CHHS13/578

Canberra Hospital and Health ServicesOperational ProcedureNurse Initiated X-Rays (NIX) For Adults & Children – Department of Respiratory and Sleep MedicineContents

Contents....................................................................................................................................1

Purpose.....................................................................................................................................2

Alerts (if applicable)..................................................................................................................2

Scope........................................................................................................................................ 2

Section 1 – Roles and Responsibilities......................................................................................2

Section 2 – Criteria and Procedure for NIX...............................................................................3

Implementation........................................................................................................................ 3

Related Policies, Procedures, Guidelines and Legislation.........................................................4

References................................................................................................................................ 4

Search Terms............................................................................................................................ 5

Doc Number Version Issued Review Date Area Responsible PageCHHS13/578 2.0 Aug 2013 July 2018 Medicine 1 of 4

Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register

CHHS13/578

Purpose

To define staff responsibilities in relation to nurse initiated x-rays (NIX) within the Canberra Hospital, Department of Respiratory and Sleep Medicine (DRSM):

To ensure that designated DRSM nursing staff are appropriately educated/trained to assess patients and appropriately order diagnostic imaging

To enable designated registered nurses with the necessary skills and knowledge to request an x-ray for TB screening and Cystic Fibrosis (CF) patients following an assessment and examination where an x-ray is deemed to be necessary

To minimise waiting times of those patients requiring treatment and to appropriately reduce the patient’s journey for the episode of care

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Scope

The scope allows for a registered nurse working in the Department of Respiratory & Sleep who successfully completes the approved learning package and supervised NIX process to order chest x-rays for:

TB screening – staff surveillance TB screening – student placement TB screening – contact tracing TB screening – TB Health Undertaking TB screening – current TB patients and ongoing care

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Section 1 – Roles and Responsibilities

Authority: For all x-rays ordered by a nurse under according to this procedure, the medical officer responsible for the patient is responsible for the NIX process and will be consulted in relation to any radiographer concerns. All x-ray reports and films/discs must be reviewed by a medical officer.

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Section 2 – Criteria and Procedure for NIX

It is expected that nurses operating is accordance with this procedure will: Consult with a medical officer if there is any doubt or concern or if the patient is a

child <5 years old

Inclusion criteria:

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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register

CHHS13/578

Health Care Workers – staff TB surveillance Contacts of active TB patients – this may include children <5 years of age TB patients for review TB Health Undertaking patients

Exclusion criteria: Any patient who cannot be adequately examined (e.g. intoxicated) Patients who are pregnant, or suspected of being pregnant. A medical officer must

deem the test necessary and appropriate protection for the mother and unborn child provided.

Non-English speaking patients where interpreter services have not been utilised and informed consent cannot be gained.

Children < 18years of age without parent / guardian consent Refusal of patient to undergo the procedure

Nursing responsibilities: Obtain and document the patient’s history relevant to nursing TB assessment Determine inclusion/exclusion criteria for NIX Initiate request for x-ray as per standing orders Document in the patient’s medical record that a nurse initiated x-ray has been

ordered. Keep responsible Medical Officer informed

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Implementation

This procedure will be communicated to staff during orientation and through line managers at staff meetings.

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Related Policies, Procedures, Guidelines and Legislation

Policies Patient Identification and Procedure Matching Policy Consent and Treatment

Procedures CHHS Healthcare Associated Infections Clinical Procedure CHHS Patient Identification and Procedure Matching Procedure

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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register

CHHS13/578

Legislation and Standards Radiation Protection Act 2006 ACT Health Professionals Act 2004 ACT Health Records (Privacy & Access) 2004 ACT National Privacy Principles (NPP) – Privacy Act 1988 (Cth) Public Health Act 1997

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References

Cornforth P 2007 Nurse Practitioner (Primary Care) X-ray Protocol Wandsworth Teaching primary care trust NHS

Calvary Health Care ACT Nurse Initiated X-ray Clinical policy

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Search Terms

X-ray, xray, NIX, DRSM, TB, tuberculosis, respiratory, nurse

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Disclaimer: This document has been developed by ACT Health, Canberra Hospital and Health Services specifically for its own use. Use of this document and any reliance on the information contained therein by any third party is at his or her own risk and Health Directorate assumes no responsibility whatsoever.

Policy Team ONLY to complete the following:Date Amended Section Amended Divisional Approval Final Approval 16/03/2018 Entire document

reviewed for currencyED, Medicine CHHS PC Chair

This document supersedes the following: Document Number Document Name

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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register