Researchers identified 1,874 patients attending four NHS hospitals for assessment before surgery. House officers assessed 926 patients and appropriately trained nurses assessed 948 patients. A specialist registrar examined each patient after the nurse or house officer to judge their performance.
Patients faced a one in seven chance of a house officer failing to detect something that might affect their management and a one in eight chance of an appropriately trained nurse doing the same.
Nurses were judged to be non-inferior to house officers, although there was variation among them in terms of the quality of history taking. House officers ordered nearly twice as many unnecessary tests as nurses.
For most hospitals in the United Kingdom there will not be enough house officers to carry out pre-operative assessment, say the authors. However, they conclude that some pre-operative assessment is necessary for their training, and so they cannot be entirely replaced by nurses, even if this is seen as a role within which nurses could develop a career.