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Does Nurse-Led Pre-operative Assessment Reduce the Cancellation Rate of Elective Surgical In-Patient Procedures?: A Systematic Review of the Research Literature

Published online by Cambridge University Press:  15 August 2005

Sarah E. Craig
Sarah E. Craig
Affiliation:
Pre-operative Assessment Clinic, Chelsea and Westminster Hospital NHS Trust, London, UK
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Abstract

Pre-operative assessment (POA) has been advocated for use to achieve a number of goals including reducing cancelled operations on the day of surgery, and therefore waiting lists. POA has historically been provided by junior doctors, but the change in focus of their role in addition to the new roles being taken on by nurses has led to nurse-led POA. The aim of this review was to determine whether nurse-led POA reduces the cancellation rate of elective surgical in-patient procedures. The Cochrane Library, Medline, Cinahl and Embase databases were searched for systematic reviews, randomised control trials and cohort studies examining nurse-led POA. After applying inclusion criteria only four cohort studies were deemed to be suitable to be critically appraised. One study had no cancellations in either the doctor or nurse-led POA groups. Another study had low cancellation rates in the nurse-led POA group, but the control group was not suitably defined for adequate verification as to whether the cancellation rates were lower because they had been pre-assessed. The final two studies revealed similar absolute risk reductions, number needed to treat and odds ratios. In summary nurse-led POA appears to reduce cancellation rates on admission, but the evidence for this is relatively weak, primarily because study samples have been small. Further trials are needed which have samples that are sufficient to detect a true difference between the intervention and control group if one exists.

Keywords

Systematic reviewPre-operative assessmentNurse-ledCancellation ratesElective surgical in-patients
Type
Original Article
Information
British Journal of Anaesthetic & Recovery Nursing , Volume 6 , Issue 3 , September 2005 , pp. 41 - 47
Copyright
© 2005 Cambridge University Press

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References

REFERENCES

Altman D. Practical Statistics for Medical Research. London: Chapman and Hall, 1991.
Barnes PK, Emerson PA, Hajnal S, Radford WJP, Congleton J. Influence of an anaesthetist on nurse-led, computer-based, pre-operative assessment. Anaesthesia 2000; 55: 576–589.Google Scholar
Bramhall J. The role of nurses in pre-operative assessment. Nursing Times 2002; 98 (40): 34–35.Google Scholar
Casey D, Omrod G. The effectiveness of nurse-led surgical pre-assessment clinics. Professional Nurse 2003; 18 (12): 685–687.Google Scholar
Craig JV, Smyth RL. The Evidence-Based Practice Manual for Nurses. London: Churchill Livingstone, 2002.
DoH . The NHS Plan: A Plan for Investment, A Plan for Reform. London: DoH, 2000.
Easterbrook PJ. Basic Medical Sciences for MRCP Part 1 (2nd edn). London: Churchill Livingstone, 1999.
Golubtsov BV, Di Paola M, Baldwin E, McCall L. Pre-operative orthopaedic assessment clinic for major joint replacement operations: an assessment of value. Health Bulletin 1998; 56 (3): 648–652.Google Scholar
Greenhalgh T. How to Read a Paper – The Basics of Evidence Based Medicine. London: BMJ Books, 2001.
Greenhalgh T, Donald A. Evidence Based Health Care Workbook. London: BMJ Publishing Group, 2000.
Jones A, Penfold P, Bailey M, Charig C, Choolun D, Rollin A-M. Pre-admission clerking of urology patients by nurses. Professional Nurse 2000; 15 (4): 261–266.Google Scholar
Kerridge R, Lee A, Latchford E. The perioperative system: a new approach to managing elective surgery. Anaesthesia and Intensive Care 1996; 23 (5): 591–596.Google Scholar
Livingstone J, Harvey M, Kitchin N, Shah N, Wastell C. Role of pre-admission clinics in a general surgical unity: a 6-month audit. Annals of the Royal College of Surgeons 1993; 75: 211–212.Google Scholar
McKibbon A, Eady A, Marks S. PDQ Evidence-Based Principles and Practice. Hamilton: BC Decker Inc, 1999.
Newton V. Care in pre-admission clinics. Nursing Times 1996; 92 (1): 27–28.Google Scholar
National Institute for Clinical Excellence. Pre-operative Tests: The Use of Routine Pre-operative Tests for Elective surgery, 2003. Available at: www.nice.org.uk
NHS Management Executive. Junior Doctors: The New Deal. London: NHSME, 1991.
Rai MR, Pandit JJ. Day of surgery cancellations after nurse-led pre-assessment in an elective surgical centre: the first 2 years. Anaesthesia 2003; 58: 692–711.Google Scholar
Reed M, Wright S, Armitage F. Nurse-led general surgical pre-operative assessment clinic. The Royal College of Surgeons of Edinburgh 1997; 42: 310–313.Google Scholar
Sackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB. Evidence Based Medicine. London: Churchill Livingstone, 2000.
Tibble J, Przemioslo R. Pre-assessment for colonoscopy reduces non-attendance rates. Gut 1999; 44 (Suppl. 1): 15A.Google Scholar
UKCC. The Scope of Professional Practice. London: UKCC, 1992.
Walsgrove H. Piloting a nurse-led gynaecology pre-operative-assessment clinic. Nursing Times 2004; 100 (3): 38–41.Google Scholar
Whiteley MS, Wilmott K, Galland RB. A specialist nurse can replace pre-registration house officers in the surgical pre-admission clinic. Annals of the Royal College of Surgeons of England 1997; 79 (Suppl.): 257–260.Google Scholar