Authors (including presenting author) :
Cheung YS (1), Yim CW (2), Lai TL (1), Au CK (1)
Affiliation :
(1) Department of Medicine, Tseung Kwan O Hospital, (2) Medicine and Geriatric department, United Christian Hospital
Introduction :
Rheumatic diseases can affect multiple organs. Timely diagnosis and treatment is imperative for disease control and hence decreasing patients’ morbidity, mortality, and functional impairment.
We already have new cases triage or early screening service for rheumatoid arthritis (RA). However, other than RA, various rheumatic diseases such as vasculitic rash, ANA positivity, also needed to be handled by rheumatologists.
To address the increasing demand of rheumatic services and to mitigate the long waiting time of rheumatology clinic, Rheumatology nurse (RhN) can aid in early triage referrals to enhance the effective use of resources
Objectives :
The study aim is to evaluate the safety and the effectiveness of new rheumatology case triage by specialty nurses.
Methodology :
This is a retrospective study of the period from 1 /1/2023 to 31/12/2023. Referrals obtained from medical outpatient clinic, were first screened by rheumatologists, and suitable cases were directed to RhN for further management.
RhN performed detailed history taking, clinical assessment and arrange relevant investigations in their first visit. Patients will be seen again within 12 weeks to explain the result of investigations, and provide education and counselling about rheumatic diseases. Further clinical follow-ups will be arranged after discussed with rheumatologists. Further RhN clinic for interval monitoring will be arranged, if needed.
Result & Outcome :
Totally 83 referrals were screened by rheumatology nurse, 31 were males and 52 were females. Seventy-seven cases completed 2 RhN clinic visits.
The main reasons for referrals were abnormal blood results (43.4%), such as positive ANA and rheumatic symptoms (51.8%), for example, rash and back pain.
After RhN screening, 24 (28.9 %) cases required earlier evaluation by formal. The reasons for advancement of follow-ups were active manifestation of rheumatic disease which requiring commencement of specific therapies.
No attendance to emergency department for the other cases (59/83) within 4 weeks after second visit. Only 1 case seek for help via telephone hotline, as she developed active symptoms. Two cases were arranged RhN clinic for interval monitoring.
This primitive result suggested that new case referrals triage by RhN is a safe and effective way to enhance public rheumatology service. Hope it can help the rheumatic patients requiring early attention.
