatening limb conditions or injures, such as a tibial plateau fracture. This article gives an overview of tibial plateau fractures, including anatomy, and presents a case study to analyse critically the management of a patient with this injury and the care provided by a RANP. In the context of the case study, the article reviews the RANP's diagnostic decisions and the available management options.
{"title":"Assessment and management of patients with tibial plateau fractures in emergency departments.","authors":"Barry McBrien","doi":"10.7748/en.2019.e1981","DOIUrl":"https://doi.org/10.7748/en.2019.e1981","url":null,"abstract":"Tibial plateau fractures are complex injuries and relatively common presentations in emergency departments (EDs), yet the diagnosis is not always obvious. Patients with this injury are managed increasingly in EDs by registered advanced nurse practitioners (RANPs), who are recognised in Ireland as senior clinical decision-makers. RANPs are broadening their scope of practice to maximise their responses to current and emerging challenges in healthcare services. They use a range of skills, including taking comprehensive health histories, problem solving, clinical decision-making and using their expert judgement to diagnose and create management plans for patients who attend EDs. In Ireland, RANP is a protected title and practitioners work within an agreed scope of practice, meeting criteria set by the Nursing and Midwifery Board of Ireland to register. RANPs ensure continuity of care, improve the quality of care, provide a quick response to patient care, reduce waiting times and improve flow of patients through EDs. The main scope of RANPs' practice in emergency care includes management of patients with non-life-threatening limb conditions or injures, such as a tibial plateau fracture. This article gives an overview of tibial plateau fractures, including anatomy, and presents a case study to analyse critically the management of a patient with this injury and the care provided by a RANP. In the context of the case study, the article reviews the RANP's diagnostic decisions and the available management options.","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81774468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article explores secondary traumatic stress (STS) and the emotional challenges that emergency nurses face when dealing with traumatised patients. The few studies on STS have shown a higher occurrence of STS symptoms in emergency nurses but provide limited evidence on how personal experiences may contribute to STS. Risk factors identified include repeated exposure to trauma; morbidity and mortality; personal trauma; chronic stressors; workload and emergency department pressures. STS can lead to reduced job satisfaction, sick leave and burnout. Protective factors include awareness and self-care, emotional intelligence, social support and education about STS. Strategies to minimise STS include balancing personal and professional life and the support of employers to help reduce compassion fatigue and aid staff retention.
{"title":"Awareness of secondary traumatic stress in emergency nursing.","authors":"Donna Barleycorn","doi":"10.7748/en.2019.e1957","DOIUrl":"https://doi.org/10.7748/en.2019.e1957","url":null,"abstract":"This article explores secondary traumatic stress (STS) and the emotional challenges that emergency nurses face when dealing with traumatised patients. The few studies on STS have shown a higher occurrence of STS symptoms in emergency nurses but provide limited evidence on how personal experiences may contribute to STS. Risk factors identified include repeated exposure to trauma; morbidity and mortality; personal trauma; chronic stressors; workload and emergency department pressures. STS can lead to reduced job satisfaction, sick leave and burnout. Protective factors include awareness and self-care, emotional intelligence, social support and education about STS. Strategies to minimise STS include balancing personal and professional life and the support of employers to help reduce compassion fatigue and aid staff retention.","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73198705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AIM Stable ankle injuries are highly prevalent in the UK. Prevention of complications and reoccurrence is essential. The literature shows that plaster of Paris and AirLoc brace are clinically effective treatments for such injuries. However, there is no research measuring patients' satisfaction with these treatments. This study compared options in the treatment of severe ankle sprains and distal fibular avulsion fractures from patients' perspectives. The aim was to determine patients' preferred treatment between below knee plaster cast and AirLoc brace in the management of stable ankle injuries. METHOD A total of 39 patients who presented at an urban hospital with stable ankle injuries were recruited into a randomised controlled trial. Patient satisfaction levels were measured by questionnaire one week into treatment. The null hypothesis was 'there is no significant difference in satisfaction levels between the two devices'. FINDINGS There were statistically significant higher patient satisfaction levels in the AirLoc group compared to the plaster cast group. After analysis by the unrelated t-test, the null hypothesis was rejected. Comfort, daily activities, sleep, work and social life were the main contributing factors. Additionally, 67% of the AirLoc group compared to 46% of the plaster cast group were able to return to work. The number needed to treat for one additional AirLoc patient to return to work was 4.8 (five patients). CONCLUSION Patients' preferred treatment is the AirLoc brace. The inquiry method could be used to provide patient-centred care in other fields.
{"title":"A comparison of two interventions in the treatment of severe ankle sprains and lateral malleolar avulsion fractures.","authors":"S. Powell","doi":"10.7748/en.2019.e1945","DOIUrl":"https://doi.org/10.7748/en.2019.e1945","url":null,"abstract":"AIM\u0000Stable ankle injuries are highly prevalent in the UK. Prevention of complications and reoccurrence is essential. The literature shows that plaster of Paris and AirLoc brace are clinically effective treatments for such injuries. However, there is no research measuring patients' satisfaction with these treatments. This study compared options in the treatment of severe ankle sprains and distal fibular avulsion fractures from patients' perspectives. The aim was to determine patients' preferred treatment between below knee plaster cast and AirLoc brace in the management of stable ankle injuries.\u0000\u0000\u0000METHOD\u0000A total of 39 patients who presented at an urban hospital with stable ankle injuries were recruited into a randomised controlled trial. Patient satisfaction levels were measured by questionnaire one week into treatment. The null hypothesis was 'there is no significant difference in satisfaction levels between the two devices'.\u0000\u0000\u0000FINDINGS\u0000There were statistically significant higher patient satisfaction levels in the AirLoc group compared to the plaster cast group. After analysis by the unrelated t-test, the null hypothesis was rejected. Comfort, daily activities, sleep, work and social life were the main contributing factors. Additionally, 67% of the AirLoc group compared to 46% of the plaster cast group were able to return to work. The number needed to treat for one additional AirLoc patient to return to work was 4.8 (five patients).\u0000\u0000\u0000CONCLUSION\u0000Patients' preferred treatment is the AirLoc brace. The inquiry method could be used to provide patient-centred care in other fields.","PeriodicalId":94315,"journal":{"name":"Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76130367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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