2. Improving The Patients Experience An Audit To Establish The Effectiveness Of A Dedicated Biologics Nurse Specialist Post Domini J Bryer, MA Biologics Nurse Specialist Regional Rheumatology Centre, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, United Kingdom

3. Biologics Nurse Specialist Post established in April 2003 Centre of excellence within Yorkshire region for biologic therapies Increasing numbers of patients receiving biologic therapies Evidence of need for specific biologic services to monitor care & provide ongoing support Need for a dedicated nurse specialist for this client group (Hamilton et al 2001)

4. Development of the Role Performance indicators To improve patient care Streamline the biologics service Establish a biologics advice line Resource for expert advice

5. Method An audit tool was devised based on Improving the Patients Experience (DoH) Leeds Satisfaction Questionnaire (Hill 1997) Discussion with key members of team Pilot testing of tool for patient use

6. Questionnaires Given Out to Patients Receiving Biologic Therapy Infliximab 150 patients attending the day case unit over an eight week period 75% returned Etanercept & Humira 50 patients attending the biologic out- patients clinic 70% returned

7. Results:Key Areas Improving access and waiting More information, more choice A clean, comfortable, friendly place to be Safe high quality co- ordinated care Building closer relationships Further support structures/service development

8. Improving Access and Waiting Direct contact with the BNS 97% of patients attending the day unit 67% of patients attending the out- patient clinic 24% waited too long on treatment days 3% waited too long for course of treatment to begin

9. More Information, More Choice Complex regimes explained 80% aware of investigations & results 9% unaware of side effects key members of the team involved as required 81% encouraged to ask questions

11. A clean, comfortable, friendly place to be 97% satisfied with environment 3% feelings not accounted for Service improvements highlighted Comments made on a relaxing, friendly environment

12. Safe High Quality Co-ordinated Care “Having someone who sees you at every treatment session provides a welcome continuity of service and saves having to go through what can be an extensive medical history. If the person knows you it’s reassuring to know that they can spot changes in your general health that are perhaps so gradual to you that you don’t notice them.”

13. Building Closer Relationships “In my view a patient needs someone they can trust who is responsive and thorough as well as technically proficient. This breeds confidence and respect as well as trust. This role and the person in it has created that situation and the climate which patients benefit from”

14. Service Development GP’s need to be more aware of biologic therapies Increased awareness of other support networks Feedback on success of treatments 15% wanted a more flexible service Development of Biologic Web site Further support from BNS

16. Conclusion & Recommendations Biologics Nurse Specialist role is significant in providing ongoing support, advice & education The therapeutic relationship between nurse specialist and patient is invaluable Patient involvement in future service provision Further exploration of the nurse-led service is recommended as the role develops

17. Thank You Thank you to All My Colleagues at Chapel Allerton Hospital, Leeds Domini.Bryer@leedsth.nhs.uk