Specially trained nurses, known as nurse practitioners, may help speed the diagnosis and management of patients with back pain who would normally wait months to see a surgeon, according to a new study.
In this pilot study, a nurse practitioner at Toronto Western Hospital in Ontario, Canada gave patients exactly the same clinical diagnosis as two orthopedic spine surgeons at the hospital in 100 percent of the 177 patients she assessed.
In addition, 74 percent of the patients said they were happy to see her rather than wait up to a year to see a surgeon, and 96 percent were satisfied with her assessment.
“Waiting times for specialty consultations in public health care systems worldwide are lengthy and impose undue stress on patients waiting for further information and management of their condition,” said Angela Sarro, the nurse practitioner in the study. “Back pain can be very unpleasant and debilitating and 85 percent of us will experience it at some point in our lives.”
The study also found:
- Just over 91 percent of patients understood their condition better after seeing the nurse practitioner than after seeing a surgeon.
- Patients waited ten to 21 weeks to see the nurse practitioner, with an average wait of 12 weeks. This compared with a wait of ten to 52 weeks to be see a surgeon in a conventional clinic.
- About a quarter of the patients (26 percent) said they would have preferred to have been seen by a surgeon in a conventional clinic, but 77 percent of those patients would not have wanted to wait an extra three to four months to do so.
“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,” said Dr. Yoga Raja Rampersaud, one of the spinal surgeons in the study.
“Although skill levels will vary from one nurse practitioner to another, physicians can work with them to help them to develop expertise in their specialty area,” Rampersaud said.
There are currently 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, the researchers said.
“However, we feel that there may be scope for government-funded triage clinics led by nurse practitioners to reduce waiting times for spine consultations,” Sarro said.
The study is published in the December issue of the Journal of Advanced Nursing.
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