Patrick McCabe, Emmet Thompson, Audrey Butler, Lester D’Souza, Hamid Khan, Eric Masterson, Dermot O’Farrell, Finbarr Condon, Brian Lenehan
Background: The role of Orthopaedic Advanced Nurse Practioner (OANP) is novel within the Irish healthcare system, despite its proven benefit internationally, with huge potential to enhance fracture clinic activity, reduce Non-Consultant Hospital Doctors (NCHD) workload and enhance the overall fracture clinic experience for patients. The aim of this study was to assess the role of our OANP, in the management of fracture clinic patients through an intra-departmental comparison with NCHDs.
Methods: Over a set period in September 2017, the management of a cohort of new patients presenting to our orthopaedic fracture clinic, who were treated primarily by the OANP, was prospectively assessed. All patients fulfilled strict criteria to allow for primary management by the OANP. These patient profiles were subsequently appraised by a selection of NCHD’s who proposed a specific treatment plan for each patient. These plans were then compared and contrasted to those implemented by the OANP. Following this, a further distinct group of patient profiles, blinded to both the OANP and NCHDs, was assessed to confirm consistency.
Results: Overall, management plans implemented by the OANP and NCHDs were broadly comparable with scaphoid, radial head and clavicle fractures demonstrating almost complete concordance in management. Differences were observed in the use of rigid and semi-rigid fracture fixation, re-X-ray rates and discharge rates between the OANP and NCHDs.
Conclusions: These findings validate the role of our OANP in the management of fracture clinic patients when compared to NCHDs, thus confirming the positive impact such a role can confer.
