Ionising radiation in urology: consideration of individuals of childbearing age

Nurse prescribing of medical ionising radiation (X-ray) in Ireland has been in place since 2007 when legislation (electronic Irish Statute Book (eISB), 2017) was enacted to enable nurses to take on this expanded role. Following this, the Nurse and Midwifery Board of Ireland (NMBI) introduced the ‘Requirement and Standards for Nurse Education Programmes for Authority to Prescribe Ionising Radiation (X-ray)’ (NMBI, 2008). In line with recent legislative changes the term ‘prescriber’ is now replaced with ‘referrer’ (eISB, 2018).

Establishing this significant shift in nursing practice involved a multidisciplinary, collaborative approach, both locally and nationally. This enabled the development of robust systems of clinical governance to facilitate nurses to refer patients for X-rays while adhering to their scope of practice (NMBI, 2015). The aim of nurse referral for X-rays is to improve timely, efficient and effective access to care, leading to improved patient flow and satisfaction (Health Service Executive (HSE), 2009). An independent evaluation of the initiative in Ireland highlighted that nurse referrers of X-rays are suitably prepared for the role and refer for ionising radiation appropriately and effectively, and clearly identified the positive impact on patients (Drennan et al, 2014). However, a study related to the independent evaluation reported that nurses had greater confidence in their own profession's competence in ionising radiation referral when compared to physicians and radiographers (Hyde et al, 2016).