Name: Susan Mills
Job Title: Gynaeoncology Clinical Nurse Specialist
Organisation: Nottingham City Hospital NHS Trust
Email: smills1@ncht.trent.nhs.uk
Telephone: 0115 9691169 ext 46162
Key team: Karin Williamson - Lead Clinician, Cathy Bown – Sonographer, Sue Mills - Specialist Nurse
Abstract:
Audit pre nurse led clinic highlighted delay in diagnosis of endometrial cancer up to 311 days.
NHS Guidelines state patients referred on 2/52 wait should have a diagnosis in 31 days by 2005
Patients had 4 separate visits to hospital before diagnosis.
1 visit to outpatients.
2-3 week wait for ultrasound scan
Further visit to clinic for results of scan
Further appointment for out patient hysteroscopy and biopsy
Further visit for results of biopsy.
Reduce patient and relatives anxiety
Reduce number of visits and waiting times to diagnosis
1 year course at Bradford University in Hysteroscopy training for nurses
Hands on training in own area. 50 observed, 50-100 supervised 50-100 unsupervised hysteroscopies.
Written assessment plus viva.
1 of first 8 nurses in UK to become accredited nurse hysteroscopist.
Started nurse led PMB clinic Jan 2003.
Support from lead clinician Miss K Williamson Gynaeoncologist
Cathy Bown Sonographer
Developed protocols and risk assessment
All patients have scan and medical history and examination on first visit by CNS
Audit Dec 2003
Total number of referrals 378
15 DNA total seen 368
189 referred for hysteroscopy (2nd visit)
126 discharged
23 cancers diagnosed.
Times to diagnosis 17-83 days
13 patients diagnosed under 31 days 51%
Pre nurse led clinic 23% diagnosed under 31 days.
High patient satisfaction levels.
Continuity of care.
No cover for clinic for A/L or study leave
Ad- hoc clinics to meet demand for referrals
Need additional hysteroscopy lists
So many patients are pleased with the reduction in numbers of visits and reduced time to diagnosis.
Prefer female practitioner.
Patients diagnosed with cancer already known to me therefore better support mechanism already in place
Need to look at increasing service to meet the demand and continue to improve times to diagnosis.
Derby City General Hospital have approached me re setting up a similar service
Have spoken at conferences about this new role and service at NCH.
