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

Alison Craswell; Jacqueline Peet; Aletta Cowen; Dimple Charters; Stacey Watts

doi:10.1016/j.auec.2026.02.001

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

Journal article

Open access

Peer reviewed

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

Alison Craswell, Jacqueline Peet, Aletta Cowen, Dimple Charters and Stacey Watts

Australasian Emergency Care, Vol.Advanced access

10-Feb-2026

DOI: https://doi.org/10.1016/j.auec.2026.02.001

PMID: 41672836

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Abstract

Ambulatory care

Computerized tomography (CT) scan

Consensus method

Emergency department

Fast track

Nurse practitioner

Radiology/imaging

Scope of practice

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.

Details

Title: Developing a clinical guideline supporting nurse practitioner requesting computerized tomography scans via consensus methodology
Authors: Alison Craswell (Corresponding Author) - University of the Sunshine Coast
Jacqueline Peet - University of the Sunshine Coast
Aletta Cowen - Metro North Health (Australia)
Dimple Charters - Metro North Health (Australia)
Stacey Watts - Metro North Health (Australia)
Publication details: Australasian Emergency Care, Vol.Advanced access
Publisher: Elsevier Ltd
DOI: 10.1016/j.auec.2026.02.001
ISSN: 2588-994X
PMID: 41672836
Copyright note: © 2026 The Author(s). Published by Elsevier Ltd on behalf of College of Emergency Nursing Australasia. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Grant note: This study was funded by a Novice research grant from The Common Good, The Prince Charles Hospital Foundation, CKW2022-10.
Organisation Unit: Healthy Ageing Research Cluster; School of Health - Nursing
Language: English
Record Identifier: 991214551302621
Output Type: Journal article

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