Pre-operative screening: criteria for referring to anaesthetists.
Nurses assess patients pre-operatively using screening questionnaires and locally-developed protocols. Our objectives were to determine which questions might identify patients who should be seen by an anaesthetist before the day of surgery. A review of the literature and a preliminary questionnaire to establish questions to be tested was followed by a modified, two-round Delphi questionnaire to determine the level of agreement by anaesthetists. There was agreement for referring patients who gave a positive response to questions that query: restricted exercise tolerance; previous anaesthetic problems; family history of anaesthetic problem; pathology affecting neck movement; angina; arrhythmia; heart failure; asthma; epilepsy; insulin-dependent diabetes mellitus; liver disease and unspecified kidney disease. There was equivocal agreement on questions that report a myocardial infarction over one year ago, cerebrovascular accident, non insulin-dependent diabetes mellitus and thyroid disease. Nurses should use these criteria during pre-operative assessment to decide the timing of evaluation by an anaesthetist.
Hilditch
W G
WG
University Department of Anaesthesia, Gartnavel General Hospital, 30 Shelley Court, Glasgow G12 OYN, UK.
Asbury
A J
AJ
Crawford
J M
JM
D000776:Anesthesiology / Q000458:organization & administration*; D003697:Delphi Technique; D006801:Humans; D008403:Mass Screening / Q000451:nursing / Q000592:standards; D011300:Preoperative Care / Q000451:nursing* / Q000592:standards; D012017:Referral and Consultation / Q000592:standards*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012606:Scotland; D011795:Surveys and Questionnaires