Citation

Considine J, Shaban RZ, Curtis K, Fry M. Eur. J. Emerg. Med. 2019; ePub(ePub): ePub.

Affiliation

Northern Sydney Local Health District, University of Technology Sydney, Sydney, New South Wales, Australia.

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/MEJ.0000000000000604

PMID

30920429

Abstract

The aim of this study was to systematically review the literature on the effectiveness of nurse-initiated X-ray for emergency department patients with distal limb injuries. The review protocol was registered with PROSPERO and CINHAL, MEDLINE and EMBASE were searched for studies comparing nurse-initiated vs physician-initiated X-ray. Because of heterogeneity of patients, providers and outcomes, a meta-analysis was not performed. The 16 included studies were conducted between 1971 and 2018 and involved 8881 participants. There were four randomised trials and 12 observational studies that focussed on X-ray request accuracy (n = 14), emergency department processes (n = 6) and patient outcomes (n = 2). The quality of evidence for each outcome ranged from very low-to-moderate. Compared with physician-initiated X-ray, nurse-initiated X-ray uses no more resources, is safe and acceptable to patients. Nurse-initiated X-ray did not reduce time to X-ray or waiting time but in some studies, reduced emergency department length of stay and unplanned follow-up.

Language: en