It is clear from section 2.1 above that providing timely and effective pain relief is a desirable outcome for patients and staff, and ENI-FIB has great potential in this regard. Current ACI (NSW) policy supports this approach. However, this means the introduction of a new practice to Australian EDs. This NSW Health-funded study seeks to answer the question: needs to happen in order to get Nurse-initiated FIB to become standard practice in a ‘what NSW ED?’ STUDY OBJECTIVES Primary Objective The primary objective of this study is the generation of data to support/disprove the following hypotheses: The process of early, nurse initiated, standardised FIB (ENI FIB) for suspected fractured NOF can be successfully, safely, sustainably and economically introduced into a busy, tertiary level metropolitan emergency department. ENI FIB can be generalised to a busy, regional emergency department with no deterioration of efficacy, safety, sustainability or economic performance. Secondary Objectives The secondary objectives of this study are to support/disprove the following hypotheses: ENI FIB provides equi-analgesia but more rapid pain relief compared to standard, medically instituted FNB The use of ENI FIB will reduce opiate drug requirements in some patients and lead to a corresponding decrease in opiate related delirium. ENI FIB can provide adequate and safe analgesia to patients with mild to moderate cognitive impairment as judged by a triage applied Six Item Scanner (SIS) tool. STUDY DESIGN Type of Study This study uses a prospective, stepped wedge design, which will allow comparability (both vertically and horizontally) of pre and post-intervention data. The pre-intervention data collection phase provides a control. Study Design Overview: This study design will allow comparability (both vertically and horizontally) of pre and post-intervention data. The pre-intervention data collection phase provides a control. The study will be conducted over two sites: Royal North Shore Hospital Emergency Department, a tertiary level metropolitan ED; and Gosford Hospital ED, which is regionally situated. The patient population for the study will be all patients >65 years of age presenting to either ED with a suspected #NOF. The provider population will be senior nursing staff trained to perform FIBs. The study duration will be 24 months. We will first implement a practice change at RNSH: from the existing model where patients with #NOF are administered a medically initiated nerve block usually relatively late in their
It is clear from section 2.1 above that providing timely and effective pain relief is a desirable outcome for patients and staff, and ENI-FIB has great potential in this regard. Current ACI (NSW) policy supports this approach. However, this means the introduction of a new practice to Australian EDs. This NSW Health-funded study seeks to answer the question: ‘what needs to happen in order to get Nurse-initiated FIB to become standard practice in a NSW ED?’ STUDY OBJECTIVES Primary Objective The primary objective of this study is the generation of data to support/disprove the following hypotheses: The process of early, nurse initiated, standardised FIB (ENI FIB) for suspected fractured NOF can be successfully, safely, sustainably and economically introduced into a busy, tertiary level metropolitan emergency department. ENI FIB can be generalised to a busy, regional emergency department with no deterioration of efficacy, safety, sustainability or economic performance. Secondary Objectives The secondary objectives of this study are to support/disprove the following hypotheses: ENI FIB provides equi-analgesia but more rapid pain relief compared to standard, medically instituted FNB The use of ENI FIB will reduce opiate drug requirements in some patients and lead to a corresponding decrease in opiate related delirium. ENI FIB can provide adequate and safe analgesia to patients with mild to moderate cognitive impairment as judged by a triage applied Six Item Scanner (SIS) tool. STUDY DESIGN Type of Study This study uses a prospective, stepped wedge design, which will allow comparability (both vertically and horizontally) of pre and post-intervention data. The pre-intervention data collection phase provides a control. Study Design Overview: This study design will allow comparability (both vertically and horizontally) of pre and post-intervention data. The pre-intervention data collection phase provides a control. The study will be conducted over two sites: Royal North Shore Hospital Emergency Department, a tertiary level metropolitan ED; and Gosford Hospital ED, which is regionally situated. The patient population for the study will be all patients >65 years of age presenting to either ED with a suspected #NOF. The provider population will be senior nursing staff trained to perform FIBs. The study duration will be 24 months. We will first implement a practice change at RNSH: from the existing model where patients with #NOF are administered a medically initiated nerve block usually relatively late in their
372161-HREC%20ENI%20FIB%20Protocol%20Version%20I%2026.08.2016.docx