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Nurse and Midwife Referral for Radiological Procedures (ONMSD)

The policy for the introducing of nurse referral of ionising radiation originated in the Department of Health and Children (DOHC), to improve patient care in 2007. The current legislation Statutory Instruments (S.I.) No. 256 of 2018, (with amendments S.I. No. 332 and S.I. No. 413 of 2019), which replaces S.I. No. 478 and all its amendments including S.I. No. 303, stipulates the definitions and conditions for medical ionising radiation, including the definition of ‘referrers’. The legislation includes registered nurses and midwives maintained on the register of nurses by the Nursing and Midwifery Board of Ireland (NMBI), as referrers. In practice this legislation authorises a nurse to refer an individual (patient/service user) to a practitioner for medical exposure provided that the nurse has successfully completed an education programme (approved by the NMBI) to prepare for this role.

Nurse and midwife referral practice is underpinned by Irish legislation and associated regulation through the Health Information and Quality Authority (HIQA) and professional regulation through the NMBI. Under S.I. No. 256 of 2018, HIQA is the competent authority for medical ionising radiation procedures with responsibility for inspecting and enforcing these regulations. The HSE has developed governance arrangements for nurse / midwife referral outlined in the HSE National Nurse and Midwife Authority to Refer for Radiological Procedures Guideline 2021 which reflects the legislative, regulatory and professional changes.

Statutory instrument No 30 of 2019 Radiological Protection Act 1991 (Ionising Radiation) Regulations 2019 lays down basic safety standards for protection against the dangers arising from exposure to ionising radiation for workers and the general public

Related Documents

Programme sponsorship

Funding is available for registered nurses who wish to apply to undertake the standalone nurse and midwife referral for radiological procedures education programme to expand their scope of practice. This funding is available to registered nurses employed by the Health Service Executive (HSE) and HSE funded agencies (Section 38) who meet the Higher Education Institutions (HEI) entry criteria.

Related topic

Sponsorship for the Nurse and Midwife Referral for Radiological Procedures Programme

Registration on the National Database of Nurse and Midwife Referrers for Radiological Procedures

All nurses who have successfully completed a Nurse and Midwife Referrers for Radiological Procedures education programme must register on the “HSE National Database of Nurse and Midwife Referrers for Radiological Procedures” The National Database tracks referral activity across all facilities nationwide. The Director of Nursing on behalf of the health service provider must give the final approval and enter the nurse/midwife referrer onto the HSE National Database (see related documents above).

The main purpose of the database is to provide one national searchable database which is accessible by the HSE ONMSD National Lead for Nurse and Midwife Referral for Radiological Procedures.

Retrieved data is used to:

  • Monitor the progress of each nurse funded by the HSE from commencement of the education programme and following registration on the HSE National Database of Nurse and Midwife Referrers for Radiological Procedures.
  • Allow ease of data retrieval to generate standard and drillable reports at local, regional and national level.

Reports on “Nurse Authority to Refer for Radiological Procedures” are generated by using the information from this database. Personal details are not disclosed for these reports. The data is only used for statistical purposes.

Nurses and Midwives with Authority to Refer Patients for Radiological Procedures and who are registered on the national database have restricted access to their own activity on this system.

Clinical Audit

Clinical audits should include the monitoring and evaluation of performance by developing and implementing clinical and non-clinical audits and implementing improvements based on the findings.

Toolkits to support Clinical Audit

Continuing Professional Development (CPD) Day 2023

Please click the links below to access the programme outline and presentations:

CDP Day 2024 Programme Save the Date - 27 June (PDF, size 749 KB, 1 page)

CDP Day 2023 Programme Outline - 8 June and 22 June 2023


Role of the National Lead

The national lead:

  • drives and supports the continued implementation and audit of nurse and midwife referral for radiological procedures nationally
  • supports stakeholders to provide advice and support in the development and evaluation of nurse and midwife referrers for radiological procedures
  • drives continuing professional development for nurse and midwife referrers
  • provides strategic clinical leadership, advice and guidance based on current best practice
  • defines key objectives and identifying action plans including key performance indicators


Dr Maureen Flynn, National Lead for Nurse Referral for Radiological Procedures (interim), ONMSD.
Mobile: 087 931 7014