The accuracy of paediatric limb radiograph interpretation by nurse practitioners in a single centre

•There is limited research assessing the ability of NPs interpreting paediatric X-rays.•The study compared the accuracy between NPs and consultant radiologists.•A total of 242 (82%) of radiographs were correctly identified by NPs.•The sensitivity of the NP limb radiographic interpretation was 92%, with a specificity of 78%. Nurse practitioners (NP) are an integral part of the urgent and emergency care workforce in the United Kingdom providing safe and effective care. Despite this, there is limited research assessing the ability of NPs to correctly interpret isolated paediatric limb injury radiographs in the urgent and emergency care environment. The aim of this study was to compare the accuracy in interpreting isolated paediatric limb radiographs between NPs and consultant radiologists. A nurse-led urgent care centre (UCC) in central London, United Kingdom. 296 paediatric patients with isolated limb injuries who had a radiograph requested and interpreted by an NP. Thirteen NPs (adult registered) with various backgrounds and qualifications participated in this prospective, single-centre healthcare analysis. Review of all clinical presentations at the UCC over a 3-month period (September–November 2017) identified 296 paediatric patients (aged 2–15) who received a peripheral limb radiograph. Clinical records for each patient were analysed to document demographics, mechanism of injury, NP examination findings, radiographic interpretation and formal radiologist report. NP interpretation of each radiograph was classified as definite fracture, possible fracture or no fracture. This was compared to the final radiologist report (considered the gold standard) to calculate the sensitivity and specificity of NP radiograph interpretation. NPs reported a total of 94 radiographs (32%) as definite fracture, 176 (59%) as no fracture and 26 (9%) as possible fracture, as compared to radiologists at 71 (24%), 218 (74%) and 7 (2%). A total of 242 (82%) of radiographs were correctly identified by NPs, while 54 (18%) were incorrectly interpreted. The sensitivity of the NP limb radiographic interpretation was 92%, with a specificity of 78%. The findings validate the clinical and diagnostic skills of NPs in the interpretation of isolated paediatric limb radiographs.