Reducing time to analgesia in the emergency department using a nurse-initiated pain protocol: a before-and-after study.

Suboptimal management of pain in emergency departments (EDs) remains a problem, despite having been first described over two decades ago. A 'before-and-after' intervention study (with a historical control) was undertaken in one Western Australian tertiary hospital ED to test the effect of a 'nurse-initiated pain protocol' (NIPP) intervention. A total of 889 adult patients were included: 144 in the control group and 745 in the intervention group.

Effect of nurse initiated X-rays of the lower limb on patient transit time through the emergency department.

Objective: To compare outcomes of nurse initiated X-rays (NIX) with emergency physician (EP) initiated X-rays (EPIX) of isolated lower limb injuries in patient transit time (from triage to discharge) through the emergency department (ED).

Method: A prospective, interventional study using a historical control group. Data were collected at each contact point from triage (including time of EP's initial assessment of patient, X-ray request and review, patient disposition decision and discharge time).