This week’s content addresses common techniques and testing that can be prescribed by the Nurse

Practitioner. Please Review ONE of the following videos and post for the class what you have learned this
week after reviewing.

Watch the following video on suturing or on appropriate ordering of imaging:

 Suture Skills Course - Learn Best Suture Techniques

o OR

 Ordering the most appropriate imaging test- Appropriateness

criteria https://acsearch.acr.org/list

Radiology is a very helpful tool to rule out diagnosis or find the root of problems that are

hidden to the naked eye. While it is useful in very many instances, there is a large risk in overuse

of this tool and can lead to unnecessary radiation or waste of resources. (Oren, et. Al., 2019) The

attached link helps to differentiate between useful tools or decide which imaging tools are

needed in which circumstances. There are several campaigns to use low value and to be more

judicious in the ordering of radiology tests, laboratory tests, and medications to make it easier for

patients to receive care at a lower price and relying more on clinical presentation and use critical

thinking to treat illness and injury. However, these campaigns are not effective in discontinuing

the wasteful ordering for patients. (Cliff, et. Al., 2021)

For radiation exposure, nurse practitioners need to be aware of the history of the patient

as well as age. This makes a large difference in radiation exposure. More evidence has come out

that radiation is not as benign as originally thought. Some researchers compare it as “controlled

substances” and should be used on rare occasions to reduce repeated imaging and exposure to

toxic waves. (Brower & Rehani, 2021) One could alter radiation to a ultrasound, if possible or

one with less radiation involved. These are often more expensive, however. Therefore, tools such

as the test appropriateness criteria are much needed as new nurse practitioners. As new

providers, yet nurses, we understand what information that certain radiology tests can provide.

Now, armed with the provider role, there needs to be a shift in mindset to realize when we can
use other resources or special orthopedic test (ie. Empty can test) or in case of internal organs

(Murphy’s point).

References:

Brower, C., & Rehani, M. M. (2021). Radiation risk issues in recurrent imaging. The British journal of

radiology, 94(1126), 20210389. https://doi.org/10.1259/bjr.20210389

Cliff, B. Q., Avancena, A. L., Hirth, R. A., & LEE, S. Y. D. (2021). The Impact of Choosing Wisely

Interventions on Low‐Value Medical Services: A Systematic Review. The Milbank

Quarterly, 99(4), 1024-1058. https://doi.org/10.1111/1468-0009.12531

Oren, O., Kebebew, E., & Ioannidis, J. P. (2019). Curbing unnecessary and wasted diagnostic

imaging. Jama, 321(3), 245-246. doi:10.1001/jama.2018.20295