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首页> 外文期刊>BMJ Open >A randomised trial comparing the clinical effectiveness of different emergency department healthcare professionals in soft tissue injury management
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A randomised trial comparing the clinical effectiveness of different emergency department healthcare professionals in soft tissue injury management

机译：一项随机试验，比较了不同急诊科医疗专业人员在软组织损伤管理中的临床效果

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Objectives To evaluate the clinical effectiveness of soft tissue injury management by emergency nurse practitioners (ENPs) and extended scope physiotherapists (ESPs) compared to the routine care provided by doctors in a UK emergency department (ED). Design Randomised, pragmatic trial of equivalence. Setting One adult ED in England. Participants 372 patients were randomised; 126 to the ESP group, 123 to the ENP group and 123 to the doctor group. Participants were adults (older than 16?years) presenting to the ED with a peripheral soft tissue injury eligible for management by any of the three professional groups. Patients were excluded if they had any of the following: injury greater than 72?hours old; systemic disease; dislocated joints; recent surgery; unable to give informed consent (eg, dementia), open wounds; major deformities; opiate analgesia required; concurrent chest/rib injury; neurovascular deficits and associated fracture. Interventions Patients were randomised to treatment by ESPs, ENPs or routine care provided by doctors (of all grades). Main outcome measures Upper-limb and lower-limb functional scores, quality of life, physical well-being, preference-based health measures and the number of days off work. Results The clinical outcomes of soft tissue injury treated by ESPs and ENPs in the ED were equivalent to routine care provided by doctors. Conclusions As all groups were clinically equivalent it is other factors such as cost, workforce sustainability, service provision and skill mix that become important. This result validates the role of the ENP, which is becoming established as an integral part of minor injuries care, and demonstrates that the ESP should be considered as part of the clinical skill mix without detriment to outcomes. ISRCTN-ISRCTN trials register number 70891354.
机译：目的与英国急诊科（ED）的医生提供的常规护理相比，评估急诊护士（ENP）和扩大范围的理疗师（ESP）对软组织损伤管理的临床效果。设计等效性的随机，实用试验。在英格兰设置一名成人ED。参与者372例患者被随机分组​​; ESP组为126，ENP组为123，医生组为123。参加者是成年人（年龄在16岁以上）出现在急诊科的周围软组织损伤，可以由三个专业组中的任何一个进行管理。患有以下情况的患者被排除在外：损伤大于72小时;全身性疾病关节脱臼;最近的手术;无法给予知情同意（例如痴呆），开放性伤口;主要畸形需要鸦片镇痛;并发胸/肋骨损伤;神经血管缺陷和相关的骨折。干预措施患者被随机分配接受ESP，ENP或医生（所有级别）提供的常规护理。主要结果指标上肢和下肢功能评分，生活质量，身体健康，基于偏爱的健康措施以及下班天数。结果急诊ESP和ENP治疗软组织损伤的临床结果与医生提供的常规护理相同。结论由于所有组在临床上都是等效的，因此其他因素（例如成本，劳动力可持续性，服务提供和技能组合）变得很重要。该结果证实了ENP的作用，ENP已被确立为轻伤护理的组成部分，并表明ESP应该被视为临床技能组合的一部分，而不会损害结果。 ISRCTN-ISRCTN试用注册号70891354。

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