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Nurse-led triage of otolaryngology out-patient referrals: an acceptable alternative?

Published online by Cambridge University Press:  02 July 2009

I F Hathorn ,
M L Barnes  and
R E Mountain
I F Hathorn*
Affiliation:
Otolaryngology Department, Ninewells Hospital and Medical School, Dundee, Scotland, UK
M L Barnes
Affiliation:
Otolaryngology Department, Ninewells Hospital and Medical School, Dundee, Scotland, UK
R E Mountain
Affiliation:
Otolaryngology Department, Ninewells Hospital and Medical School, Dundee, Scotland, UK
*
Address for correspondence: Mr Iain Hathorn, ENT Department, Raigmore Hospital, Old Perth Road, Inverness IV2 3UJ, Scotland, UK. Fax: 01463 706028 E-mail: [email protected]
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Abstract

Objectives:

To establish the safety and effectiveness of nurse-led triage of otolaryngology out-patient referrals.

Method:

One hundred consecutive general practitioner referrals were reviewed by two consultants, two specialist registrars, two foundation year two senior house officers and two otolaryngology nurses. One of the nurses had received triage training. All referrals were triaged as ‘urgent’, ‘soon’ or ‘routine’ by each rater.

Results:

The triage-trained nurse's results demonstrated good agreement with those of the senior consultant (80 per cent). This agreement was similar to that with the other consultant (77 per cent) and the specialist registrars (79 and 82 per cent). Weighted κ statistics (correcting for chance agreement) showed that the triage-trained nurse had the second closest agreement to the senior consultant (0.66). After the actual out-patient appointments, retrospective review of the patients' case notes revealed that none had been triaged inappropriately by the trained nurse, and no urgent cases had been missed.

Conclusions:

Triage of out-patient referrals by trained ENT nurses is safe and effective, and is an acceptable alternative to traditional consultant vetting of referrals.

Keywords

Primary Health CareReferral And ConsultationNurse PractitionersOtolaryngology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 10 , October 2009 , pp. 1160 - 1162
Copyright
Copyright © JLO (1984) Limited 2009

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Footnotes

Presented at the Joint Anglo-American Meeting (American Association of Otolaryngology–Head and Neck Surgery and ENT UK), Royal College of Surgeons of Ireland, 6–8 July 2008, Dublin, Ireland.

References

1British Association of Otorhinolaryngologists, Head and Neck Surgeons. Manpower and Workload for Otorhinolaryngology, Head and Neck Surgery. London: British Association of Otorhinolaryngologists, Head and Neck Surgeons 2000Google Scholar
2Inpatient, daycase and outpatient activity. In: http://www.isdscotland.org/isd/4156.html [30 January 2009]Google Scholar
3Hospital episode statistics for England, outpatient statistics, 2006–07. In: http://www.hesonline.nhs.uk/Ease/servlet/ContentServer?siteID=1937&categoryID=894 [30 January 2009]Google Scholar
4Dale, J, Crouch, R, Lloyd, D. Primary care: nurse-led telephone triage and advice out-of-hours. Nurs Stand 1998;12:41–5CrossRefGoogle ScholarPubMed
5Wennike, N, Williams, E, Frost, S, Masding, M. Nurse-led triage of acute medical admissions: accurate and time-efficient. Br J Nurs 2007;16:824–7CrossRefGoogle ScholarPubMed
6Rendell, J. Implementing a nurse-led telephone advice system in ophthalmology. Insight 1999; 24:112–19Google ScholarPubMed
7Patterson, V, Humphreys, J, Chua, R. Email triage of new neurological outpatient referrals from general practice. J Neurol Neurosurg Psychiatry 2004;75:617–20CrossRefGoogle ScholarPubMed
8Rajkumar, GN, Small, DR, Conn, IG. Computerised triage in a prostate assessment clinic. Prostate Cancer Prostatic Dis 2004;7:118–21CrossRefGoogle Scholar
9Altman, DG. Practical Statistics for Medical Research. London: Chapman & Hall/CRC, 1990CrossRefGoogle Scholar
10Fleiss, JL. Statistical Methods for Rates and Proportions, 2nd edn.New York: John Wiley, 1981Google Scholar
11Pothier, DD, Repanos, C. Referral letters: are we prioritising consistently? J Laryngol Otol 2005;119:377–80CrossRefGoogle ScholarPubMed