Do clinical nurse specialist led stroke follow‐up clinics reduce post‐stroke hospital readmissions and recurrent vascular events?

2020 ◽  
Vol 50 (10) ◽  
pp. 1202-1207
Author(s):  
Alex Kao ◽  
Jeremy Lanford ◽  
Lai‐Kin Wong ◽  
Annemarei Ranta
2019 ◽  
Vol 90 (e7) ◽  
pp. A32.2-A32
Author(s):  
Alex Kao ◽  
Jeremy Lanford ◽  
Lai-Kin Wong ◽  
Anna Ranta

IntroductionPost-discharge stroke follow-up clinics have been associated with improved outpatient care and reduced readmission. Pre-2014 there was no consistent follow-up care offered at Wellington Hospital. Our aim was to determine whether the establishment of a clinical nurse specialist (CNS) follow-up clinic reduced the readmission 12-monthrate.MethodsThis is a sequential comparison of patient admitted with stroke one year prior and one year after the clinic was established in 2013. The primary outcome was hospital 12-month hospital readmission rate; main secondary outcome was recurrent vascular event. Patients were identified from the hospital discharge records and underwent detailed electronic chart review. Results were adjusted for differences in baseline characteristics.ResultsWe identified 874 patients; 439 pre- and 435 post-nurse clinic implementation. There was no significant difference between the one-year readmission rate after the establishment of the stroke follow up clinic (adjusted OR=1.06; 95% CI, 0.85–1.64; p=0.804) and no difference in recurrent composite vascular events at one-year (adjusted OR=1.20; 95% CI, 0.68–2.11; p=0.528). The median (IQR) time to follow-up to clinic after discharge was 85 (63–98.5) days. There was a trend towards a reduction in vascular events when limiting the analysis to patients who actually attended clinic, but this trend disappeared when adjusting for baseline inter-group differences.ConclusionsThere was no reduction in the one-year hospital readmission or vascular event recurrence rate for patients with stroke following the establishment of a nurse specialist led stroke follow up clinic. Earlier timed follow-up and the psychosocial value offered by these clinics requires further evaluation.


Pflege ◽  
2011 ◽  
Vol 24 (1) ◽  
pp. 21-28 ◽  
Author(s):  
Andrea Ullmann-Bremi ◽  
Anna-Barbara Schlüer ◽  
Gabriela Finkbeiner ◽  
Yvonne Huber

Im angloamerikanischen und nordeuropäischen Raum wurden verschiedene ANP-Einzelrollen entwickelt, unter anderem die der Clinical Nurse Specialist und der Nurse Practitioner. Diese universitär ausgebildeten Pflegespezialisten sind in der Schweiz weiterhin sehr rar. Um vor diesem Hintergrund die Praxis dennoch nachhaltig weiterentwickeln zu können, wurden in den letzten acht Jahren im Kinderspital Zürich kontinuierlich Advanced-Nursing-Practice-Teams (ANP-Teams) aufgebaut. Dieser Ansatz bewährte sich durch gezielte und angemessene Leistungserbringung in hochkomplexen Situationen. In diesem Artikel wird die Zusammensetzung der ANP-Teams diskutiert, wobei der Personalmix einen Schlüsselfaktor darstellt. Unterstützende Elemente stellen dabei sowohl die Aufgabendefinition als auch Aufgabenteilung in Klinik- und Konzeptteams dar. Die ANP-Teams arbeiten motiviert und zielgerichtet, sie integrieren Pflegende verschiedenster Erfahrungs- und Ausbildungsniveaus, wodurch gegenseitiges Lernen gefördert wird.


2003 ◽  
Vol 4 (1) ◽  
pp. 10-19
Author(s):  
Duncanson V

T his article describes a small study aimed at making a purchasing recommendation to the purchasing manager, providing a cost-benefit analysis of the most commonly used brands of non-sterile latex examination gloves. One of the nine makes of glove tested remained consistent with the agreed criteria for assessment and, if introduced as the only option available, would result in a saving of $15,150 per annum on Site A of a recently merged secondary care Trust. Also, the importance of the consultancy role of the clinical nurse specialist in improving practice was demonstrated.


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