Nurses plastering and splinting in the emergency department: an integrative review

Abstract

Objective: Increasing numbers of presentations, high acuity of patients and a decreased access to hospital beds contribute to lengthy waiting times in Emergency Departments (EDs). Implementing models of care to improve patient flow through EDs is imperative. This integrative review was undertaken to evaluate existing evidence regarding the impact of nurses’ plastering and splinting in EDs.

Setting: Data included in the review was drawn from five International databases that include publications exploring acute care interventions using PRISMA guidelines. An unbiased search and then application of exclusion criteria by three independent researchers delineated 11 papers for inclusion. Full-text analysis using a predefined framework enabled development of the primary outcomes.

Primary argument: The research question guiding this integrative review is:
What is the impact on patient and staff satisfaction, cost, ED length of stay, ED re-presentation rates when ED nurses apply plasters and splints to patients who present to ED with a fractured or sprained limb?
While no literature focused specifically on outcomes from nurses applying plasters or splints, studies indicated that plastering, as part of a suite of nursing skills, had positive effects on patient outcomes such as reduced waiting times to treatment.

Conclusions: There is insufficient evidence to inform protocols for nurses to perform plastering and splinting. Further research evaluating the impact of nurses using this skill in their practice is required to support evidence-based practice.