Nurse initiated X-rays: a leap forward for children and nurses

Donald Puckridge, Malcolm Higgins, Alison Hutton

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    2 Citations (Scopus)


    Paediatric emergency nurses can accurately and suitably order x-rays for paediatric patients with isolated extremity injuries. Secondary aims of this study were to decrease patient emergency department (ED) time and improve satisfaction for patients, parents, nursing and medical staff. This initiative has many benefits, including decreased patient ED waiting time as well as improving satisfaction for patients, parents and nursing staff. Data was obtained through audits and surveys. The study was conducted in a major Australian metropolitan hospital. Audit data was extracted from the PED's information system (EDIS) and radiology reporting systems that are generated by way of the x-ray request forms and completed by nurses. Further information was obtained from two surveys: one completed by emergency nursing staff, which provided information on parents' views about the x-ray process. The other survey was completed by the PED's doctors. Nurse-initiated x-rays (NIXR) audit forms were available for 147 presentations during the study period of April to June 2000. Fractures were detected in 74 (51%) of the x-rays ordered by nurses. This number compared favourably with doctors' x-rays over the same period, where 56% of the x-rays ordered detected fractures. The study has demonstrated that nursing staff can accurately and effectively order NIXR for children with isolated limb injuries in our ED. The study also showed that as a direct result of NIXR, waiting time was reduced for children with these injuries.

    Original languageEnglish
    Pages (from-to)7-12
    Number of pages6
    JournalNeonatal, Paediatric and Child Health Nursing
    Issue number1
    Publication statusPublished - Mar 2010


    • Accuracy
    • Nurse-initiated x-rays
    • Waiting times and parent satisfaction


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