Triage nurse requested x rays—the results of a national survey

Abstract

Objective—To ascertain the prevalence and experiences of triage nurse requested x ray systems among accident and emergency (A&E) departments in the UK.

Method—A descriptive study of a postal survey of 225 major A&E departments listed in the British Association for Accident and Emergency Medicine directory.

Results—Altogether 165 (73%) questionnaires were returned. Fifty nine (35%) departments indicated that they currently had a triage nurse requested radiology system. Of those departments that did not have such a system, the main reasons were that it was not necessary, radiologists or A&E consultants were opposed to the idea, that nurses were not capable/did not want the system, or that it would delay triage.

Of those departments that do operate a nurse requesting system, most have started doing so in the last three years, and allow nurses of E grade and above who have completed an in house training course and radiation protection certificate to request x rays. Protocols vary, but usually allow requests for limb radiology in patients over 5 years old.

Many departments have audited their system, with positive results. In all departments that currently operate the system, staff and patients felt that the system was either good or excellent.

One department abandoned the system, after a trial, because they felt that x ray requesting was not a nursing role.

Conclusion—The system of triage nurse requested x rays is generally well received and departments considering adopting this system can be reassured. Pitfalls and possible protocols for A&E departments intending to start triage nurse requested x rays are suggested.