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Biomedical subjects

B J Finlayson

Publications and source records attributed to B J Finlayson.

10 recordsLinked to original sources
PubMed2000

Triage nurse requested x rays--are they worthwhile?

OBJECTIVE: To study an established triage nurse x ray requesting system to determine whether sending defined groups of patients for radiography before assessment by doctors or emergency nurse practitioners (ENPs) resulted in shorter waiting times for patients without compromising quality of care. METHODS: Prospective randomised controlled study of "walking wounded" patients attending a district general hospital. Data were collected over two separate two week periods, six months apart, in the middle of two senior house officer appointment periods. A total of 675 patients were entered into the study. Analysis of results was achieved using standard statistical methods. RESULTS: Altogether 335 patients were in the nurse x ray group and 340 in the control group. The triage categories of the groups were similar. A 36% mean time reduction of 37.2 min (95% confidence interval 30.2 to 44.2, p=0.000) from time of triage to time of treatment decision was achieved in the nurse requested group. Triage nurses requested 8% (p=0.002) fewer x rays than doctors or ENPs and had a 6% higher positive "hit" rate (p=0.03). In 7.8% (26 cases), patients in the triage nurse group were judged to require radiographs or further views by the doctor or ENP; of these, 11 cases showed a positive finding on radiography. The time from triage to assessment by doctor or ENP was not lengthened by prior requesting of radiography (nurse x ray group 64.4 min, control group 63.7 min, p=0.79). CONCLUSIONS: A triage nurse x ray requesting system speeds up the progress of walking wounded patients through the department without compromising service quality. Further benefits are staff and patient satisfaction and a greater sense of team working for all staff.

Emergency Service, Hospital↗
PubMed2000

Triage nurse requested x rays--the results of a national survey.

OBJECTIVE: To ascertain the prevalence and experiences of triage nurse requested x ray systems among accident and emergency (A&E) departments in the UK. METHOD: A descriptive study of a postal survey of 225 major A&E departments listed in the British Association for Accident and Emergency Medicine directory. RESULTS: Altogether 165 (73%) questionnaires were returned. Fifty nine (35%) departments indicated that they currently had a triage nurse requested radiology system. Of those departments that did not have such a system, the main reasons were that it was not necessary, radiologists or A&E consultants were opposed to the idea, that nurses were not capable/did not want the system, or that it would delay triage. Of those departments that do operate a nurse requesting system, most have started doing so in the last three years, and allow nurses of E grade and above who have completed an in house training course and radiation protection certificate to request x rays. Protocols vary, but usually allow requests for limb radiology in patients over 5 years old. Many departments have audited their system, with positive results. In all departments that currently operate the system, staff and patients felt that the system was either good or excellent. One department abandoned the system, after a trial, because they felt that x ray requesting was not a nursing role. CONCLUSION: The system of triage nurse requested x rays is generally well received and departments considering adopting this system can be reassured. Pitfalls and possible protocols for A&E departments intending to start triage nurse requested x rays are suggested.

Emergency Service, Hospital↗
PubMed1989

A review of trauma deaths in an accident and emergency department.

There were 56 deaths following trauma in the adult Accident and Emergency Department of the University Hospital, Nottingham, over a 5-year period from 1983 to 1987. Forty-six of these deaths followed road-traffic accidents. The trauma deaths made up 16% of all adult deaths and 0.13 per thousand new attenders. We found evidence of inappropriate management in four cases, all relating to inadequate volume replacement. In two patients, the degree of hypovolaemia was not appreciated and in the other two, volume replacement was not commenced within 30 min of arrival in the department. Prompt treatment of hypovolaemic shock with appropriate fluids in adequate quantities cannot be overemphasized.

Accidents↗
PubMed1988

Femoral nerve block for analgesia in fractures of the femoral neck.

The purpose of this study was to investigate the efficacy of femoral nerve blocks in patients with fractures of the neck of the femur. Thirty-six patients with femoral neck fractures attending the accident department over a three month period received femoral blocks from one of the two authors. The effect of the block was assessed both subjectively and objectively. Thirty patients reported a worthwhile reduction in pain following the procedure and this was supported by objective blockade in 29. In all six patients who reported no benefit, the block failed objectively. There were no complications of the procedure.

Adult↗
PubMed1986

The value of a next day hand injury review clinic.

A daily hand injury review clinic takes place at East Birmingham Hospital. The purpose of this study is to determine whether this clinic is beneficial in reducing the morbidity of neglected hand injuries, and to compare the running of the clinic with the original criteria laid down at its inception as a "once only' screening clinic. We conclude that such a clinic is highly beneficial, and recommended that it should be standard practice in other hospitals.

England↗