An audit of paediatric fever in NHS Direct: consistency of advice by nurses using computerised decision support software systems

Three written scenarios, based on paediatric fever, with expected outcomes of self‐care (scenario 1), GP routine care (scenario 2) and urgent care (scenario 3), were presented to 100 nurse advisors working in NHS Direct, the 24‐hour nurse‐led telephone helpline. Nurse advisors used one of three types of computerised decision support software to determine an outcome for each scenario, and in addition offered self‐care advice. There was variation between nurses in the outcomes for each scenario: 80 per cent of nurse advisors recommended self‐care only for scenario 1, 51 per cent recommended GP routine care for scenario 2, and 88 per cent recommended urgent care for scenario 3. Similar variations were found for the self‐care advice.