title: Evaluation of a Regional Australian Nurse-Led Parkinson's Service Using the Context, Input, Process, and Product Evaluation Model.
abstract: OBJECTIVE
  A nurse-led Parkinson's service was introduced at Canberra Hospital and Health Services in 2012 with the primary objective of improving the care and self-management of people with a diagnosis of Parkinson's disease (PD) and related movement disorders. Other objectives of the Service included improving the quality of life of patients with PD and reducing their caregiver burden, improving the knowledge and understanding of PD among healthcare professionals, and reducing unnecessary hospital admissions. This article evaluates the first 2 years of this Service.
  
  
  METHODS
  The Context, Input, Process, and Product Evaluation Model was used to evaluate the Parkinson's and Movement Disorder Service.
  
  
  BACKGROUND
  The context evaluation was conducted through discussions with stakeholders, review of PD guidelines and care pathways, and assessment of service gaps. Input: The input evaluation was carried out by reviewing the resources and strategies used in the development of the Service.
  
  
  METHODS
  The process evaluation was undertaken by reviewing the areas of the implementation that went well and identifying issues and ongoing gaps in service provision. Product: Finally, product evaluation was undertaken by conducting stakeholder interviews and surveying patients in order to assess their knowledge and perception of value, and the patient experience of the Service. Admission data before and after implementation of the Parkinson's and Movement Disorder Service were also compared for any notable trends.
  
  
  RESULTS
  
  
  
  BACKGROUND
  Several gaps in service provision for patients with PD in the Australian Capital Territory were identified, prompting the development of a PD Service to address some of them. Input: Funding for a Parkinson's disease nurse specialist was made available, and existing resources were used to develop clinics, education sessions, and outreach services.
  
  
  METHODS
  Clinics and education sessions were implemented successfully, with positive feedback from patients and healthcare professionals. However, outreach services were limited because of capacity constraints on the Parkinson's disease nurse specialist. Product: The Service has filled an important health need in the local context; 98.3% of patients surveyed reported that the Service met their needs and helped them understand their care plan, achieving the primary objective of improving patient self-management. Interviews with stakeholders provided positive feedback about the value and usefulness of the Service, and healthcare professionals reported improvement in their knowledge about PD management. The evaluation also identified ongoing gaps in service provision and highlighted areas for potential improvement. No discernible trends in admission rates before and after the implementation of the Service were identified.
  
  
  CONCLUSIONS
  The introduction of a nurse-led PD service has had a positive impact on the provision of care for patients with PD and is a valued service. The evaluation highlighted some ongoing gaps in service provision and has generated some recommendations to address these.
authors: Author Affiliations: Public Health Trainee (Dr Jones), ACT Health, Holder, ACT; Project Officer (Ms Hopkins), Division of Medicine, Canberra Hospital and Health Services; Lecturer in Nursing (Ms Wherry), The University of Canberra; Head of Department and Professor (Dr Lueck), Australian National University Medical School, Department of Neurology, Canberra Hospital and Health Services; Staff Specialist (Dr Das), Department of Neurology, Canberra Hospital and Health Services; and Director of Chronic Disease Management (Dr Dugdale), Canberra Hospital and Health Services; Director, Centre for Health Stewardship, Australian National University, Canberra, ACT, Australia.
authors: Belinda
authors: B
authors: Jones
authors: Genevieve
authors: G
authors: Hopkins
authors: Sally-Anne
authors: SA
authors: Wherry
authors: Christian J
authors: CJ
authors: Lueck
authors: Chandi P
authors: CP
authors: Das
authors: Paul
authors: P
authors: Dugdale
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D024802:Nurse's Role; D009732:Nursing Care / Q000592:standards*; D010300:Parkinson Disease / Q000451:nursing*; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D012648:Self Care / Q000379:methods*; D011795:Surveys and Questionnaires