Emergency nurse practitioners’ use of a modified Edinburgh red eye diagnostic algorithm: Prospective observational study

Abstract

Background: Emergency nurse practitioners have traditionally been reluctant to treat acute red eyes in Hong Kong emergency departments. The Edinburgh Red Eye Diagnostic Algorithm is the only validated tool to assist non-ophthalmologists to make diagnoses. Objectives: This study investigates the utility of a modified version used by emergency nurse practitioners. Methods: This is a prospective single-centre cohort study in a university hospital emergency department in Hong Kong, comparing red eye patients seen by emergency nurse practitioners with the aid of the algorithm to patients seen by emergency doctors. Data on patient-reported symptom severity were obtained on the day of consultation and information on resolution of symptoms at 1 week following emergency department attendance via telephone interviews. Results: A convenience sample of 50 patients was recruited to the emergency nurse practitioner group and 130 patients were recruited to the doctors’ group over 9 weeks. Reductions in symptom severity were seen in both groups (>70% in both groups reported moderate to very severe discomfort on day 0; ~90% in both groups reported none or mild discomfort on day 7). There was no difference between the two groups ( p = 0.55, analysis of covariance). Symptom resolution was reported in 96% in the emergency nurse practitioner group and 98.5% in the doctor’s group, which was not statistically significant ( p = 0.31, χ2 test). Conclusion: Emergency nurse practitioners using the Edinburgh Red Eye Algorithm to manage red eye patients in a Hong Kong emergency department achieve similar patient-reported outcomes compared to emergency department doctor consultations.