Detection Rate of Fractures by Triage Nurses Applying the Ottawa Foot Rule

Abstract

Aim: The purpose of this study was to investigate the detection rate of fractures by triage nurses by applying the Ottawa foot rule.Materials and Methods: This is a prospective observational validation study that was designed in a training and research hospital between January and December 2013 on 98 patients with isolated foot injury. After triage nurses were provided training on the Ottawa foot rule for 4 hours, they evaluated patients with foot trauma by applying the rule. Foot radiographs were obtained from all trauma patients who were evaluated in the triage. Radiographs were evaluated by an emergency medicine specialist and fractures were determined.Results: Data collection procedures included the evaluation of 90 out of 98 patients who demonstrated one or more qualities of the Ottawa foot rule according to the trained nurses. The fracture prediction rate of the triage nurses using the Ottawa foot rule was found to be 14.4%. The sensitivity of the “the inability to take four steps in the Emergency Department” was 100% and the specificity was 41.6%. Of all patients, 69.2% with fractures were aged <55 years, while 30.8% were aged ≥55 years.Conclusion: This study revealed that triage nurses could successfully perform the Ottawa foot rule after a brief training. According to the Ottawa foot rule applied by the triage nurses, the “inability to take four steps in the Emergency Department” rule was found to be the most significant.

Keywords

• Emergency department
• Ottawa foot rule
• foot trauma