The Effect of a Nursing Triage Protocol for Minor Orthopedic Trauma in an Emergency Department: A Randomized Controlled Trial

More than 90% of patients with minor orthopedic injuries are categorized as non-urgent which can result in prolonged waiting times in the emergency department. A total of 220 adults presenting between March and May 2023 with non-urgent orthopedic distal limb injuries were included in this single center, unblinded, randomized, parallel-group, controlled trial. A nurse performed the physical examination and initiation of X-ray during triage in the intervention group while an emergency physician performed these after triage in the usual care group. The results of 108/110 (intervention) and 107/110 participants (usual care) were analyzed. The intervention group had a significantly lower flow time between emergency department registration and X-ray request. The usual care group had significantly lower flow time between X-ray request and emergency department discharge. There was no difference in total length of stay, patient satisfaction and treatment adjustment between groups. The nursing triage protocol reduced flow time between registration and request for X-ray but did not affect total length of stay.