Should nurses be allowed to request X-rays in an accident & emergency department?

A prospective study was carried out during the month of November, 1990 in the A&E Department, St John's Hospital, Livingston in order to assess the extended role of the A&E nurse and their ability to request X-rays prior to patients being seen by a doctor. A total of 579 randomly selected patients were triaged by A&E Department nurses. Almost 3/4 of these patients were X-rayed at the request of the triage nurse. Less than 7% of these X-rays were considered to have been unnecessary by the doctor who subsequently managed the patient. Of those patients who had an X-ray after seeing a doctor, more than 90% fell within the X-ray triage criteria but had not had an X-ray requested by the triage nurse. Overall, nurses were shown to request X-rays correctly and efficiently with the result that patients had to spend less time in the A&E Department.