Evaluation of the effectiveness of a specialist nurse in the management of inflammatory bowel disease (IBD)

Objective To determine the effect of a specialist nurse on the management outcome of patients with inflammatory bowel disease (IBD), Design Audit of the management of a cohort of patients in the year prior to the employment of the specialist nurse and the year immediately after. Subjects 339 patients, both male and female, with either Crohn's disease or ulcerative colitis, resident in the Cambridge health district. Setting Addenbrooke's Hospital NHS Trust Outpatient Centre. Main outcome measures Health status was measured by blood tests (C-reactive protein, albumin and haemoglobin) throughout the year, symptom indices, number of clinic attendances, admissions to hospital and length of stay. Quality of life was measured via a postal questionnaire. Results Hospital visits were reduced from 1377 to 853 (38% reduction) and in-patient length of stay measured in bed-days from 516 to 417 (19% reduction). The number of patients in remission increased from 63 to 69%. Patient satisfaction improved in key areas, in particular, access to information on IBD and advice on avoidance of illness and maintaining health. Of a total of 251 calls to the telephone helpline, only 19 patients were referred for a medical opinion and five patients required hospital admission. Conclusion The IBD nurse specialist is a valuable and cost-effective member of the gastroenterology team. (C) 2000 Lippincott Williams & Wilkins.