Abstract
We report the role of our advanced nurse practitioner (ANP) with particular relevance to cost effectiveness, patient satisfaction and data collection.
Our nurse practitioner has been involved in arthroplasty care since 1996. Her duties include preoperative assessment, health advice, informed consent, clinical follow up and maintenance of a database for research/audit. Follow up radiographs are reviewed regularly by the entire medical team in a teaching environment. Relative costs of this service were calculated using outpatient charging data. 100 postal questionnaires were used to assess patient satisfaction. Patients answered 13 questions relating to the service they received.
Knee arthroplasty follow up through the nurse led clinic was half the cost of follow up through the consultant led clinic. 80 patients returned the postal questionnaire. Responses were very supportive of the nurse practitioner service. 76 (95%) of patients were happy to be assessed by the ANP and felt that their problems were dealt with appropriately. 17 (21%) of patients felt they should be seen by a surgeon at some stage during their routine follow up. Overall, 75 (94%) of patients were very satisfied or satisfied with the service, 1 (1%) was dissatisfied and 4 (5%) did not answer this question.
Increasing patient numbers and demand for high quality care combined with a decrease in doctors hours worked has lead to a shortage of time for discussion of ‘prehabilitation’ and postoperative care. Long term clinical and radiological follow up leading to adequate research and audit must not be compromised. A trained nurse practitioner working in conjunction with the surgical team is a cost effective way of improving total patient care, audit and research within a department. We have found a high degree of patient satisfaction with this approach.
The abstracts were prepared by Mr R. B. Smith. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.
