Background There is a widening care gap in Canada between patients who need Rheumatology care and the capacity of the system to deliver that care in a timely manner. At Rheumatology Health Team Hamilton we have developed several models of team-based care with trained rheumatology nurses.
One successful team -based model has been a nurse managed injection clinic treating patients with inflammatory arthritis or soft tissue pain. All patients fill out a health check questionnaire and authorize their consent before receiving injections, ensuring patient safety. Nurses use a set of directives written by the rheumatologist as guidelines for the clinic with a Rheumatologist always present on site.
This clinic allows immediate access and assessment of patients with flares or potentially needing steroid injections. Currently this clinic administers nearly 100 injections per week. The purpose of this study was to assess patient perspectives on how they view this team -based model as compared to a traditional MD model which historically would cause a delay of treatment by 8-10 weeks before an assessment of their disease was possible.
Objectives To determine patients satisfaction with a nurse led corticosteroid injection clinic to manage symptomatic flares.
Methods A cross-sectional study sampling 217 consecutive patients who attended the injection clinic was conducted at Dr. Bensen's Rheumatology Practice in Hamilton, Canada from May 2013 to June 2013. Patients were given a structured self-administered questionnaire to determine their satisfaction with the steroid injection clinic run by the nurses. Those that have English as a second language were excluded as well as anyone who wasn't able to understand and follow directions on the questionnaire. Efficacy and relevance was assessed by patients answering eight qualitative questions.
Results The results of this study indicated that patients were offered timely access to care at critical times when they were experiencing a flare of disease symptoms. 83% of patients responded that their pain was better managed in this clinic. 96% of patients affirmed that they were able to be seen within 2 weeks of their onset of symptoms. All patients surveyed felt comfortable discussing their health issues with the nurse and felt confident in the nurse's assessment and injection techniques. Overall the patients reported that because of this nurse led injection clinic model their quality of life living with a rheumatologic condition improved.
Conclusions Our results show that a nurse run steroid injection clinic is both valued by patients for pain and inflammation management and is readily available. This demonstrates a high degree of satisfaction with the nurse run program and they feel very strongly that without this clinic their pain management would not be optimal. Without this clinic, patients indicated that they would seek treatment elsewhere, mostly with their family doctors, emergency rooms, or walk-in clinics, resulting in further congestion in an already overwhelmed healthcare system. This study determined that nurse run steroid injection clinics are both needed and valued by our patients in Hamilton, Canada.
Disclosure of Interest : None declared