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Improving access to digital ulcer care through nurse-led clinic: a service evaluation

Ngcozana, T; Ong, VH; Denton, CP; (2020) Improving access to digital ulcer care through nurse-led clinic: a service evaluation. Musculoskeletal Care , 18 (1) pp. 92-97. 10.1002/msc.1433. Green open access

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Abstract

OBJECTIVE Digital ulcers (DU) remain one of the most burdensome co‐morbidities in systemic sclerosis. The objectives of the study were to describe patient‐level stratification and to evaluate a nurse‐led DU clinic service development. METHODS A nurse‐led digital ulcer clinic was established to identify patients with DU and manage them. Patients were recruited through scleroderma clinics, GP referrals, and self‐referrals. The clinic involved patients being treated with appropriate treatment. Patients were stratified according to their DU risk level based on number and severity of ulcers. Among these, 22 patients were asked to complete a patient satisfaction survey. Data were analyzed descriptively. RESULTS Seventy‐five patients were seen in the clinic, 46 (61%) were 56 years of age and above. Patients were identified as high (23%), medium (51%) or low risk (26%) for development of DU. The duration of DU history was from 7 months to 40 years. Prior to attending the nurse‐led DU clinic, 90% of patients had received up to six courses of antibiotics for their DU, 76% had attended A&E, and 90% had unscheduled appointments. 90% had been seen by the GP due to DU and subsequently required hospital admissions. During the nurse‐led clinic follow‐up, only two patients had emergency admission. All patients reported that their needs in personal care of DU were met. CONCLUSION There are a significant number of people with SSc who have DUs affecting their quality of life as well as needing more healthcare services. A dedicated specialist nurse‐led DU clinic may improve overall care of patients.

Type: Article
Title: Improving access to digital ulcer care through nurse-led clinic: a service evaluation
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/msc.1433
Publisher version: https://doi.org/10.1002/msc.1433
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: nursing, patient experiences, rheumatology
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
URI: https://discovery.ucl.ac.uk/id/eprint/10090786
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