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Implementation and evaluation of an ophthalmic nurse practitioner emergency eye clinic.

Kirkwood BJ, Pesudovs K, Loh RS, Coster DJ

NH&MRC Centre for Clinical Research Excellence in Ophthalmology Outcomes Research, Department of Ophthalmology, Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia. bradkirkwood@bigpond.com

BACKGROUND: To describe the implementation and assess the efficacy of an ophthalmic nurse practitioner (ONP) emergency eye clinic. METHODS: In a 13-month period, patients were assessed in an ONP emergency eye clinic in a teaching hospital setting. The ONP clinic was run on a defined scope of practice. Risk assessment was carried out in two audit sessions, 4 weeks duration each, at months 1 and 7. Patient outcomes were monitored for reattendance to the department following discharge. RESULTS: A total of 259 patients were assessed, 143 (55.2%) were within the scope of practice. In the two audit periods, concordance with the ophthalmologist was high, diagnosis 100% and management 95.2%. Many patients assessed (111, 42.9% of total) had minor external eye conditions--chiefly corneal foreign body or abrasion (n = 50), conjunctivitis (n = 14) and minor (non-alkali) chemical injuries (n = 11). No reattendance was noted in these patients when monitored for a mean of 12 months (range 7-19 months). CONCLUSIONS: This study demonstrates the safety and effectiveness of an ONP emergency eye clinic when practising within a defined scope of practice. An ONP-led emergency eye clinic is a viable addition to acute ophthalmic eye care in Australia.

Published 11 January 2006 in Clin Experiment Ophthalmol, 33(6): 593-7.
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