AB1557-HPR DEVELOPING THE GUIDELINE FOR OUTPATIENT APPOINTMENT OF A CLINICAL NURSE SPECIALIST AT THE EAST-TALLINN CENTRAL HOSPITAL RHEUMATOLOGY CENTER. DEVELOPMENT PROJECT

Background

Rheumatic diseases can increase the economic and social burden on the individual and their relatives’ ones, as well as on the health care system and society. Based on international empirical experience, it can be stated that in an exemplary Rheumatology center, both the outpatient appointment of a (general) nurse and the outpatient appointment of a clinical nurse specialist work as a team. The Rheumatology Center of East Tallinn Central Hospital is the only center in Estonia that specializes in rheumatic patients, where (general) nurses are proceed, but the extent to which the current health care service meets the needs of rheumatic patients has not yet been assessed. In addition, the health insurance fund launched a pilot project to clarify the difference between outpatient appointment of a clinical nurse specialist and independent appointment of a (general) nurse. However, there is no evidence-based guideline for outpatient appointments for rheumatic patients.

Objectives

The aim of the development project was to develop the guideline for outpatient appointment of a clinical nurse specialist for rheumatology based on evidence-based literature and expert opinions at the Rheumatology Center of East-Tallinn Central Hospital.

Methods

The development project process took place as a plan-do-study-act cycle, using the method of systematic review of the literature to develop the guideline and the method of written survey to obtain an expert opinion on it. Verbal responses from experts for organizational diagnostics and the guideline feedback was analyzed using content analysis. Quantitative or numerical responses were analyzed using descriptive statistics to calculate the frequency distributions (n and %) for each response.

Results

The guideline developed as part of the development project supports the implementation of a new clinical nurse specialist care service for rheumatic patients.

Conclusion

Based on previous research analyzed and surveys conducted by experts at the Rheumatology Center, it can be argued that the clinical nurse specialist service differs significantly from the (general) nurse outpatient appointment and is more responsive to the needs of rheumatic patients. There are potential benefits for the clinical nurse specialist of the outpatient appointment to the organization and to society, as this service increases the level of reliability, efficiency, and availability of all nursing care.

References

[1]Batšinskaja, D. Developing the guideline for outpatient appointment of a clinical nurse specialist at the East-Tallinn Central Hospital Rheumatology Center. Development project. Tallinn: Tallinn Healthcare College, 2022

[2]Schober, M., Lehwaldt, D., Rogers, M., Steinke, M., Turale, S., Pulcini, J., Roussel, J., Stewart, D. (2020). Guidelines on advanced practice nursing ICN APN report https://www.icn.ch/system/files/documents/2020-04/ICN_APN%20Report_EN_WEB.pdf

Acknowledgements

Thank you experts for their opinion.

Disclosure of Interests

None declared

The Carter Center's assistance to river blindness control programs: establishing treatment objectives and goals for monitoring ivermectin delivery systems on two continents

Periodic mass treatment with ivermectin in endemic communities prevents eye and dermal disease due to onchocerciasis. As part of an international global partnership to control onchocerciasis, The Carter Center's Global 2000 River Blindness Program (GRBP) assists the ministries of health in ten countries to distribute ivermectin (Mectizan, donated by Merck & Co.). The GRBP priorities are to maximize ivermectin treatment coverage and related health education and training efforts, and to monitor progress through regular reporting of ivermectin treatments measured against annual treatment objectives and ultimate treatment goals (e.g., full coverage, which is defined as reaching all persons residing in at risk villages who are eligible for treatment). Since the GRBP began in 1996, more than 21.2 million ivermectin treatment encounters have been reported by assisted programs. In 1999, more than 6.6 million eligible persons at risk for onchocerciasis received treatment, which represented 96% of the 1999 annual treatment objective of 6.9 million, and 78% of the ultimate treatment goal in assisted areas.