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Can nurses apply the Canadian C-Spine Rule? A pilot study

Published online by Cambridge University Press:  21 May 2015

Anne-Maree Kelly ,
Luke Bradshaw  and
Debra Kerr
Anne-Maree Kelly*
Affiliation:
Joseph Epstein Centre for Emergency Medicine Research, Western Health, and The University of Melbourne, Melbourne, Victoria, Australia
Luke Bradshaw
Affiliation:
Advanced Medical Science Program, The University of Melbourne
Debra Kerr
Affiliation:
Joseph Epstein Centre for Emergency Medicine Research, Western Health, and The University of Melbourne
*
Joseph Epstein Centre for Emergency Medicine Research, Western Hospital, Private Bag, Footscray 3011, Australia; 03 8345 6315, fax 03 9318 4790, Anne-Ma ree.Kelly@wh.org.au

Abstract

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Objective:

The aim of this study was to determine the inter-rater agreement between physicians and nurses regarding eligibility for application of the Canadian C-Spine Rule (CCR) and assessment of the criteria of the CCR.

Methods:

In this observational study, nurses and physicians independently assessed the CCR criteria in a convenience sample of patients with potential C-spine injury. Data were entered onto separate data sheets. The outcomes of interest were the inter-rater agreement between nurse and physician regarding eligibility for application of the rule, for assessment of each component of the rule and for interpretation of the rule overall, assessed by kappa analysis.

Results:

In total, 88 cases were eligible for analysis. Physicians and nurses agreed on which patients were eligible for CCR application in 96.6% of cases. Inter-rater agreement for most CCR criteria was good (κ > 0.61), with the exception of midline tenderness (κ = 0.58) and range of motion, which most nurses did not test.

Conclusion:

This study shows that nurses have the potential to reliably apply the Canadian C-Spine Rule but require further training in the assessment of midline tenderness and range of motion.

Keywords

cervical spine clearancenursesCanadian C-Spine Rule
Type
EM Advances • Innovations en MU
Information
Canadian Journal of Emergency Medicine , Volume 6 , Issue 3 , May 2004 , pp. 161 - 164
Copyright
Copyright © Canadian Association of Emergency Physicians 2004

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