A nurse-led gynaecology emergency assessment service

A gynaecology emergency assessment unit was established because an increasing number of women were being referred to the gynaecology ward for assessment. On average 180 women a month are assessed at the unit and there is potential for that number to increase. An audit has revealed that only 7.2% of women seen in the unit required admission, the remainder being suitable for treatment as outpatients. Before the unit was established it was normal practice for any referrals to be automatically admitted until the junior doctor on call could assess them and decide an appropriate care plan.     

Effectiveness of a nurse-led pregnancy termination clinic

A new nurse-led service was developed for women requesting pregnancy termination. Compared with the previous service, the nurse-led clinic reduced waiting times and cost almost 40 per cent less.     

Development of a nurse-led skin camouflage clinic

This article outlines the development of an outpatient skin camouflage service and summarises findings from an audit of the service after one year, which resulted in the clinic expanding to a monthly all-day session.     

Development of a nurse-led ileo-anal pouch clinic

The ileo-anal pouch procedure is now seen as the operation of choice for individuals suffering with ulcerative colitis or familial adenomatous polyposis (Fazio, 1999); however, patient follow-up after this surgery remains variable. This article highlights the effectiveness of running a nurse-led follow-up service. A patient satisfaction survey has shown that having a familiar face at each follow-up visit is hugely beneficial, providing continuity and reassurance for patients and their relatives. This nurse-led clinic provides adequate time for patients to discuss a variety of issues including management of sore perianal skin and pouch dysfunction. The growth and development in clinical skills, knowledge and nursing autonomy has seen the emergence of many nurse-led clinics, where nurses are utilizing their advanced skills. Within the nurse-led ileo-anal pouch clinic in Oxford, physical and/or internal examination, and investigations, such as rigid or flexible pouchoscopy, are performed. Such procedures were positively evaluated by patients.     

Patient satisfaction in a nurse-led rheumatology clinic

Patient satisfaction with a nurse-led rheumatology clinic was tested using the Leeds Satisfaction Questionnaire (LSQ), which was specially developed and shown to be both reliable (Cronbach's alpha, 0.96) and stable (test-re-test r = 0·83). A total of 70 patients with rheumatoid arthrists, aged 22–75 years were randomly allocated to either a nurse's or a rheumatologist's clinic and seen on six occasions over a year. They completed the LSQ on entry and there were no significant differences between them. By week 48 the medical cohort showed significantly increased satisfaction with access and continuity ( P < 0.05) but no change in overall satisfaction. The patients in the nurse-led clinic recorded significant increases in overall satisfaction and in all subscales ( P < 0.0001). Between-group comparison at week 48 showed the nurse's patients to be significantly more satisfied than those of the rheumatologist.     

The development of a nurse-led outpatient orthopaedic clinic

In the past 18 months nurses at the orthopaedic outpatients department at Harrogate District Hospital have radically transformed their roles by developing a nurse-led joint replacement follow-up clinic. This clinic, initiated in response to both local and national developments, has led to increased nurse autonomy as well as a demonstrable improvement in patient services.     

How a nurse-led clinic cut outpatient waiting times

Joe Annandale describes how changing the respiratory nurse specialist role can improve outpatient waiting times and meet patients' needs.     

The benefits of a nurse-led preoperative assessment clinic

OPAC has proved itself a valuable service, not only to patients but also in ensuring the efficient management of these patients' care throughout their contact with the hospital. It has been shown that a registered nurse is able to use this service as a means of identifying a variety of problems that can affect patient admission and use this foresight to alleviate patient concerns, plan to enable early discharge and minimise lost and disrupted theatre times. This post has since become a regular provision within the orthopaedic service, funded by the trust, and is a routine service provided to all orthopaedic patients due to undergo elective orthopaedic surgery. In addition, the clinic monitors waiting lists and removes those patients who no longer require or wish to have surgery. Quality care is provided promptly and efficiently on a one-to-one basis and patients experience minimum disruption due to the centralisation of clinic services. Nurse-led clinics appear more cost-effective as they employ a senior nurse instead of a consultant or anaesthetist and this is achieved without losing the quality of patient care. In the new, modern and dependable NHS, nurse-led clinics are the way forward.     

The development of a nurse-led complex wound clinic

This article describes the development of a nurse-led complex wound clinic in Lincolnshire in April 2003, and describes one patient's experience of the service. It also explores the benefits of collaborative initiatives that have the potential to improve patient outcomes.     

Meeting the information needs of women with breast cancer: Piloting a nurse-led intervention

This study evaluated a telephone intervention, administered by specialist breast care nurses, that aimed to meet the information needs of women with breast cancer. The intervention was developed from previous work that examined priority information needs. Participants were allocated to a telephone intervention (n = 67) or control group (n = 68). Data were collected by means of semi-structured interviews with participants at two time points (3 months and 8-12 months post-diagnosis) and focused on patient satisfaction with sources of information, information needs and psychological morbidity. Interviews were also conducted with breast care nurses to ascertain their views on administering the intervention. The intervention group reported fewer physical problems at Time 2 and were more likely to have had their information needs met than women in the control group. The control group were more likely to utilise media sources of information at Time 2 whereas women in the intervention group reported breast care nurses as their most prominent source of information. There were no significant differences in psychological morbidity between the two study groups. The findings indicate that the intervention is a feasible and acceptable approach to meeting the information needs of women with breast cancer. Further research is required to evaluate the intervention in a randomised controlled trial.     

A patient satisfaction survey of a nurse-led colorectal clinic

A new service was set up to achieve government targets to see patients with signs or symptoms of a possible colorectal cancer within two weeks of referral from their GP. The new clinics were nurse-led. A patient satisfaction survey was used to assess patients' opinions about the clinic. The results showed patients had a positive view of the clinic.     

A regional nurse-led osteoporosis clinic.

This article describes the work of a nurse-led osteoporosis clinic and its perceived benefits to both patients and staff.     

Running a nurse-led nebulizer clinic in a district general hospital

The widespread home use of nebulizers for delivering bronchodilating medication in patients with a variety of respiratory conditions is well documented, as is the lack of appropriate assessment before this form of treatment is prescribed (Cochrane et al, 1985). When it is considered that the use of nebulizers at home is increasing (Drug Information Bulletin, 1994), it is essential that appropriate assessment is undertaken in line with British Thoracic Society recommendations in order to ensure that the degree of benefit is sufficient to justify the inconvenience, potential dangers and high cost of nebulizer therapy in the home. This article examines a nurse-led nebulizer assessment clinic that was set up as part of a service for providing home nebulization for long-term use in patients with chronic obstructive pulmonary disease or chronic severe asthma.     

Setting up a community nurse-led healed leg ulcer clinic

The success of compression therapy and emphasis on healing rates of venous ulcers in studies has shifted the emphasis from prevention to cure. Venous insufficiency is, in the majority of cases, a chronic condition. From a patient's perspective, unless they are suitable for corrective surgery, he/she will never be rewarded with a cure. Patients often need to make permanent life-style changes to reduce the risk of ulceration or re-ulceration and may require differing levels of support to achieve this. The implementation of a designated clinic for patients with healed leg ulcers in a primary care trust in the east end of London is the first step in promoting a collaborative approach to prevention of leg ulcer recurrence.