Nurse-led clinics can manage faecal incontinence effectively: results from a tertiary referral centre.
OBJECTIVE
In May 2010, a specialist nurse-initiated assessment and treatment algorithm for faecal incontinence (FI) was introduced at the department of Anal Physiology, Aarhus University Hospital, Denmark. This study aimed to evaluate the effectiveness of and patient satisfaction with the program.


METHODS
A medical file audit was preformed on patients evaluated and treated for FI and discharged after September 2010. Patients were invited to participate in a structured telephone interview. This study aimed to enrol 100 patients. Patients were asked if they were satisfied with their current level of continence status (yes/no), and a numerical satisfaction score and Wexner score were recorded. These results were compared to baseline and at time of discharge.


RESULTS
One-hundred patients completed the telephone interview; 73 of these patients were satisfied after a median of 420 (range: 114-586) days following discharge from the program. A median of one outpatient consultation followed by one telephone follow-up was required before the patients were discharged. The Wexner score was significantly reduced by 3.9 (±4.4) (P < 0.001) points among the satisfied and non-significantly reduced by 0.52 (± 3.3) (P = 0.42) points among the dissatisfied patients at follow-up compared to baseline. The satisfied and dissatisfied patients at follow-up did not differ in baseline characteristics including Wexner score.


CONCLUSIONS
FI can successively be evaluated and conservatively managed by specialist nurses, and these nurses achived high satisfaction rates among their patients. The concept of specialist nurse-led clinics will reduce waiting lists, and descrease the number of patients needing to be evaluated by a surgeon.
Surgical Research Unit, Department of Surgery P, Aarhus University Hospital, Tage-Hansens Gade, Aarhus C, Denmark.
J
J
Duelund-Jakobsen
Surgical Research Unit, Department of Surgery P, Aarhus University Hospital, Tage-Hansens Gade, Aarhus C, Denmark.
S
S
Haas
Surgical Research Unit, Department of Surgery P, Aarhus University Hospital, Tage-Hansens Gade, Aarhus C, Denmark.
S
S
Buntzen
Surgical Research Unit, Department of Surgery P, Aarhus University Hospital, Tage-Hansens Gade, Aarhus C, Denmark.
L
L
Lundby
Surgical Research Unit, Department of Surgery P, Aarhus University Hospital, Tage-Hansens Gade, Aarhus C, Denmark.
G
G
Bøje
Surgical Research Unit, Department of Surgery P, Aarhus University Hospital, Tage-Hansens Gade, Aarhus C, Denmark.
S
S
Laurberg
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D004043:Dietary Fiber / Q000008:administration & dosage; D004733:Enema; D005242:Fecal Incontinence / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D057184:Practice Patterns, Nurses'; D012017:Referral and Consultation; D012720:Severity of Illness Index; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult
Faecal incontinence; conservative therapy; patient satisfaction; treatment