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Developing a clinical guideline supporting nurse practitioner requesting computerized tomography scans via consensus methodology.

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Τίτλος: Developing a clinical guideline supporting nurse practitioner requesting computerized tomography scans via consensus methodology.
Συγγραφείς: Craswell A; University of Sunshine Coast (UniSC), School of Health, Sippy Downs, QLD, Australia; Sunshine Coast Health Institute, QLD, Australia; Metro North Hospital and Health Service-Caboolture, Woodford Hospitals, Kilcoy, QLD, Australia. Electronic address: acraswel@usc.edu.au., Peet J; University of Sunshine Coast (UniSC), School of Health, Sippy Downs, QLD, Australia; Metro North Hospital and Health Service-Caboolture, Woodford Hospitals, Kilcoy, QLD, Australia. Electronic address: jpeet2@usc.edu.au., Cowen A; Metro North Hospital and Health Service-Caboolture, Woodford Hospitals, Kilcoy, QLD, Australia. Electronic address: Aleeta.Cowen@health.qld.gov.au., Charters D; Metro North Hospital and Health Service-Caboolture, Woodford Hospitals, Kilcoy, QLD, Australia. Electronic address: Dimple.Charters@health.qld.gov.au., Watts S; Metro North Hospital and Health Service-Caboolture, Woodford Hospitals, Kilcoy, QLD, Australia. Electronic address: Stacey.Watts@health.qld.gov.au.
Πηγή: Australasian emergency care [Australas Emerg Care] 2026 Sep; Vol. 29 (3), pp. 250-257. Date of Electronic Publication: 2026 Feb 10.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Published by Elsevier Ltd on behalf of College of Emergency Nursing Australasia Country of Publication: Australia NLM ID: 101727782 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2588-994X (Electronic) Linking ISSN: 2588994X NLM ISO Abbreviation: Australas Emerg Care Subsets: MEDLINE
Imprint Name(s): Original Publication: [Chatswood, NSW] : Published by Elsevier Ltd on behalf of College of Emergency Nursing Australasia, [2018]-
Ιατρικοί όροι (MeSH): Nurse Practitioners*/trends , Nurse Practitioners*/standards , Nurse Practitioners*/statistics & numerical data , Tomography, X-Ray Computed*/methods , Tomography, X-Ray Computed*/statistics & numerical data , Tomography, X-Ray Computed*/standards , Consensus* , Practice Guidelines as Topic*, Emergency Service, Hospital/organization & administration ; Emergency Service, Hospital/statistics & numerical data ; Humans ; Surveys and Questionnaires
Περίληψη: Background: Predicted nurse shortages internationally call for nurses to work at their full scope of practice. Nurse practitioners recommending computerised tomography imaging require medical signoff impacting emergency department flow. We aimed to develop a clinical guideline to support nurse practitioner-led requesting of computerised tomography scans for adults presenting to emergency department ambulatory care at a regional hospital.
Methods: We used a RAND/UCLA appropriateness method over two phases. Literature from a detailed review using a systematic process was extracted and synthesized into categories and shared via an online survey platform for phase one. Aggregated votes and comments were re-shared in summary before phase two, a face-to-face meeting of expert stakeholders.
Results: Five experts anonymously participated in phase one, and six contributed to the phase two meeting. Phase one agreement on appropriateness on the three literature generated topics ranged between 60 % and 80 %. Concerns about the need for emergency departments to be strategic with resources and fears of risk of increase in radiation exposure to patients were raised. In phase two, seven of the proposed eight items reached consensus (83 %-100 %).
Conclusion: The agreed guideline supporting nurse practitioner ordering of computerised tomography scans provides a pathway to improve ambulatory care flow for patients with specific conditions.
(Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Competing Interests: Declaration of Competing Interest No conflict of interest to declare
Contributed Indexing: Keywords: Ambulatory care; Computerized tomography (CT) scan; Consensus method; Emergency department; Fast track; Nurse practitioner; Radiology/imaging; Scope of practice
Entry Date(s): Date Created: 20260211 Date Completed: 20260814 Latest Revision: 20260814
Update Code: 20260815
DOI: 10.1016/j.auec.2026.02.001
PMID: 41672836
Βάση Δεδομένων: MEDLINE
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  Data: Developing a clinical guideline supporting nurse practitioner requesting computerized tomography scans via consensus methodology.
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  Data: <searchLink fieldCode="AU" term="%22Craswell+A%22">Craswell A</searchLink>; University of Sunshine Coast (UniSC), School of Health, Sippy Downs, QLD, Australia; Sunshine Coast Health Institute, QLD, Australia; Metro North Hospital and Health Service-Caboolture, Woodford Hospitals, Kilcoy, QLD, Australia. Electronic address: acraswel@usc.edu.au.<br /><searchLink fieldCode="AU" term="%22Peet+J%22">Peet J</searchLink>; University of Sunshine Coast (UniSC), School of Health, Sippy Downs, QLD, Australia; Metro North Hospital and Health Service-Caboolture, Woodford Hospitals, Kilcoy, QLD, Australia. Electronic address: jpeet2@usc.edu.au.<br /><searchLink fieldCode="AU" term="%22Cowen+A%22">Cowen A</searchLink>; Metro North Hospital and Health Service-Caboolture, Woodford Hospitals, Kilcoy, QLD, Australia. Electronic address: Aleeta.Cowen@health.qld.gov.au.<br /><searchLink fieldCode="AU" term="%22Charters+D%22">Charters D</searchLink>; Metro North Hospital and Health Service-Caboolture, Woodford Hospitals, Kilcoy, QLD, Australia. Electronic address: Dimple.Charters@health.qld.gov.au.<br /><searchLink fieldCode="AU" term="%22Watts+S%22">Watts S</searchLink>; Metro North Hospital and Health Service-Caboolture, Woodford Hospitals, Kilcoy, QLD, Australia. Electronic address: Stacey.Watts@health.qld.gov.au.
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  Data: <searchLink fieldCode="JN" term="%22101727782%22">Australasian emergency care</searchLink> [Australas Emerg Care] 2026 Sep; Vol. 29 (3), pp. 250-257. <i>Date of Electronic Publication: </i>2026 Feb 10.
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  Data: <i>Original Publication</i>: [Chatswood, NSW] : Published by Elsevier Ltd on behalf of College of Emergency Nursing Australasia, [2018]-
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  Data: Background: Predicted nurse shortages internationally call for nurses to work at their full scope of practice. Nurse practitioners recommending computerised tomography imaging require medical signoff impacting emergency department flow. We aimed to develop a clinical guideline to support nurse practitioner-led requesting of computerised tomography scans for adults presenting to emergency department ambulatory care at a regional hospital.<br />Methods: We used a RAND/UCLA appropriateness method over two phases. Literature from a detailed review using a systematic process was extracted and synthesized into categories and shared via an online survey platform for phase one. Aggregated votes and comments were re-shared in summary before phase two, a face-to-face meeting of expert stakeholders.<br />Results: Five experts anonymously participated in phase one, and six contributed to the phase two meeting. Phase one agreement on appropriateness on the three literature generated topics ranged between 60 % and 80 %. Concerns about the need for emergency departments to be strategic with resources and fears of risk of increase in radiation exposure to patients were raised. In phase two, seven of the proposed eight items reached consensus (83 %-100 %).<br />Conclusion: The agreed guideline supporting nurse practitioner ordering of computerised tomography scans provides a pathway to improve ambulatory care flow for patients with specific conditions.<br /> (Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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  Data: Declaration of Competing Interest No conflict of interest to declare
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  Data: <i>Keywords: </i>Ambulatory care; Computerized tomography (CT) scan; Consensus method; Emergency department; Fast track; Nurse practitioner; Radiology/imaging; Scope of practice
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