Exactitud de la valoración preoperatoria por parte del enfermero y del médico residenteuna revisión sistemática

Zusammenfassung

Objectives: (1) To determine the accuracy of the nurse and the Senior House Officer for the preoperative assessment, contrasted by the anaesthesiologist as the gold standard so as to discriminate the adequacy of people for surgery, and (2) To explore the sources of heterogeneity on the studies. Methods: Design: Sistematic review of research articles about preoperative assessment. Databases: CUIDEN, IME, CINAHL, LILACS, EMBASE, MEDLINE, ISI Proceedings, Google Scholar y Cochrane Library. The statistical analysis was performed by the software METADISC. Results: 2 articles found which evaluated the preoperative assessment performed by nurses. None of them studied the preoperative assessment performed by senior house officers. No articles were found which justify the use of the anaesthesiologist as a gold standard. There is a great heterogeneity between the sensitivity results of the articles found. This situation stops the data aggregation for the analysis. The best sensitivity and specificity data found were 83 and 87.3%, respectively. Conclusion: The accuracy of the Senior House Officer for the preoperative assessment is unknown. Considering the unknown validity and reliability of the anaesthesiologist as a gold standard, the best accuracy data found of the nurse for the preoperative assessment is limited to guarantee the perioperative safety, without interfering with other roles of the nurse related to the pre and postoperative care.