Is a doctor needed in the adult ENT pre-admission clinic?
OBJECTIVE
Pre-admission clinics are traditionally run jointly by nurses and doctors. Within an adult ENT pre-admission clinic, we wished to assess what doctors added to nurses' pre-clerking, to determine whether doctors were actually needed in the clinic.


METHODS
Prospective study, looking at how often doctors, seeing patients after ward-based nurses, changed or added to clerking or tests as organized by nurses.


RESULTS
Out of 184 patients, doctors changed or added to nurses' clerking or planned investigations in 47 patients (26 per cent), making 64 different changes. The commonest reasons for changes were ordering blood tests (22 changes), chest X-rays (eight), cancelling due to hypertension (seven), altering drug history (five) and requesting electrocardiograms (five changes).


CONCLUSIONS
Most changes made by doctors could be eliminated by designing a pre-admission clinic protocol that could easily be used by nurses. We recommend that all ENT departments consider implementing nurse-led pre-admission clinics.
Daniel
M
M
Department of Otorhinolaryngology / Head & Neck Surgery, Leicester Royal Infirmary, Leicester LE1 5WW, UK. mdaniel@doctors.org.uk
Banerjee
A R
AR
D000328:Adult; D003955:Diagnostic Tests, Routine / Q000379:methods; D006801:Humans; D008505:Medical Staff, Hospital; D009722:Nurse Practitioners; D009741:Nursing Staff, Hospital; D010038:Otorhinolaryngologic Diseases / Q000175:diagnosis*; D010343:Patient Admission; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies