[X-ray requests for minor limb injuries. A systematic review]

Area of Science:

• Emergency Medicine
• Radiology
• Nursing Practice

Background:

• Emergency Department (ED) overcrowding leads to prolonged waiting times, negatively impacting patient and staff satisfaction.
• Extended ED stays can increase the risk of adverse events and reduce overall department efficiency.

Purpose of the Study:

• To evaluate if nurses requesting X-rays during triage for isolated injuries improves ED patient flow.
• To assess the impact on length of stay (LOS) and waiting times.
• To determine nurses' satisfaction and the accuracy of X-ray requests.

Main Methods:

• A systematic review adhering to PRISMA guidelines.
• Searched PubMed and CINAHL databases for full-text articles from 1995 onwards.
• Included studies focusing on adult populations with minor limb trauma.

Main Results:

• 14 studies were analyzed, including RCTs, observational, pilot, and quasi-experimental designs.
• Triage nurses requesting X-rays significantly reduced waiting and staying times in the ED.
• Patient and staff satisfaction levels were notably improved.

Conclusions:

• Proactive X-ray requests during triage can effectively decrease ED waiting and length of stay.
• This approach positively influences both patient and nursing staff satisfaction.
• X-ray accuracy is contingent upon nurse education and the utilization of validated tools, such as the Ottawa Ankle Rules.