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Trial registered on ANZCTR
Registration number
ACTRN12611000953932
Ethics application status
Approved
Date submitted
2/09/2011
Date registered
5/09/2011
Date last updated
17/05/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Reducing time to analgesia in the emergency department using a nurse-initiated pain protocol: a before-and-after study.
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Scientific title
In adult patients presenting to the Emergency Department in pain does a nurse-initiated pain protocol compared to usual practice reduce time to analgesia
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Secondary ID [1]
262981
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
acute pain
270703
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Condition category
Condition code
Other
270881
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0
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Research that is not of generic health relevance and not applicable to specific health categories listed above
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Nurse-initiated pain protocol in emergency department - involved the administration of various oral analgesic medications (type of drug and dose specified) depending on the patient's pain score (0-10). For example, 2 x paracetamol 500mg oral (or 2 x Ibuprofen 200mg ) for mild pain (pain score 1-3); 2 x paracetamol 500mg with codeine 30mg (or 3 x Ibuprofen 200mg/Codeine 12.8mg) for moderate pain (pain score 4-6), and oxycodone 5mg for severe pain (pain score 7+). The nurse-initiated analgesia protocol could only be used once for each patient without further consultation with a medical officer, ie the duration was for initial pain relief in the Emergency Department only. The nurse-initiated protocol was trialled between 4 April 2009 and 25 June 2009.
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Intervention code [1]
269324
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Treatment: Drugs
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Comparator / control treatment
Usual pain management - which requires patient to first be assessed by a medical officer - data collected in the 12 months prior to the intervention ie 2008-2009
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Control group
Historical
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Outcomes
Primary outcome [1]
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time to first pain score
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Assessment method [1]
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Timepoint [1]
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time interval from time of arrival at triage in ED to time of first pain assessment score (in minutes)
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Primary outcome [2]
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time to analgesia
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Assessment method [2]
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Timepoint [2]
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time interval from time of arrival at triage in ED to time of first analgesic drug administered (in minutes)
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Secondary outcome [1]
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adequacy of analgesic effect as defined by Jao et al Emergency Medicine Australasia 2011, 23(2):195-201
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Assessment method [1]
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Timepoint [1]
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pain score recorded after first analgesic medication administered
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Eligibility
Key inclusion criteria
All adult patients presenting to the ED with pain
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Minimum age
18
Years
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Maximum age
100
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients meeting the following conditions were excluded: presented with chest pain of presumed cardiac origin or headache; were triaged as emergency or urgent (Australasian Triage Score 1 & 2)[12]; exhibited unstable vital signs; were pregnant or lactating; had known contraindications to one of the study drugs; declined analgesia; or already had an analgesia related management plan in place.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Before-and-after study with a historical ('usual practice') control. The intervention was administered to a convenience sample of non-consecutive patients attending the same ED.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
n/a
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
4/04/2009
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Actual
4/04/2009
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Date of last participant enrolment
Anticipated
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Actual
25/06/2009
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Date of last data collection
Anticipated
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Actual
25/06/2009
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Sample size
Target
288
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Accrual to date
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Final
889
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Recruitment in Australia
Recruitment state(s)
WA
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Sir Charles Gairdner Hospital Research Fund
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Address [1]
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Hospital Avenue, Nedlands, Western Australia 6009
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Professor Judith Finn
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Address
Discipline of Emergency Medicine (M516)
The University of Western Australia
35 Stirling Highway
Crawley, 6009, Western Australia
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Dr Roger Swift
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Address [1]
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Emergency Medicine
Sir Charles Gairdner Hospital
Hospital Avenue, Nedlands, Western Australia 6009
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Country [1]
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Australia
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Other collaborator category [1]
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Individual
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Name [1]
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Professor Ian Jacobs
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Address [1]
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Discipline of Emergency Medicine (M516)
The University of Western Australia
35 Stirling Highway
Crawley, 6009, Western Australia
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Country [1]
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Australia
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Other collaborator category [2]
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Individual
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Name [2]
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A/Prof Nick Gibson
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Address [2]
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Discipline of Emergency Medicine (M516)
The University of Western Australia
35 Stirling Highway
Crawley, 6009, Western Australia
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Country [2]
252246
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Australia
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Other collaborator category [3]
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Individual
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Name [3]
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Ms Amanda Rae
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Address [3]
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Emergency Medicine
Sir Charles Gairdner Hospital
Hospital Avenue, Nedlands, Western Australia 6009
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Country [3]
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Australia
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Other collaborator category [4]
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Individual
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Name [4]
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Ms Tamara Watters
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Address [4]
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Emergency Medicine
Sir Charles Gairdner Hospital
Hospital Avenue, Nedlands, Western Australia 6009
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Country [4]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Sir Charles Gairdner Hospital
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Ethics committee address [1]
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Hospital Avenue, Nedlands, Western Australia 6009
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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27/01/2009
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Approval date [1]
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05/02/2009
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Ethics approval number [1]
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QIA#2226
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Summary
Brief summary
We sought to introduce and evaluate the practice of ‘nurse-initiated analgesia’ in the emergency department of a busy tertiary hospital in Western Australia, whereby the ED triage nurse (or other specifically trained ED nurse) administered analgesic medications according to a pre-defined protocol, without the patient being first assessed by a medical officer.
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Trial website
Nil
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Trial related presentations / publications
Finn J, Rae A, Gibson N, Swift R, Watters T, Jacobs I. Reducing time to analgesia in the emergency department using a nurse-initiated pain protocol: A before-and-after study. Contemporary Nurse. 2012;43(1):29-37.
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Public notes
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Contacts
Principal investigator
Name
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Prof Judith Finn
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Address
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School of Nursing, Midwifery & Paramedicine
Curtin University
Kent Street Bentley Western Australia 6102
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Country
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Australia
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Phone
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+ 61 8 9266 4447
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Judith Finn
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Address
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School of Nursing, Midwifery & Paramedicine
Curtin University
Kent Street Bentley Western Australia 6102
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Country
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Australia
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Phone
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+ 61 8 9266 4447
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Judith Finn
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Address
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School of Nursing, Midwifery & Paramedicine
Curtin University
Kent Street Bentley Western Australia 6102
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Country
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Australia
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Phone
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+ 61 8 9266 4447
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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