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A newly released TWH study shows that patients suffering from back pain get quicker diagnosis and treatment when a Nurse Practitioner conducts the first examination. Traditionally, patients face long and anxiety-ridden wait times—up to 52 weeks—before an initial examination by a spine surgeon. But the year-long study has found that wait times for patients examined by a Nurse Practitioner were significantly shorter, ranging from 10 to 21 weeks.
"Waiting times for specialty consultations in public healthcare systems worldwide are lengthy and impose undue stress on patients waiting for further information and management of their condition" says Angela Sarro, study author and Nurse Practitioner. "Back pain can be very unpleasant and debilitating, and 85% of us will experience it at some point in our lives."
The impetus for this year long study conducted was the fact that in about 90% of cases, patients are not surgical candidates. Their treatment plan usually consists of education, and non-invasive therapies to help manage their conditions. So TWH designed the study to determine patient satisfaction when a Nurse Practitioner conducts the first examination.
In all, 96% of patients reported that they were satisfied with the care and treatment plan given by the Nurse Practitioner. The study also showed the Nurse Practitioner consistently came up with the same clinical diagnosis as Drs. Yoga Raja Rampersaud and Stephen Lewis, the orthopaedic spine surgeons who co-authored it.
Nurse Practitioners receive specialized training as part of their education. They have traditionally worked in health care centres and primary care practices in the community, but their roles are changing and moving into areas such as emergency departments.
"At the moment there are clinical, legal and funding barriers in the Canadian health system that prevent nurse practitioners from being fully independent when it comes to assessing and managing patients who require specialist care. However, we feel that there may be scope for government-funded triage clinics led by nurse practitioners to reduce waiting times for spine consultations.", says Ms. Sarro.
Co-author Dr Yoga Raja Rampersaud adds, "We believe that our study demonstrates that nurse practitioners can play an effective and efficient role in delivering timely health care to patients requiring specific disease management in a specialty setting."
TWH is now assessing the potential to expand the role of Nurse Practitioners to become the point of contact for ongoing care of patients with a variety of conditions.
The study is entitled "Nurse practitioner-led surgical spine consultation clinic," and is published in the December 2010 issue of the Journal of Advanced Nursing. It was conducted in 2008.