Document Detail


Diagnostic accuracy of emergency nurse practitioners versus physicians related to minor illnesses and injuries.
MedLine Citation:
PMID:  20624563     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Our objectives were to determine the incidence of missed injuries and inappropriately managed cases in patients with minor injuries and illnesses and to evaluate diagnostic accuracy of the emergency nurse practitioners (ENPs) compared with junior doctors/senior house officers (SHOs). METHODS: In a descriptive cohort study, 741 patients treated by ENPs were compared with a random sample of 741 patients treated by junior doctors/SHOs. Groups were compared regarding incidence and severity of missed injuries and inappropriately managed cases, waiting times, and length of stay. RESULTS: Within the total group, 29 of the 1,482 patients (1.9%) had a missed injury or were inappropriately managed. No statistically significant difference was found between the ENP and physician groups in terms of missed injuries or inappropriate management, with 9 errors (1.2%) by junior doctors/SHOs and 20 errors (2.7%) by ENPs. The most common reason for missed injuries was misinterpretation of radiographs (13 of 17 missed injuries). There was no significant difference in waiting time for treatment by junior doctors/SHOs versus ENPs (20 minutes vs 19 minutes). The mean length of stay was significantly longer for junior doctors/SHOs (65 minutes for ENPs and 85 minutes for junior doctors/SHOs; P < .001; 95% confidence interval, 72.32-77.41). DISCUSSION: ENPs showed high diagnostic accuracy, with 97.3% of the patients being correctly diagnosed and managed. No significant differences between nurse practitioners and physicians related to missed injuries and inappropriate management were detected.
Authors:
Christien van der Linden; Resi Reijnen; Rien de Vos
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-12-08
Journal Detail:
Title:  Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association     Volume:  36     ISSN:  1527-2966     ISO Abbreviation:  J Emerg Nurs     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-13     Completed Date:  2010-10-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7605913     Medline TA:  J Emerg Nurs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  311-6     Citation Subset:  N    
Copyright Information:
2010 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.
Affiliation:
Accident and Emergency Department, Medical Center Haaglanden,, The Hague, The Netherlands. chris10vanderlinden@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Child
Child, Preschool
Clinical Competence / statistics & numerical data*
Cohort Studies
Emergency Service, Hospital / statistics & numerical data*
Female
Fractures, Bone / diagnosis
Hospitals, Teaching
Humans
Incidence
Infant
Internship and Residency*
Male
Medical Errors / statistics & numerical data*
Medication Errors / statistics & numerical data*
Middle Aged
Netherlands / epidemiology
Nurse Practitioners*
Physicians
Pneumothorax / diagnosis
Retrospective Studies
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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