Abstract
To evaluate the implementation of advanced practice nursing in emergency care in Norway for patients with orthopaedic injuries, including hip fractures. The outcomes relate to quality of care and patient trust. A non-inferiority study comparing an advanced practice nursing care model with a standard (physician-led) care model. Data will be collected from patient records and through the Patient Trust Questionnaire, completed by patients. The data will be analysed by descriptive and inferential statistics. Funding for the research was granted in 2015 and the regional ethical committee approved the current study in February 2019. In Norway and the other Nordic countries, advanced practice nursing is still in its infancy, especially in the emergency care context. This study will evaluate advanced practice nursing in this new context. The study will add to knowledge on the quality of care provided for orthopaedic patients with minor orthopaedic injuries or hip fractures as delivered by advanced practice nurses and physicians, respectively. It will also evaluate how well-advanced practice nursing is accepted by patients in this new context.
Highlights
Emergency department (ED) presentations are increasing (Bjornsen, Uleberg, & Dale, 2013; Tang, Stein, Hsia, Maselli, & Gonzales, 2010) and overcrowding is a common problem (Velt et al, 2018)
The study will add to knowledge on the quality of care provided for orthopedic patients with minor orthopedic injuries or hip fractures as delivered by advanced practice nurses and physicians, respectively
Another is the implementation of advanced practice nursing (APN), i.e., ED throughput can be increased by expanding nursing roles and the scope of nursing practice (Elder, Johnston, & Crilly, 2015)
Summary
One approach used to increase ED throughput is the introduction of clinical pathways for specific patient groups (Eriksson, Kelly-Pettersson, Stark, Ekman, & Skoldenberg, 2012; Wireklint Sundstrom et al, 2014). Another is the implementation of advanced practice nursing (APN), i.e., ED throughput can be increased by expanding nursing roles and the scope of nursing practice (Elder, Johnston, & Crilly, 2015). This study will add to knowledge on the quality of care provided by advanced practice nurses in comparison to physicians for orthopedic patients with hip fractures or minor orthopedic injuries, i.e. injuries and/or closed fractures in the elbow and/or distal of elbow and/or distal of the knee (listed in Appendix 1). The results are expected to be generalizable and add knowledge on APN in emergency care in an international perspective
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