Masterclass 1 - Nurse-delivered Intravitreal Injection Service in Ophthalmology I

Aim: To present the ‘Nurse Injector’ role & responsibilities in Sunderland Eye Infirmary (SEI) and United Kingdom (NHS) overall.


Methods: The presentation goes through the challenges faced by a busy Medical Retina service at a tertiary referral centre in Northeast of England, especially the work force issues and the factors which lead to the development of ‘Nurse Injector’ role. 


The process involved in training ‘Nurse Injectors’, their curriculum and finally their certification to work independently is discussed. Continued governance process of their performance is the most important aspect and this needs to be in place even before a ‘Nurse Injector’ is appointed to the role. Understanding the remuneration, local regulations and indemnity is really needed to develop an effective local training programme.


Once trained, not losing the Injectors and staff retention can be a challenge. If not well structured, the role can become very monotonous and can lead to job dis-satisfaction and fatigue. Having a pool of Injectors, especially part time can be a good strategy. Once established, how best to utilise this work force and expand their role would the next task.


Conclusion: The effective contribution made by the ‘Nurse Injectors’ at SEI and in overall NHS are discussed along with patient satisfaction rates.

Implementation of a nurse-led intravitreal injection service is a pivotal initiative to address the escalating demand for timely, cost-effective and accessible ophthalmic care. Central to establishing this service is ensuring safety at every step. The talk provides insights into upholding high competency standards, selecting suitable patients based on evidence-based criteria, fostering informed patient participation, and establishing protocols for managing adverse events. These strategies are essential for meeting the evolving needs of ophthalmology practice and enhancing patient outcomes.

Nursing has evolved, with the change in nursing landscape; nurses are capable to contribute more. In traditional practice, only doctors are allowed to perform certain tasks, such as intravenous cannulation. Comparing to our current nursing practices, nursing has come a long way in term of providing nursing care. 
Ophthalmic nurses play a significant role in eye health promotion, disease prevention and low vision rehabilitation services. In ophthalmology, our nurses are trained to perform above their licence. For example, nurses are now able to perform intravitreal injection, handling patient from end to end for fundus angiography, perform lacrimal duct syringing independently, etc. 
Nurses want to contribute more, by allowing themselves to practice above their license; there is greater sense of achievement and satisfaction. By providing them with new learning opportunities, new skills and empowering them; it gives them a sense of fulfilment as they continue to practice in their specialised field. Which will improve nurses’ job satisfaction and help with retention.
With nurses performing more in an ophthalmic setting, patients are benefiting from streamlining of processes, reduction of wait time, hence improvement of overall patients’ experience.
Nursing is not only a ‘job,’ but a profession, a career of which we are proud.

Ophthalmic nursing has undergone a significant transformation, transitioning from solely assisting doctors to leading patient treatment, notably in administering intravitreal injections. The increasing demand for these injections has overwhelmed doctors, resulting in prolonged patient wait times. Traditionally, ophthalmologists handled patient reviews, medication prescriptions, and treatments, including intravitreal injections. However, recognizing the benefits of nurse-led care and after specialized training, our institution has adapted to accommodate the rising patient load.
Implementing these changes involves developing new processes and workflows to ensure service success. Challenges and setbacks are acknowledged along the way before achieving desired outcomes. Nursing is a continuous learning journey, with professionals constantly upgrading skills to meet job demands. Support from management and experienced colleagues is crucial for successfully implementing nurse-led intravitreal injection services. 
By embracing these changes and assuming new responsibilities, nurses enhance patient care and ease the burden on doctors. The shift to nurse-led intravitreal injections improves healthcare delivery and meets the needs of a growing patient population. Through ongoing training and support, nurses proficiently conduct procedures, enhancing overall system efficiency. Successful nurse-led services highlight healthcare professionals' dedication to continuous improvement and evolution in practice.