Radiographic interpretation by nurse practitioners in a minor injuries unit.
OBJECTIVE
To compare nurse practitioners with senior house officers (SHOs) for their ability to request and interpret correctly a limited range of x ray views of patients attending a minor injuries unit.


METHODS
Retrospective analysis of case records.


METHODS
150 accident and emergency (A&E) records with x ray requests were randomly selected from the SHOs' first, second, and third 2-month period of their 6-month appointments; 150 record cards were randomly selected from a nearby minor injuries unit over the same period. Copies of the records were reviewed blind and a decision made as to whether x ray requests were appropriate; x ray interpretation was compared with that of a consultant radiologist.


RESULTS
106 x rays were taken on the MIU patients (71%) and 124 on the A&E patients (83%). There was no statistically significant differences in the ability of the nurse practitioners and the SHOs to request and interpret appropriate x rays. In both groups the decision to carry out an x ray was considered appropriate in 70% of patients; x rays were positive in about one third. The sensitivity of radiological interpretation was 93% in both groups, and there were 2% missed positives.


CONCLUSIONS
Appropriately trained nursae practitioners are at least as good as SHOs in recognising the need for an x ray and are as competent in their interpretation.
Freij
R M
RM
Department of Accident and Emergency Medicine, St Mary's Hospital, London.
Duffy
T
T
Hackett
D
D
Cunningham
D
D
Fothergill
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D009722:Nurse Practitioners; D011859:Radiography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014947:Wounds and Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging*