BACKGROUND: The aim of the study was to compare the initial management and the outcomes of patients with open tibia fractures referred to a tertiary orthopaedic unit using a mobile software application (app), Vula Medical Referral (VULA), with those referred by handwritten referral letters (HWRL). METHODS: A retrospective analysis was performed on data collected from the clinical records of patients diagnosed with open tibia fractures and referred to a tertiary level orthopaedic trauma unit over two years. The referrals originated from a community health centre and a district-level hospital via electronic means (VULA) or physical referral letters (HWRL). The primary outcomes of interest included the initial patient management, the referral delay and definitive fracture management. Comparative complication rates within one year were an additional outcome of interest. RESULTS: One hundred and sixty-two cases were analysed, 103 (64%) in the VULA group and 59 (36%) in the HWRL group. The two groups displayed no significant differences in demographics or injury characteristics. There was a difference in the time from referral to the time of assessment at the tertiary centre (p = 0.028), with the VULA group having a shorter time (mean of 5 hours vs 6 hours). Differences were noted between the referral groups regarding referral documentation content, initial management strategies and complication rates. There were three (2%) patients with non-union and 17 (11%) with infection. The VULA group had comparatively fewer complications, 6% (6 of 103) compared to 24% (14 of 59) in the HWRL group. CONCLUSION: This study found that using the VULA app resulted in better transfer of information and documentation of initial management of open fractures by the referring institution. Time from referral to being assessed by orthopaedics was also marginally better. While our findings suggest that there may be a lower complication rate with the use of the mobile application, further research is required to confirm this. Level of evidence: Level 4

Resumo O presente artigo visa propor um conceito e um instrumento de realização profissional (RP), definida teoricamente como a percepção de se ter alcançado as metas de carreira mais importantes ou a avaliação positiva de que se está no caminho para alcançar tais metas. A Escala de Realização Profissional (PFS) foi desenvolvida para operacionalizar a RP, sendo sua estrutura testada em dois estudos. No Estudo 1, no qual participaram 406 trabalhadores, resultados da análise fatorial exploratória evidenciaram a validade de construto da PFS. No Estudo 2, no qual participaram 270 trabalhadores, os resultados oriundos da análise fatorial confirmatória e da modelagem por equações estruturais indicaram que a PFS apresenta índices de ajuste do modelo satisfatórios. Conclui-se que tanto o conceito de realização profissional quanto a PFS são úteis para mapear o grau de importância, alcance e progresso das metas de carreira, funcionando como ferramenta de diagnóstico para o gerenciamento de carreira.

Abstract This paper aims to propose a concept and an instrument of professional fulfillment (PF), which is theoretically defined as the perception of having attained or being on the right track for attaining one’s most important career goals. The Professional Fulfillment Scale (PFS) was developed in order to operationalize PF, being tested across two studies. Regarding Study 1, in which 406 workers took part, results from exploratory factor analysis evidenced construct validity for PFS. In Study 2, in which 270 workers took part, results from confirmatory factor analysis and structural equation modeling presented satisfactory model fit indices for PFS. We conclude that both the professional fulfillment concept and the scale are useful for mapping people’s importance and achievement of career goals and evaluation of progress, working as a diagnostic tool for career management.

Resumen El presente artículo tiene como objetivo proponer un concepto y un instrumento de realización profesional (RP), la cual se define teóricamente como la percepción de haber alcanzado las metas más importantes de la carrera o la evaluación positiva de que se está en camino de lograrlas. La Escala de Realización Profesional (ERP) fue desarrollada para operacionalizar la RP, siendo su estructura puesta a prueba en dos estudios. En el estudio 1, en el cual participaron 406 trabajadores, los resultados del análisis factorial exploratorio mostraron validez de constructo de la ERP. En el estudio 2, en el que participaron 270 trabajadores, los resultados provenientes del análisis factorial confirmatorio y del modelado por ecuaciones estructurales, indicaron que la ERP presenta índices de ajuste de modelo, satifactorios. Como conclusión podemos decir que tanto el concepto como el instrumento de la ERP, son útiles para asignar el grado de importancia, alcance y progreso de las metas de la carrera, funcionando como una herramienta de diagnóstico para la gestión de la misma.