Journal of Professional Nursing

Nurse practitioner access to radiology and laboratory services

Fiona Unac, RN, MN, Clinical Nurse Specialist, Radiology Department, Hawke’s Bay District Health Board, Hastings
Bob Marshall, PhD, Research Professor, Eastern Institute of Technology, Taradale, Hawke’s Bay
Ruth Crawford, RN, MPhil (Nursing), Principal Lecturer, Eastern Institute of Technology, Taradale, Hawke’s Bay  

Reference:  Unac, F., Marshall, B., & Crawford, R. (2010). Nurse practitioner access to radiology and laboratory services. Nursing Praxis in New Zealand, 26(1), 27-37.

Abstract:

Abstract
With the advent of the New Zealand nurse practitioner (NP) role in 2001, ordering, conducting and interpreting diagnostic and laboratory tests became part of the NP scope of practice. However, anecdotal literature suggests there are national inconsistencies, barriers and limitations for some nurse practitioners in accessing diagnostic services. This paper is a report on a quantitative descriptive survey completed in 2008 exploring NP access to radiology and laboratory services. A purposive sample of all New Zealand registered NPs (as at 1 July 2008) were invited to participate (n=47). The response rate was 79% (n=37). The findings demonstrated some positive trends particularly in accessing laboratory tests, but generally there are barriers, inconsistencies and limitations for NPs when ordering tests. The majority of respondents directly order laboratory tests (75%, n=27) that are processed under their own name. Access to radiology services is variable. Only 44% (n=15) of respondents order plain x-rays/ultrasounds and 9% (n=3) order advanced radiology tests that are processed under their own name. The research highlighted the need for national consistency and improved NP access to radiology and laboratory services.

Keywords
New Zealand nurse practitioner, radiology tests, laboratory tests, barriers

Background
In New Zealand, NPs are the highest level of clinical expert in the nursing profession. They are educationally prepared at Masters degree level (or equivalent) and they have a minimum of four years experience in their specialty scope (Nursing Council of New Zealand, 2002). NPs are required to practice within the legal boundaries of the NP scope of practice as well as demonstrating meeting NP competencies. This scope includes ordering, conducting and interpreting diagnostic and laboratory tests. However, the literature suggests inconsistencies in NPs access to diagnostic testing. Some NPs have been able to access diagnostic ........

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