ONE-STOP SHOP Urology clinic cuts treatment down from four visits to just one
Christine McBrearty
T
herese Kelly, Advanced Nurse Practitioner (ANP), Sinéad McGarrigle and Christine McBrearty, both Candidate Advanced Nurse Practitioners (cANP) Urology, are putting the patient at the centre of their work to deliver Sláintecare reform in the Saolta Hospital Group. Working on the Sláintecare funded Urology Pathway – Proof of Concept project, Therese, Sinéad and Christine are leading ANP Urology clinics to assess treat and manage patients with Lower Urinary Tract (LUTS) symptoms. 95% of treatment required in urology can be carried out as day cases. In a programme designed with the National Clinical Programme for Surgery, Models of Care for Urology, led by Professor Eamonn Rogers, patients are referred by their GP through HealthLink. Referrals are triaged with the consultant urologist and referred on to the ANP LUTS clinic. The clinics are run through a See and Treat model, which is a one-stop shop for the patient and cuts treatment down from a potential four visits, to one visit to the ANP LUTS clinic. During the 16-month pilot period for this project, the team delivered 3,832 patient appointments. 95% of these patient appointments (3,632) were ANP-delivered while the remaining 5% (200) were delivered by the consultant. Overall, 53% of these patients were new patients, who were
Rachel Kenna
removed from the consultant’s outpatient waiting list, and 47% were review patients. Therese Kelly is a Registered Advanced Nurse Practitioner Urology, working in Galway University hospital and Portiuncula Hospital Galway. She has worked in the field for nearly 30 years having worked in units in Dublin and the UK. Therese says her vision working on this project is to ‘enhance access to urological nurses' service for patients, enhance patients’ understanding of their condition and enable patients to manage their condition’. “I wanted patients to feel comfortable talking about their urological condition. I wanted to make a difference and influence change in nursing,” she said. Therese is involved in research to provide an evidence base for her practice, and in professional development for herself and her colleagues. “We have a journal club where we discuss latest research articles and discuss potential research projects for the unit. I do regular audits, guideline development and am involved in the training of two cANP LUTS.” Therese says that Sláintecare funding has now made urology services more accessible to her patients. “Sláintecare has enabled me to enhance the service I can give patients, it has made me more accessible via satellite clinic, mobile and virtual/attend anywhere clinics. It has empowered me to try change. There is more development we can do in non-oncology urology, Rome wasn’t built in
Sinéad McGarrigle
a day, but the change we have enacted in last few years in urology is amazing and all to the benefit of the patients which is why we all do our job.” Sinéad Mc Garrigle, cANP Urology in Sligo University Hospital, graduated from St Angela’s College and is currently completing a Postgraduate Diploma in Nursing (Advanced Practice). “From my experience as a staff nurse working in a busy surgical ward and caring for urology patients, I became aware of the importance for the urology patient to have the appropriate information and education around their urological condition. I was therefore keen to progress into a role where I could provide patient centred care working directly with the patient,” said Sinéad. “For me Sláintecare is ensuring that our patients are receiving safe, high-quality care, at the right time, in the right place. Through the roll out of the lower urinary tract symptoms shared care initiative and nurse led service pathway from the Urology Model of care for Ireland, we are contributing to the goals of Sláintecare. This pathway is enabling us to significantly reduce patient waiting times for LUTS assessment.” Christine McBrearty, cANP Urology in Letterkenny University Hospital, worked as a staff nurse for 17 years, and is currently completing a Masters in Advanced Nursing Practice. “Letterkenny serves a rural, older population. Population projections across the Saolta hospital group predict that from
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