Suturing as an advanced skill for registered nurses in the emergency department

OBJECTIVE: Many patients present to emergency departments (EDs) for wounds that require repair by suturing. This study looked at ascertaining the efficacy of Advanced Clinical Nurses' (ACN) suturing dermal lacerations in tertiary, regional and rural ED settings. DESIGN: Convenience sample; prospective questionnaire. SETTING: Three mixed adult and paediatric EDs. These departments were tertiary, regional and rural regional EDs. Participants: Eighty patients requiring sutures for dermal lacerations that were repaired by an ACN. Of them 24 were men and seven were women. Mean age was 40.5 years, with a range of 21-58 years. Ten results from rural ED; six from regional ED; 15 from tertiary ED. Main outcome measure(s): Any differences between suturing standards in rural, regional and tertiary EDs; clinical results of suturing performed by ACNs; local medical officers' satisfaction with wound repair. RESULTS: A total of 31 responses were received. The lacerations were located on the face in 13 patients (42%), the scalp in 10 (32%), an extremity in 2 (6%), and on the trunk in 6 (20%). A total of 196 sutures were required. Local medical officers graded wound repair as 'good' in 24 cases (77%) and adequate in seven cases (23%). There were no wound healing complications reported. CONCLUSIONS: Nurses who complete a standardised training program in wound management and repair are capable of providing high-quality, definitive care for patients who present to EDs with dermal lacerations. This is true irrespective of whether the Registered Nurse is working in a rural, regional or tertiary ED.