Nurse-led paediatric pre operative assessment: an equivalence study

AIM: to explore whether nurses can undertake the pre operative assessment of children prior to day case surgery as safely as senior house officers. DESIGN: a randomised controlled trial involving 595 children, using an equivalence methodology (a method which looks for similarity rather than a significant difference). Pre-operative assessment prior to day case surgery was randomised to either a nurse (experimental group) or a junior doctor (control group). Blinded expert verification of nurse/junior doctor performance was ascertained by an experienced anaesthetist (the 'gold standard'). RESULTS: there was equivalence between nurses and senior house officers in their ability to detect clinically significant abnormalities within the sample population. Subgroup analysis also demonstrated equivalence in respect of history taking abilities. The smaller number of clinically significant physical findings within the sample meant that equivalence in respect of physical examination remains uncertain. Although the study was limited to a single setting, the results demonstrate nurses' equivalence with junior doctors in a discrete paediatric context.