Effect of triage nurse-led application of the ottawa ankle rules on pain and patient satisfaction with emergency department care

Abstract

ObjectiveThe Ottawa Ankle Rules (OAR) is an evidence-based clinical decision tool used to predict fractures and need for radiographs in foot and ankle injury. Prior studies show that its use by both physicians and non-physicians reduces unnecessary radiographs and emergency department (ED) length of stay. This study evaluated the effect of triage nurse-led application of OAR on pain and satisfaction with ED care in patients with acute ankle injury. MethodsA quasi-experimental design was used. Data was collected from 96 participants using the numerical pain rating scale and the Brief Emergency Department Patient's Satisfaction Scale. The intervention group had 46 participants and the control group had 50 participants. ResultsThere was no statistically significant difference in level of pain on arrival (U = 1028, p = 0.34) and on discharge (U = 991, p = 0.21) from the ED between the control and intervention group. There was a significant difference between the control and intervention group in overall satisfaction with care received in the ED (t = 5.60; p = 0.000). There was also a significant difference between the two groups in their satisfaction with: ED staff (t = 4.12; p = 0.00); ED environment (t = 4.00; p = 0.00); physician care (t = 4.60; p = 0.00); general patient satisfaction (t = 6.60; p = 0.00); and patient family satisfaction (t = 3.44; p = 0.001). ConclusionTriage nurse application of the OAR improved patient satisfaction with ED care, but did not lead to a significant reduction in acute ankle injury related pain.