Évaluation de la demande anticipée de radiographies par l’infirmier organisateur de l’accueil (IOA) aux urgences du Centre Hospitalier d’Agen

Abstract : Introduction: the main objective of this study was to assess the effect of triage nurse-initiated X-ray on length of stay. Material and method: this monocentric, observational and prospective study was conducted in two phases : a before study implementation phase from April to December 2016 (Phase I) ; and an after study implementation phase from October to December 2017 (Phase II) within The Agen-Nérac Hospital (St Esprit site) E.R. Only-three-years old or more patients, admitted to the ambulatory care for isolated benign mechanical bone trauma without vascular disorders were included. A generalized additive model was used to assess the protocol effects induced on the transit time. Results: 6618 patients met the inclusion criteria : 2864 in Phase I and 3254 in phase II. Implementing the protocol resulted in a 20 % reduction in the length of stay in E.R. for patients with early radiography (risk ratio at 0.80 (95 % CI of [0.73-0.81])). It also resulted in an overall 5 % reduction in transit times for all patients in the ambulatory care, with or without radiography (risk ratio at 0.95 (95 % CI of [0.92-0.98])). Conclusion: this study suggests that nurse-initiated X-ray protocol in minor trauma leads to a significant decrease in transit time.
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Master Thesis
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Florian Despeysses. Évaluation de la demande anticipée de radiographies par l’infirmier organisateur de l’accueil (IOA) aux urgences du Centre Hospitalier d’Agen. Médecine humaine et pathologie. 2019. ⟨dumas-02151087⟩

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