TY - JOUR
T1 - Nurse Led Clinics; a Novel Model of Care for Compensated Liver Cirrhosis
T2 - A Qualitative Analysis
AU - Ramachandran, Jeyamani
AU - Lawn, Sharon
AU - Tang, Matilda Swee Sun
AU - Pati, Anuradha
AU - Wigg, Luisa
AU - Wundke, Rachel
AU - McCormick, Rosemary
AU - Muller, Kate
AU - Kaambwa, Billingsley
AU - Woodman, Richard
AU - Wigg, Alan
PY - 2022/1
Y1 - 2022/1
N2 - A nurse-led cirrhosis clinic model for management of stable, compensated cirrhotic patients is practised in our unit since 2013, wherein these patients are reviewed every six months by specialist nurses in community clinics under remote supervision of hepatologists. We evaluated the experiences of patients and healthcare providers involved in the model to understand the acceptability, strengths, and limitations of the model and obtain suggestions to improve. A qualitative design using in-depth interviews was employed, followed by thematic analysis of eight patients, one attending physician both nurse and hospital clinics, four hepatologists, and three experienced specialist nurses running the nurse-led cirrhosis clinic. Patients expressed satisfaction and a good understanding of the nurse-led cirrhosis clinic, preferring it to hospital clinics for better accessibility and the unique nurse-patient relationship. Upskilling and provision of professional care in a holistic manner were appreciated by specialist nurses. The hepatologists expressed confidence and satisfaction, although they acknowledged the difference between the medical training of specialist nurses and hepatologists. The greater availability of hospital clinic time for sick patients was welcomed. Increased specialist nurse staffing, regular forums to promote specialist nurse learning, and formalization of the referral process were suggested. No adverse experiences were reported by patients or staff. The nurse-led cirrhosis clinic model for compensated liver cirrhosis was well received by patients, hepatologists, and specialist nurses. Wider implementation of the model could be considered after further investigations in other settings.
AB - A nurse-led cirrhosis clinic model for management of stable, compensated cirrhotic patients is practised in our unit since 2013, wherein these patients are reviewed every six months by specialist nurses in community clinics under remote supervision of hepatologists. We evaluated the experiences of patients and healthcare providers involved in the model to understand the acceptability, strengths, and limitations of the model and obtain suggestions to improve. A qualitative design using in-depth interviews was employed, followed by thematic analysis of eight patients, one attending physician both nurse and hospital clinics, four hepatologists, and three experienced specialist nurses running the nurse-led cirrhosis clinic. Patients expressed satisfaction and a good understanding of the nurse-led cirrhosis clinic, preferring it to hospital clinics for better accessibility and the unique nurse-patient relationship. Upskilling and provision of professional care in a holistic manner were appreciated by specialist nurses. The hepatologists expressed confidence and satisfaction, although they acknowledged the difference between the medical training of specialist nurses and hepatologists. The greater availability of hospital clinic time for sick patients was welcomed. Increased specialist nurse staffing, regular forums to promote specialist nurse learning, and formalization of the referral process were suggested. No adverse experiences were reported by patients or staff. The nurse-led cirrhosis clinic model for compensated liver cirrhosis was well received by patients, hepatologists, and specialist nurses. Wider implementation of the model could be considered after further investigations in other settings.
KW - Liver cirrhosis
KW - nurse-led clinics
KW - nurse-patient relationship
KW - Specialist nurse training
KW - specialist care
UR - http://www.scopus.com/inward/record.url?scp=85124055172&partnerID=8YFLogxK
U2 - 10.1097/SGA.0000000000000620
DO - 10.1097/SGA.0000000000000620
M3 - Article
C2 - 34369404
AN - SCOPUS:85124055172
SN - 1538-9766
VL - 45
SP - 29
EP - 42
JO - Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates
JF - Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates
IS - 1
ER -