Article
A pilot randomised controlled trial of medical versus nurse
clerking for minor surgery
Helen Rushfortha, Alison Blissc, David Burgeb, Edward Alan Glaspera
a University of
Southampton School of Nursing and Midwifery, Level B, South Block,
Southampton General Hospital, Southampton SO16 6YD, UK, b Department of
Child Health, Southampton General Hospital, c Shackleton Department of Anaesthetics,
Southampton General Hospital
Correspondence to: Ms Rushforth email: her{at}soton.ac.uk
Accepted 4 May 2000
BACKGROUND
Nurse led clerking is
currently practiced in a growing number of UK centres, but there is a
paucity of evidence to underpin the safety of this innovation.
AIMTo assess the safety of nurse
led clerking in paediatric day case and minor surgery.
METHODSChildren aged 3 months to
15 years were randomly assigned to clerking by either a nurse or a
senior house officer (SHO) (resident). All children were then
independently reassessed by a specialist registrar anaesthetist to
provide a "gold standard" against which practitioner performance
could be judged.
RESULTSIn 60 children studied,
nurses identified a significantly greater proportion of the detectable
abnormalities present in the sample (p = 0.16). This difference is
attributable to nurses' greater accuracy in history taking
(p = 0.04); no conclusions regarding the comparability of nurses'
and SHOs' skills in physical examination can be derived from the
current study.
CONCLUSIONEvidence attests to the
likelihood of nursing having superior skills in history taking to SHOs.
Exploration of nursing safety in undertaking physical examination,
however, requires the conduct of a large scale equivalence study. Only
then can conclusions be drawn as to whether nurse led physical
assessment offers children a standard of care equivalent to that which
they currently receive from SHOs.
Keywords: nurse led; clerking; preoperative assessment; equivalence
© 2000 by Archives of Disease in Childhood
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Arch. Dis. Child. 2000 83: 0.[Extract] [Full Text] [PDF]
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