Audit of a Inflammatory Bowel Disease Nurse Led Telephone Advice Line
Cathy Walsh Advanced Nurse Practitioner supported by Aine Slevin Clinical Audit Facilitator
Letterkenny University Hospital Letterkenny Co. Donegal
Inflammatory Bowel Disease is a chronic condition and advice lines for chronic disease are well established. Advice lines are fundamental part of the IBD services. They offer support and advice for patients and have been shown that early intervention via an advice line can have a major impact in avoiding hospitalisation due to a flare up. The use of biologic medication has increased the workload to the advice lines as patients require a repeat Hi Tech prescription.
The increasing demands to the IBD telephone advice lines was observed. The aim was to examine aspects of the advice line and to highlight any deficiencies that would require corrective action. The objective was to establish if aspects of the advice line were in accordance with IBD standards.
Criteria to measure against the IBD UK standards and European Crohn's and Colitis Organisation (ECCO) and British Society of Gastroenterology (BSG). Prospective data collection was collected by ANP IBD and analysed by the Clinical Audit Facilitator using IBM SPSS Statistics v 24.
29% Hi Tech prescription calls, 21% Flare up calls, 21% Query re results/Investigations, 7.5% medication query, 7.5% Appt query. Other included: Covid related, GP query, letter regarding condition and administration related queries. Calls returned within 36 hours (59%) The recommendation is to call return by end of the next working day.
This audit indicates that the highest number of calls are related to repeat Hi Tech prescriptions. These are dealt with a day to day basis within a busy workload. The Quality improvements developed are: 1. A dedicated virtual Hi Tech prescription clinic has been developed to address this issue. This will ensure a better, improved and safer standard of care for patients. A dedicated administrator allocates a clinic time, patients are assessed by phone and repeat Hi Tech prescription is prescribed. This will reduce the calls to the advice line on a day to day basis and capture the workload more effectively. 2.The advice line leaflet has been revised and the answer machine has a more specific message in order to triage calls to the service. This will aim to improve the return call times as per guidelines.