Open AccessImproving nurse initiated X‐ray practice through action research
Author(s) -
Thompson Nadine,
Murphy Margaret,
Robinson John,
Buckley Thomas
Publication year - 2016
Publication title -
journal of medical radiation sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.484
H-Index - 18
eISSN - 2051-3909
pISSN - 2051-3895
DOI - 10.1002/jmrs.197
Subject(s) - intervention (counseling) , clinical practice , emergency department , nursing , medicine , quality management , quality (philosophy) , medical education , psychology , operations management , management system , philosophy , epistemology , economics
Abstract Introduction Due to increasing demands on hospital Emergency Departments ( ED s), the role of registered nurses, with additional training, has been extended to include requesting X‐ray examinations. The aim of this study was to evaluate nurse practice guidelines for requesting X‐rays in the ED setting and to utilise inter‐professional learning and change management theory to promote practice improvements. Methods Three hundred and one nurse initiated X‐ray (NIX) requests were randomly selected between January and March 2012, and reviewed for observance of local department guidelines and quality of clinical history. The results of this preliminary review were used to inform the investigating team in order to improve and support practice. A collaborative educational intervention utilising inter‐professional learning and change management theory was implemented with an aim of improving the clinical history provided in NIX requests and development of a new policy to support clinical practice. A second review was repeated from February to April 2014 to evaluate the success of the educational intervention. Results Observance of NIX guidelines improved from pre‐intervention to post‐intervention (48% vs. 90%, P > 0.001). Quality of clinical history also significantly improved in all four essential variable criteria: (1) mechanism of injury; (2) injury location; (3) side of injury; and (4) clinical question. Conclusion This study demonstrates that utilising inter‐professional learning and change management theory can contribute to significant improvements in and support clinical practice of NIX in the emergency setting.