Background

One of the means of easing increased pressure on emergency care worldwide has been the development of advanced musculoskeletal physiotherapy practice in the emergency department setting. This model of care is in its infancy in Ireland.

Aims

To evaluate the effectiveness of an advanced practice physiotherapist working as a primary contact clinician in the emergency department at St. James’s Hospital, Dublin.

Methods

A three-month retrospective chart review was undertaken for patients assigned the advanced practice physiotherapist as their primary clinician during their emergency department attendance. Three widely accepted measures of quality in emergency medicine were used to evaluate effectiveness, namely, time from attendance to discharge, time from triage to assessment, and unplanned reattendance within seven days.

Results

A total of 129 patients were included in this study. Time from attendance to discharge was significantly less in the APP group (mean 208.5 min, standard deviation 122.4 min) than in the ED group (mean 377.1 min, standard deviation 314.7 min) (mean difference − 168.61 (95% C.I − 191.24– − 145.98)) (p < 0.001). Time from triage to assessment was significantly less in the APP group (mean 72.1 min, standard deviation 51.9 min) than in the ED group (mean 94.1 min, standard deviation 96.5 min) (mean difference − 22.08 (95% C.I − 31.28– − 12.89)) (p < 0.001). The unplanned reattendance rate was 3.9%. No adverse events were identified.

Conclusions

The findings of this study indicate that an advanced practice physiotherapist can provide a timely, effective, and safe service for patients attending the emergency department with musculoskeletal complaints in Ireland.

中文翻译：

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对爱尔兰急诊科高级实践物理治疗师的有效性评估

背景

缓解全球急诊护理日益增加的压力的方法之一是在急诊科环境中发展先进的肌肉骨骼物理治疗实践。这种护理模式在爱尔兰还处于起步阶段。

目标

旨在评估都柏林圣詹姆斯医院急诊科的高级实践物理治疗师作为主要联系临床医生的有效性。

方法

对在急诊科就诊期间指定高级执业物理治疗师作为主要临床医生的患者进行了为期三个月的回顾性图表审查。使用三种广泛接受的急诊医学质量指标来评估有效性，即从就诊到出院的时间、从分诊到评估的时间以及 7 天内计划外再就诊的时间。

结果

本研究共纳入 129 名患者。APP 组从出院到出院的时间（平均 208.5 分钟，标准差 122.4 分钟）明显短于 ED 组（平均 377.1 分钟，标准差 314.7 分钟）（平均差 − 168.61 (95% CI − 191.24– − 145.98)) ( p  < 0.001)。APP 组从分流到评估的时间（平均 72.1 分钟，标准差 51.9 分钟）明显短于 ED 组（平均 94.1 分钟，标准差 96.5 分钟）（平均差 − 22.08 (95% CI − 31.28– − 12.89)) ( p  < 0.001)。非计划重考率为3.9%。没有发现不良事件。

结论

这项研究的结果表明，高级实践物理治疗师可以为爱尔兰因肌肉骨骼疾病而前往急诊科的患者提供及时、有效和安全的服务。