Can accident and emergency nurse practitioners interpret radiographs? A multicentre study.

Meek, S; Kendall, Jason; Porter, John M.; Freij, R

doi:10.1136/emj.15.2.105

Cited by 42 publications

(35 citation statements)

References 5 publications

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“…At issue is not only the ability to detect rare disease (Asch and Parker 1988), but much more it is the ability of a provider to detect "minor" manifestations of common serious illnesses that ensures patient wellbeing. For example, physicians and NPs have been shown to be equally poor (65% poor vs. 57%) in interpreting x-rays (Meek et al 1998). Hence, strategies to expand the scope and use of substitute providers should first consider the willingness of consumers themselves to use them (Martin, Abelson, and Singer 2002).…”

Section: Discussionmentioning

confidence: 99%

Patient Willingness to Be Seen by Physician Assistants, Nurse Practitioners, and Residents in the Emergency Department: Does the Presumption of Assent Have an Empirical Basis?

Larkin

Hooker

2010

The American Journal of Bioethics

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Physician assistants (PAs), nurse practitioners (NPs), and medical residents constitute an increasingly significant part of the American health care workforce, yet patient assent to be seen by nonphysicians is only presumed and seldom sought. In order to assess the willingness of patients to receive medical care provided by nonphysicians, we administered provider preference surveys to a random sample of patients attending three emergency departments (EDs). Concurrently, a survey was sent to a random selection of ED residents and PAs. All respondents were to assume the role of patient when presented with hypothetical clinical scenarios and standardized provider definitions. Despite presumptions to the contrary, ED patients are generally unwilling to be seen by PAs, NPs, and residents. While seldom asked in practice, 79.5% of patients fully expect to see a physician regardless of acuity or potential for cost savings by seeing another provider. Patients are more willing to see residents than nonphysicians.

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Section: Discussionmentioning

confidence: 99%

Patient Willingness to Be Seen by Physician Assistants, Nurse Practitioners, and Residents in the Emergency Department: Does the Presumption of Assent Have an Empirical Basis?

Larkin

Hooker

2010

The American Journal of Bioethics

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“…Issues such as the authorization of radiography (where the body of evidence supports the practice of nurses (Freij et al 1996, Meek et al 1998) still appear to be a major problem for some practitioners, who experience varying degrees of frustration with the perceived bureaucratization in terms of service development and delivery. Nurse practitioners were felt to encounter barriers in the form of lack of cooperation from both medical and allied health professionals (B2, B11).…”

Section: Practice Of Nurse Practitionersmentioning

confidence: 99%

Nurse practitioner practice and deployment: electronic mail Delphi study

Marsden¹,

Dolan²,

Holt³

2003

Journal of Advanced Nursing

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“…9 10 There has been research into some aspects of the role of nurse practitioners in accident and emergency (A&E) and minor injury settings. [11][12][13][14][15][16] It is therefore surprising that there is little evidence about the clinical effectiveness and cost effectiveness of this model of care compared with more traditional models of care. 9 10 17-19 As part of the reorganisation of A&E services in the city of Sheffield (UK) it was planned to introduce a nurse practitioner led minor injury unit (MIU) when one of the A&E departments in the city was closed.…”

mentioning

confidence: 99%

Emergency nurse practitioners: a three part study in clinical and cost effectiveness

Sakr

2003

Emergency Medicine Journal

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Aims: To compare the clinical effectiveness and costs of minor injury services provided by nurse practitioners with minor injury care provided by an accident and emergency (A&E) department. Methods: A three part prospective study in a city where an A&E department was closing and being replaced by a nurse led minor injury unit (MIU). The first part of the study took a sample of patients attending the A&E department. The second part of the study was a sample of patients from a nurse led MIU that had replaced the A&E department. In each of these samples the clinical effectiveness was judged by comparing the "gold standard" of a research assessment with the clinical assessment. Primary outcome measures were the number of errors in clinical assessment, treatment, and disposal. The third part of the study used routine data whose collection had been prospectively configured to assess the costs and cost consequences of both models of care. Results: The minor injury unit produced a safe service where the total package of care was equal to or in some cases better than the A&E care. Significant process errors were made in 191 of 1447 (13.2%) patients treated by medical staff in the A&E department and 126 of 1313 (9.6%) of patients treated by nurse practitioners in the MIU. Very significant errors were rare (one error). Waiting times were much better at the MIU (mean MIU 19 minutes, A&E department 56.4 minutes). The revenue costs were greater in the MIU (MIU £41.1, A&E department £40.01) and there was a great difference in the rates of follow up and with the nurses referring 47% of patients for follow up and the A&E department referring only 27%. Thus the costs and cost consequences were greater for MIU care compared with A&E care (MIU £12.7 per minor injury case, A&E department £9.66 per minor injury case). Conclusion: A nurse practitioner minor injury service can provide a safe and effective service for the treatment of minor injury. However, the costs of such a service are greater and there seems to be an increased use of outpatient services.

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Can accident and emergency nurse practitioners interpret radiographs? A multicentre study.

Cited by 42 publications

References 5 publications

Patient Willingness to Be Seen by Physician Assistants, Nurse Practitioners, and Residents in the Emergency Department: Does the Presumption of Assent Have an Empirical Basis?

Patient Willingness to Be Seen by Physician Assistants, Nurse Practitioners, and Residents in the Emergency Department: Does the Presumption of Assent Have an Empirical Basis?

Nurse practitioner practice and deployment: electronic mail Delphi study

Emergency nurse practitioners: a three part study in clinical and cost effectiveness

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