Implementation and evaluation of an ophthalmic nurse practitioner emergency eye clinic.
BACKGROUND
To describe the implementation and assess the efficacy of an ophthalmic nurse practitioner (ONP) emergency eye clinic.


METHODS
In a 13-month period, patients were assessed in an ONP emergency eye clinic in a teaching hospital setting. The ONP clinic was run on a defined scope of practice. Risk assessment was carried out in two audit sessions, 4 weeks duration each, at months 1 and 7. Patient outcomes were monitored for reattendance to the department following discharge.


RESULTS
A total of 259 patients were assessed, 143 (55.2%) were within the scope of practice. In the two audit periods, concordance with the ophthalmologist was high, diagnosis 100% and management 95.2%. Many patients assessed (111, 42.9% of total) had minor external eye conditions--chiefly corneal foreign body or abrasion (n = 50), conjunctivitis (n = 14) and minor (non-alkali) chemical injuries (n = 11). No reattendance was noted in these patients when monitored for a mean of 12 months (range 7-19 months).


CONCLUSIONS
This study demonstrates the safety and effectiveness of an ONP emergency eye clinic when practising within a defined scope of practice. An ONP-led emergency eye clinic is a viable addition to acute ophthalmic eye care in Australia.
Kirkwood
Bradley J
BJ
NH&MRC Centre for Clinical Research Excellence in Ophthalmology Outcomes Research, Department of Ophthalmology, Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia. bradkirkwood@bigpond.com
Pesudovs
Konrad
K
Loh
Raymond S
RS
Coster
Douglas J
DJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D016529:Emergency Nursing / Q000592:standards*; D004636:Emergency Service, Hospital / Q000592:standards*; D005128:Eye Diseases / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006284:Health Plan Implementation / Q000592:standards*; D006784:Hospitals, Teaching / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000592:standards*; D024802:Nurse's Role; D009885:Ophthalmology / Q000592:standards*; D010359:Patient Readmission; D010865:Pilot Projects; D015397:Program Evaluation; D011446:Prospective Studies; D012017:Referral and Consultation; D013021:South Australia; D000078329:Workforce