evidence and practice
Treating buckle fractures in children with a soft cast and home removal: a quality improvement initiative
Kevin Phillips Advanced Nurse Practitioner, Emergency Department, University Hospital Waterford, Waterford, Ireland
Bernadette Breen Advanced Nurse Practitioner, Emergency Department, University Hospital Waterford, Waterford, Ireland
• To understand the treatment options available for children with buckle fractures
• To learn how soft casting could be more effective in managing buckle fractures than the traditional method of using a rigid cast
• To explore ways in which you could improve the management of buckle fractures in your area of practice
Buckle fractures of the distal radius are unique to children and a frequent presentation in the emergency department (ED). In University Hospital Waterford, Ireland, the treatment of buckle fractures followed the traditional method involving a rigid cast and a follow-up hospital appointment. However, the latest literature indicates that buckle fractures are stable and heal without complication, so a minimalist approach to treatment is recommended. Therefore, the advanced nurse practitioners in the ED introduced a change in protocol at the hospital. This involved the use of a soft cast for removal at home, with verbal and written discharge information and no follow-up appointment.
An audit was conducted to ensure that this new protocol was safe and effective, and the time and distance saved by patients through avoiding a return hospital visit was estimated. Treatment in a soft cast with verbal and written discharge information revealed a successful outcome for all 88 patients included in the audit. Avoiding return hospital visits resulted in significant travel time and distance savings for patients and families.
Emergency Nurse. doi: 10.7748/en.2020.e2043Peer review
This article has been subject to external double-blind peer review and has been checked for plagiarism using automated softwareCorrespondence
Phillips K, Breen B (2020) Treating buckle fractures in children with a soft cast and home removal: a quality improvement initiative. Emergency Nurse. doi: 10.7748/en.2020.e2043
Published online: 28 July 2020
Want to read more?
Subscribe for unlimited access
Try 1 month’s access for just £1 and get:
- Full access to the website and the online archive
- Bi-monthly digital edition
- RCNi Portfolio and interactive CPD quizzes
- RCNi Learning with 200+ evidence-based modules
- 10 articles a month from any other RCNi journal
Already subscribed? Log in
Alternatively, you can purchase access to this article for the next seven days. Buy now