A pilot randomised controlled trial of medical versus nurse clerking for minor surgery.
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.


OBJECTIVE
To assess the safety of nurse led clerking in paediatric day case and minor surgery.


METHODS
Children 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.


RESULTS
In 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.


CONCLUSIONS
Evidence 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.
Rushforth
H
H
University of Southampton School of Nursing and Midwifery, Level B, South Block, Southampton General Hospital, Southampton SO16 6YD, UK. her@soton.ac.uk
Bliss
A
A
Burge
D
D
Glasper
E A
EA
D000293:Adolescent; D000556:Ambulatory Surgical Procedures / Q000592:standards; D002648:Child; D002662:Child Health Services / Q000592:standards; D002675:Child, Preschool; D002983:Clinical Competence; D004739:England; D006801:Humans; D007223:Infant; D008487:Medical History Taking; D008505:Medical Staff, Hospital / Q000592:standards*; D013511:Minor Surgical Procedures / Q000592:standards; D009726:Nurses / Q000592:standards*; D010865:Pilot Projects; D011300:Preoperative Care / Q000592:standards; D011787:Quality of Health Care