With all the challenges facing the NHS at the current time, specialist nurses are fundamental and an important part of an ever-expanding NHS workforce. Furthermore, specialist nurses now possess more diversity and a wide range of advanced skills. In the field of rheumatology in most NHS hospitals, specialist nurses play a key role in biologic services to ensure that patients are promptly started on biological therapy to control their disease. An important element of this workup is the ability to comment on an unreported chest radiograph to facilitate a biological prescription. Some studies have shown that there is limited expertise among non-doctors with the required skills to review unreported chest X-rays confidently. The authors of this paper sought to explore whether this is the case among specialist nurses involved in the biologic prescription service among other clinicians in the same service. An online questionnaire was designed by the authors, which included seven questions and responses collected on a 5-point Likert scale. Trainee doctors, non-trainee grade doctors, and specialist nurses who were involved in the biologic prescribing team from Rheumatology, Dermatology, and Gastroenterology were invited. A total of 56 responses were obtained and analyzed. Descriptive and inferential statistics were obtained from the data. To determine if there was a statistical difference between the responses of trainee doctors and specialist nurses, the Kruskal-Wallis statistical test was used, and a post hoc test using the Dunn-Bonferroni test was used to analyze any statistically significant results. Regarding chest X-ray interpretation prior to starting biological treatment, only 8% of specialist nurses reported being confident, whereas 63% of trainees reported being confident. The Kruskal-Wallis test revealed a significant difference between specialist nurses' and doctors' confidence in interpreting unreported chest radiographs. The P-value is 0.001; thus, with available data, the null hypothesis is rejected. A Dunn-Bonferroni test (post hoc test) showed that, based on the available data, it can be assumed that the two groups had different levels of confidence between Specialist Nurses and trainee doctors. Chest X-ray interpretation skills are vital for specialist nurses in the context of biological therapy prescriptions. Therefore, we recommend access to resources, ongoing formal training, and educational sessions to help specialist nurses maintain their advanced skill sets and broaden their scope of practice to those without the required expertise.
Keywords: chest x-ray interpretation; clinical nurse specialist; pre-biologic workup; training for specialist nurses; workforce crisis.
Copyright © 2023, Mohammed Murad et al.