Abstract
Introduction: Doctors spend less consultation time giving information to the patients [Cegala] and underestimate the patients’ desire for information [Teutsch C 2003]. The communication gap is more visible when people with chronic arthritis present themselves for treatment. This also may initiate medico legal claims in NHS.
We aim to set up a nurse practitioner clinic to bridge the gap. Secondary aim is to reduce patients’ complaint about the services.
Materials: 100 questionnaires filled up by the patients on the waiting list for joint replacement, attending the specified clinic over a period of 24 months were randomly selected for analysis. Equal no of males and females were taken to eliminate gender bias on the outcome.
Methods: Patients were given detailed generic information about pre and post surgery nursing care, the operative steps and complications. They were asked to fill up 6 item questionnaires to assess the qualitative aspect of service at the end of the clinic and another 12 item questionnaires to fill up separately 6 weeks prior to their operation.
Result: 98% reported the information provided is excellent. 93% reported the clinic is excellent, as they have been told about the complication and pre and post surgery events. There is a reduction of rate of cancellation of elective joint replacement surgery from12.4% to 4.6%
Conclusion: This kind of informal group discussion enable patients with arthritis needing joint replacement to get information and aware of the kind of support available to cope in the community. We found there is a reduction of patients’ complaints about the service and effectiveness of this programme in reducing postoperative complications and use of bed days, use of own transport to return home. This may potentially lessen financial burden to the care provider.
Correspondence should be addressed to The Secretary, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
