Should nurses be allowed to request X-rays in an accident &amp; emergency department?

MacLeod, Alex; Freeland, P.

doi:10.1136/emj.9.1.19

Cited by 46 publications

(22 citation statements)

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“…Fifty eight nurse practitioners, forty three experienced senior house officers, and 41 inexperienced senior house officers were tested, and the mean scores are set out in table 3.…”

Section: Resultsmentioning

confidence: 99%

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

Meek

Kendall

Porter

et al. 1998

Emergency Medicine Journal

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Objective-To assess the ability of nurse practitioners in accident and emergency (A&E) to interpret distal limb radiographs, by comparison with senior house officers. Design-Nurse practitioners and senior house officers in 13 A&E departments or minor injury units were shown 20 radiographs of distal limbs, with brief history and examination findings, and asked to record their interpretation. Outcome measure-A total score for each subject was calculated by comparing answers against agreed correct responses.

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“…Fifty eight nurse practitioners, forty three experienced senior house officers, and 41 inexperienced senior house officers were tested, and the mean scores are set out in table 3.…”

Section: Resultsmentioning

confidence: 99%

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

Meek

Kendall

Porter

et al. 1998

Emergency Medicine Journal

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“…The results of Kelly, McCarthy, Richardson, Parris, and Kerr (1995) suggested that the average timesavings for the patient could be in the order of 45 min. Others studies found that the timesavings for patients ranged from 8 to 60 min when nurses initiated radiographs at the point of triage (Davies, 1994, Macleod & Freeland 1992Parris et al, 1997). Furthermore, in a recent study, a decrease of 45 min in the overall waiting time was noted for patients with limb injuries when nurses utilized protocols (Sorensen et al, 2012).…”

Section: Wait Times: Patient and Staff Satisfactionmentioning

confidence: 95%

“…According to Davis (1994), implementing nurse-initiated radiographs at the triage stage can reduce delays in patient assessment and management. Several studies (Ching, Leng, & See, 1999;Lee et al, 1996;Macleod & Freeland, 1992;Stiell et al, 1993;Ward, 1999;Wilkinson, 1999) support this claim.…”

Section: Wait Times: Patient and Staff Satisfactionmentioning

confidence: 97%

Requesting Wrist Radiographs in Emergency Department Triage

Streppa

Schneidman

Biron

2014

Advanced Emergency Nursing Journal

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Crowding is extremely problematic in Canada, as the emergency department (ED) utilization is considerably higher than in any other country. Consequently, an increase has been noted in waiting times for patients who present with injuries of lesser acuity such as wrist injuries. Wrist fractures are the most common broken bone in patients younger than 65 years. Many nurses employed within EDs are requesting wrist radiographs for patients who present with wrist complaints as a norm within their working practice. Significant potential advantages can ensue if EDs adopt a triage nurse-requested radiographic protocol; patients can benefit from a significant time-saving of 36% in ED length of stay (M. Lindley-Jones & B. J Finlayson, 2000)— when nurses initiated radiographs in triage. In addition, the literature suggests that increased rates of patient and staff satisfaction may be achieved, without compromising quality of radiographic request or quality of service (W. Parris,S. McCarthy, A. M. Kelly, & S. Richardson, 1997). Studies have shown that nurses are capable of requesting appropriate radiographs on the basis of a preset protocol. As there are no standardized set of rules for assessing patients, presenting with suspected wrist fractures, a training program as well as a diagnostic algorithm was developed to prepare emergency nurses to appropriately request wrist radiographs. The triage nurse-specific training program includes the following topics: wrist anatomy and physiology, commonly occurring wrist injuries, mechanisms of injury, physical assessment techniques, and types of radiographic images required. The triage nurse algorithm includes the clinical decision-making process. Providing triage nurses with up-to-date evidence-based educational material not only allowed triage nurses to independently assess and request wrist radiographs for patients with potential wrist fractures but also strengthening the link between competent nursing care and better patient outcomes. A review of the literature also found that such initiatives increase patient and staff satisfaction as well as promoting efficient use of right staff at the right time.

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“…Another difficulty with nurse triage is the limitations that may be placed on a nurse's practice. It has been shown that nurses can adhere to X-ray protocols as well as an A&E officer (Macleod & Freeland, 1992) and steer patients successfully to their GP (Carew- McColl & Buckles, 1990). The overall impact on a department may still be limited.…”

Section: Introductionmentioning

confidence: 99%