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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: iainhathorn@hotmail.com
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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.

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