Improving service delivery for relapse management in multiple sclerosis

Abstract

This action research study was conducted over an 18 month period within a district general hospital. The study has improved the quality of the service provided to people experiencing a relapse of multiple sclerosis. The authors now identify and treat a three-fold increase in relapse patients. At least 85% of these patients are treated within 10 days of reporting symptoms to a specialist nurse. Before the study, only 12% of patients received treatment within this time. The authors' data identify what patients valued about this service and also inform debate around distress associated with relapse and how services should develop to respond to this. The study is of particular importance to the UK because the National Institute for Clinical Excellence (NICE) has published guidance to the NHS about the management of this specific patient group (NICE, 2003). This study also clearly demonstrates how specialist nursing services can combine a substantial clinical role with instigating and managing change in service delivery that results in improvements in patient care.

Evaluation of the impact of nurse consultant roles in the United Kingdom: a mixed method systematic literature review

“…Several studies failed to adequately describe comparison groups (Crocker 2002, Currie et al. 2004, Ayers 2005, Warner et al. 2005, Kirk 2007, Mason 2009).…”

“…Improvements in symptomatic outcomes were evident in several quantitative and survey studies, including both physical (Pottle 2005, James & McPhail 2008, Mason 2009) and psychological outcomes (e.g. Warner et al. 2005), such as reduced anxiety (Marshall et al.…”

Clinical and Organizational Factors Related to the Reduction of Mechanical Restraint Application in an Acute Ward: An 8-Year Retrospective Analysis

“…Restraint use was conditioned not only by clinical factors but mainly by organizational factors related to staff, structure and health guidelines which, over an 8-year period, allowed its significant reduction. Only a multidimensional approach [ 72 - 74 ] could face out almost completely this procedure since violence is a complex and multi-faceted phenomenon [ 75 ]. Other studies aimed to explore the relationship between patients and staff are necessary to better identify innovative strategies for reducing violence in health settings [ 76 ].…”

Relapse in multiple sclerosis

“…Multiple sclerosis nurses facilitate a timely response to relapses; in one study 69 patients reported their relapse symptoms to a nurse sooner (within 10 days of onset) compared with a mean time of 51 days when reporting the same symptoms to a general practitioner; 85% of patients were treated for their relapse within 10 days of first reporting symptoms; and a threefold increase in treatment capacity occurred. In a more recent study, a noticeable reduction in hospital bed utilisation by patients with multiple sclerosis was seen.…”