EMERGENCY NURSE PRACTITIONER SERVICES IN MAJOR ACCIDENT AND EMERGENCYDEPARTMENTS - A UNITED-KINGDOM POSTAL SURVEY

Objective--To establish the current and predicted distribution of form al emergency nurse practitioner services in major accident and emergen cy departments in the United Kingdom; to determine organisational vari ations in service provision, with specific reference to funding, role configuration, training, and scope of clinical activity. Methods--Post al survey of senior nurses of all major accident and emergency departm ents in the United Kingdom (n = 293) in May/June 1996. Results--There were 274 replies (94% response rate): 98 departments (36%) provided a formal service; a further 91 departments (33%) reported definite plans to introduce a service by the end of 1996; smaller departments, under 40,000 new patient attendances annually, were less likely to provide a service than busier units (p < 0.001, chi(2) for trend). Three diffe rent methods of making the role operational were identified: dedicated , integrated, and rotational. Only 16 (18%) were able to provide a 24 hour service; 91 departments (93%) employed emergency nurse practition ers who had received specific training, but wide variations in length, content, and academic level were noted; 82 departments (84%) authoris ed nurse practitioners to order x-rays independently, but only 35 (36% ) allowed them to interpret radiographs; 67 (68%) permitted ''over the counter'' drug supplying under local protocol, and 52 (54%), ''prescr iption only'' drug supplying from an agreed list. Conclusions--Formal emergency nurse practitioner services are provided in all parts of the United Kingdom, with predicted figures suggesting a rapidly accelerat ing upward trend. Wide variations in service organisation, training, a nd scope of activity are evident.