Kirkwood Bradley J, Pesudovs Konrad, Latimer Paul, Coster Douglas J
Department of Ophthalmology, NHMRC Centre for Clinical Eye Research, Flinders Medical Centre and Flinders University, Adelaide, SA.
Med J Aust. 2006 Mar 20;184(6):278-81. doi: 10.5694/j.1326-5377.2006.tb00237.x.
To describe the implementation of a nurse-led preoperative cataract assessment and postoperative care clinic and to assess the safety, efficacy and outcomes.
DESIGN, SETTING AND PARTICIPANTS: A prospective study involving 185 public patients (221 eyes) referred to the Department of Ophthalmology at Flinders Medical Centre for cataract surgery. The study was conducted between February 2003 and August 2004.
Patients were assessed in the nurse-led preoperative assessment clinic. Those deemed suitable for cataract surgery were also assessed by an ophthalmologist and underwent cataract surgery if appropriate. The nurse managed postoperative care.
Concordance between nurse practitioner and ophthalmologist assessments; waiting times for first clinic appointment and surgery; visual acuity and degree of visual disability; patient satisfaction.
114 patients (61.6%) were assigned to see the ophthalmologist for cataract surgery. Median waiting times fell from 115 days (range, 23-268 days) to 21 days (range, 9-43 days) for initial clinic appointment, and from 44 days (range, 5-148 days) to 29 days (range, 14-154 days) for surgery. All 114 patients were listed for cataract surgery, and surgery had been performed on 121 eyes by the end of the study. After surgery, visual acuity improved by a mean of 0.45 logMAR (logarithm of the minimal angle of resolution) (SD, 0.24; range, 0.08-1.32). All patients had improved visual ability and high levels of satisfaction. Three quality assurance evaluations demonstrated full concordance between nurse and ophthalmologist assessments.
Implementing a nurse-led cataract assessment clinic improved access to care for public patients with cataracts. The safety and efficacy of the program and its excellent visual and patient-centred outcomes commend its adaptation and implementation to other ophthalmology departments.
描述由护士主导的术前白内障评估及术后护理门诊的实施情况，并评估其安全性、有效性和结果。
设计、地点和参与者：一项前瞻性研究，涉及185名转诊至弗林德斯医疗中心眼科进行白内障手术的公立患者（221只眼）。该研究于2003年2月至2004年8月进行。
患者在由护士主导的术前评估门诊接受评估。那些被认为适合白内障手术的患者也由眼科医生进行评估，并在适当时接受白内障手术。护士负责术后护理。
执业护士与眼科医生评估的一致性；首次门诊预约和手术的等待时间；视力和视觉残疾程度；患者满意度。
114名患者（61.6%）被安排由眼科医生进行白内障手术。首次门诊预约的中位等待时间从115天（范围23 - 268天）降至21天（范围9 - 43天），手术等待时间从44天（范围5 - 148天）降至29天（范围14 - 154天）。所有114名患者均被列入白内障手术名单，到研究结束时，已对121只眼进行了手术。术后，视力平均提高了0.45 logMAR（最小分辨角的对数）（标准差0.24；范围0.08 - 1.32）。所有患者的视觉能力均有所改善，满意度较高。三次质量保证评估表明护士与眼科医生的评估完全一致。
实施由护士主导的白内障评估门诊改善了公立白内障患者获得医疗服务的机会。该项目的安全性、有效性及其出色的视觉效果和以患者为中心的结果值得其他眼科部门采用和实施。
