Introduction Paediatric Nurse-led IBD patient reviews often occur in an unscheduled manner and without defined resources resulting in inefficient use of nurse time. We describe the process of the first year of a Paediatric Nurse-led IBD clinc.
Method The clinic was designed as a quality initiative to dedicate a weekly session for consecutive patient review and facilitate more effective use of resources. Appropriate post graduate study was undertaken by the Paediatric IBD Nurse Specialist prior to the clinic being set up which included history taking, clinical examination, prescribing, requesting tests or further investigation, referral to other services and venepuncture. A nurse-led clinic proforma and patient pathway was designed to facilitate an auditable pathway for patients coming through clinic. Clinical governance and supervision was provided at the IBD multi-disciplinary team (MDT) meeting where each patient was discussed in an MDT forum.
Results 344 patient episodes involving 124 patients took place between Feb 2013 – Dec 2014. 68 male. 93 Crohn’s disease (CD), 17 Ulcerative Colitis (UC) and 14 IBD Unclassified (IBDU). Median number of patients seen per clinic was 4. 87% of reviews were routine; 13% were rapid review (booked < 48 hrs before clinic). Reasons for review were diverse. Co-ordination of care (eg: referral to surgeons; ordering further investigations) was the most common outcome (33%). Optimisation of therapy (eg: increasing medication doses; adding other medications such as rectal therapy) was the next most common outcome (27%). Thirty four percent of patients were planned for review at the MDT clinic, 32% were planned for further nurse-led clinic review and 20% had a nurse vigilance call booked.
Conclusion The Paediatric Nurse-led IBD clinic has provided a robust and auditable addition to the IBD patient service. Co-ordination of care requiring cross boundary working with surgeons, physicians, dietitians and other members of the MDT was part of the outcome in over 1/3 of all patient reviews. This demonstrates the pivotal role of the IBD nurse within the MDT.
Disclosure of interest None Declared.
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