A successful nurse-led model in the elective orthopaedic admissions process.
OBJECTIVE
To document a nurse-led admissions process for same day orthopaedic surgery, on relatively fit patients under 70 years of age.


METHODS
Patients undergoing minor surgery, under 70 years of age, and with a body mass index (BMI) of <35, were selected from the total of patients being admitted for elective orthopaedic surgery under the Accident Compensation Commission (ACC) contract. The nurse-led project relied primarily on an admission questionnaire, on physician consultation notes, and on previous clinical records.


RESULTS
During the 6-month study, 331 patients with a median age of 38 years were categorised into 3 streams. 252 patients (76%) underwent a nursing-admission process without the need for further consultation with a junior medical officer or an anaesthetist. The remaining patients not included in the study were admitted and clerked by a house officer. No safety issues arose and the surgeons and anaesthetists were satisfied with the process. The junior medical officers described improved job satisfaction by being able to attend theatre, other educational opportunities, and working more closely with the consultant.


CONCLUSIONS
The process was safe; it improved the patient journey and job satisfaction among house surgeons; and it extended the skill base and job satisfaction of the nurses. It also allowed the hospital to cope better with the reduced number of house surgeons available. The process has now been incorporated into elective orthopaedic admissions at Burwood Hospital.
Truscott
Jennifer M
JM
Older Persons' Health and Rehabilitation, Burwood Hospital, Christchurch.
Townsend
Joanne M
JM
Arnold
Edwin P
EP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000706:statistics & numerical data; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000451:nursing* / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D017146:Models, Organizational; D009520:New Zealand; D019637:Orthopedic Procedures / Q000451:nursing* / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010865:Pilot Projects; D015397:Program Evaluation; D014218:Triage / Q000458:organization & administration