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 measure: 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.