Accuracy and efficiency of X-ray requests initiated by triage nurses in an accident and emergency department.

A study was carried out from 1 March 1995 to 31 March 1995 in the Accident & Emergency department, Pamela Youde Nethersole Eastern Hospital, Hong Kong. The aim was to assess the feasibility of requesting X-rays by triage nurses based on a pre-set protocol prior to patients being seen by a doctor. Judgement of the attending physician was used as the gold standard by which to judge the need for radiographs requested by the triage nurse. In addition, the senior medical officer or consultant would judge whether the triage nurse had applied the protocol correctly. A total of 934 patients were included in the study and 883 (94.54%) patients had X-rays requested by the triage nurse. Only 5.44% of the radiographs requested by nurses were considered to haven been unnecessary by the doctor. There was no statistically significant difference in agreement for the child and adult groups. In 917 (98%) of cases, nurses had adhered to the protocol. A saving of an average of 18.59 minutes of total service time was obtained during the study. Requesting of X-ray by triage nurse was feasible