improving the patients experience an audit to establish the effectiveness of a dedicated biologics...
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Improving The Patients Experience
An Audit To Establish The Effectiveness Of A Dedicated
Biologics Nurse Specialist Post
Domini J Bryer, MA Biologics Nurse Specialist
Regional Rheumatology Centre,Leeds Teaching Hospitals NHS Trust, Leeds,
West Yorkshire, United Kingdom
Biologics Nurse SpecialistPost established in April 2003
Centre of excellence within Yorkshire region for biologic therapies
Increasing numbers of patients receiving biologic therapies
Evidence of need for specific biologic services to monitor care & provide ongoing support
Need for a dedicated nurse specialist for this client group (Hamilton et al 2001)
Development of the Role
Performance indicators To improve patient
care Streamline the
biologics service Establish a biologics
advice line Resource for expert
advice
MethodAn audit tool was devised based on Improving the Patients Experience
(DoH) Leeds Satisfaction Questionnaire (Hill
1997)
Discussion with key members of team Pilot testing of tool for patient use
Questionnaires Given Out to Patients Receiving Biologic Therapy
Infliximab 150 patients
attending the day case unit over an eight week period
75% returned
Etanercept & Humira
50 patients attending the biologic out-patients clinic
70% returned
Results:Key Areas Improving access
and waiting
More information, more choice
A clean, comfortable, friendly place to be
Safe high quality co-ordinated care
Building closer relationships
Further support structures/service development
Improving Access and Waiting
Direct contact with the BNS 97% of patients attending the day unit 67% of patients attending the out-
patient clinic
24% waited too long on treatment days
3% waited too long for course of treatment to begin
More Information, More Choice
Complex regimes explained 80% aware of investigations &
results 9% unaware of side effects key members of the team involved
as required
81% encouraged to ask questions
Areas discussed with the Biologics Nurse
Disease32%
Family13%Support
12%
Meds31%
Other12%
A clean, comfortable, friendly place to be
97% satisfied with environment
3% feelings not accounted for
Service improvements highlighted
Comments made on a relaxing, friendly environment
Safe High Quality Co-ordinated Care
“Having someone who sees you at every treatment session provides a welcome continuity of service and saves having to go through what can be an extensive medical history. If the person knows you it’s reassuring to know that they can spot changes in your general health that are perhaps so gradual to you that you don’t notice them.”
Building Closer Relationships
“In my view a patient needs someone they can trust who is responsive and thorough as well as technically proficient. This breeds confidence and respect as well as trust. This role and the person in it has created that situation and the climate which patients benefit from”
Service Development
GP’s need to be more aware of biologic therapies
Increased awareness of other support networks
Feedback on success of treatments 15% wanted a more flexible service Development of Biologic Web site Further support from BNS
Service Development: Suggestions for Types of Further BNS Support
Pt Groups10%
Other Pts7%
Helpline24%
Network3%
Nurse Led Clinics37%
Other OPA19%
Conclusion & Recommendations Biologics Nurse Specialist role is significant
in providing ongoing support, advice & education
The therapeutic relationship between nurse specialist and patient is invaluable
Patient involvement in future service provision
Further exploration of the nurse-led service is recommended as the role develops
