Nurse practitioners may help reduce wait times without impairing quality of care. Ninety-six percent of patients with back problems were satisfied with the assessment carried out by a specially trained nurse practitioner, according to a study in the December issue of the Journal of Advanced Nursing.
Moreover, the NP came up with exactly the same clinical diagnosis as two orthopedic spine surgeons in all 177 patients she assessed. She also suggested the same management plan as the two surgeons in 95% of cases.
"Nurse practitioners can play an effective and efficient role in delivering care to patients requiring specific disease management in a specialty setting. Although the required skill set in assessing these patients may vary from NP to NP, collaboration and support from the physician can help to develop expertise in a specialty area," the paper concludes.
The aim of the year-long pilot study, conducted Toronto Western Hospital in Ontario, was to determine whether a clinic led by a nurse practitioner could speed up the diagnosis and management of patients with certain spinal conditions. (Most patients seen by spine surgeons are not surgical candidates, the researchers note; their treatment plan usually consists of education, and non-invasive therapies to help manage their conditions.)
The 96 male and 81 female patients with suspected disc herniation, spinal stenosis, or degenerative disc disease had been referred by their family doctors.
Just under 10% were correctly identified as surgical candidates by the nurse practitioner. In addition, 66 were referred for specific nerve root block, 14 for facet block, and 26 for further radiological imaging.
Overallsatisfaction was very high (96%), and 91% of patients reported that they understood their condition better after seeing the nurse practitioner.
Patients waited10 to 21 weeks to see the NP, with an average wait of 12 weeks. This compared with 10 to 52 weeks to be seen by the surgeons in a conventional clinic, with average waiting times ranging from three to four months for disc herniations to eight to 12 months for spinal stenosis.