Cooper, Mark Alastair
Diversity and effectiveness of emergency nurse practioner services in Scotland.
PhD thesis, University of Glasgow.
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ENPs are practising throughout the different types of A&E department in Scotland, but educational preparation, scope of practice, job titles and grading vary considerably.
The modified NGT was found to be an effective method to develop the Documentation Audit Tool which had good inter-rater reliability and stability. The RCT of ENP-led care was sufficiently large to demonstrate higher levels of patient satisfaction and clinical documentation quality with ENP-led compared to SHO-led care. The methods and tools developed for use in this trial could be used in other A&E departments to measure the quality of NEP-led care.
Missed injuries were relatively rare, however around a fifth of patients sought unplanned follow-up; most from GPs, a smaller proportion returned to A&E. Monitoring returns to A&E may be a useful procedure to assess the quality of minor injury care.
In summary, ENPs can provide care to patients with minor injuries, which results in high levels of patient satisfaction. Their clinical documentation is of a higher quality an complications in terms of missed injuries are low. However, A&E departments should consider ensuring they have systems in place to identify patients who re-attend, or who attend another health-care provider for unplanned follow-up, in order to ensure that missed injuries can be effectively monitored.
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