title: Nurse specialists for the administration of anti-vascular endothelial growth factor intravitreal injections.
abstract: OBJECTIVE
  The number of individuals with chronic conditions such as age-related macular degeneration (AMD) is increasing, and consequently the treatment burden for anti-vascular endothelial growth factor (anti-VEGF) intravitreal injections is also increasing. The use of nurse specialists to administer anti-VEGF intravitreal injections has been proposed to address this treatment burden. This was a prospective safety audit to determine the safety of nurse specialists for the delivery of anti-VEGF intravitreal injections.
  
  
  METHODS
  A prospective safety audit was undertaken for a nurse specialist-delivered injection service in the Ophthalmology Clinic, Greenlane Clinical Centre. The department's senior medical retinal consultant supervised the nurse specialist training programme. The clinical safety of anti-VEGF intravitreal injections delivered by nurse specialists, and the impact of this programme on clinical capacity at our Institute was reviewed.
  
  
  RESULTS
  The nurse specialists administered a total of 2,900 injections over an 18-month period. Two patients developed endophthalmitis post injection (1 infective, 1 non-infective). Two patients had a vitreous haemorrhage, and five patients had raised intraocular pressure. The incidence of post-injection endophthalmitis, vitreous haemorrhage and raised intraocular pressure was 0.07%, 0.07% and 0.17%, respectively.
  
  
  CONCLUSIONS
  The nurse specialist-delivered injection service is a safe and effective service for treatment of wet AMD, diabetic macular oedema and vein occlusion.
authors.affiliation: Ophthalmology Department, Dunedin Public Hospital, 201 Great King Street, Dunedin, New Zealand. prapri14@gmail.com.
authors.forename: Priya
authors.initials: P
authors.lastname: Samalia
authors.affiliation: Department of Ophthalmology, Greenlane Clinical Centre, Auckland, New Zealand.
authors.forename: David
authors.initials: D
authors.lastname: Garland
authors.affiliation: Department of Ophthalmology, Greenlane Clinical Centre, Auckland and University of Auckland Department of Ophthalmology, Auckland.
authors.forename: David
authors.initials: D
authors.lastname: Squirrell
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D054869:Clinical Audit; D006801:Humans; D058449:Intravitreal Injections / Q000451:nursing*; D008268:Macular Degeneration / Q000188:drug therapy*; D009520:New Zealand; D000072184:Nurse Specialists; D061214:Patient Safety; D010865:Pilot Projects; D015397:Program Evaluation; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
chemical_list: D020533:Angiogenesis Inhibitors; D042461:Vascular Endothelial Growth Factor A