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Nurse practitioners can ‘transform’ surgical departments

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The introduction of advanced nurse practitioners has “transformed” some surgical departments in the UK, according to a report, which also recommended developing the extended theatre team to enhance continuity of care and patient safety.

The report, published by the Royal College of Surgeons of Edinburgh, has made a number of critical recommendations to government to greatly improve safety in surgical treatment and patient care.

“In some specialties, such as urology, experienced nurses can provide frontline urgent clinics”

RCSED report

The college surveyed from a cross-section of the UK surgical workforce which highlighted broad inefficiencies on the frontline that impact on the working environment and delivery of a safe service. Among the 505 respondents – mostly consultants and doctors – were 11 surgical nurse practitioners.

The report – titled Improving the working environment for safe surgical care – warned that “already extremely stressful” working environments were being “compounded” by issues such as a lack of team structure and poor communication.

It also found staff felt diverted from patient-centred care by administrative and IT demands, and that being “more innovative and efficient with existing resources could make a positive difference”.

Among the report’s seven key recommendations was to “streamline and reorganise” workload to prioritise core clinical duties and create an “integrated multi-disciplinary surgical team”.

Systems and staff could be organised more efficiently to allow doctors to dedicate the maximum amount of time to the most relevant clinical responsibilities most relevant to their grade, it said.

Where appropriate, consideration should be given to developing the extended surgical team to enhance the continuity and delivery of safe surgical care, added the report.

It highlighted that the introduction of advanced surgical nurse practitioners had “transformed some departments”.

“This is a team effort and action needs to involve everyone in the team”

Report authors

This was because they offered “continuity of care to patients, a knowledge of how a unit functions and runs on a day-to-day basis, and in-depth knowledge of unit protocols for the management of specific conditions”, said the report.

“Moreover, they can help protect time for training by sharing on-call responsibilities with some of the more junior members of the team,” stated the report.

“While such persons require additional funding, those units who have invested in them have reaped rewards in improved efficiency, patient care and trainee support,” it said.

“In some specialties, such as urology, experienced nurses can provide frontline urgent clinics, thereby reducing admissions and workload for trainee doctors,” it added.

The report’s co-authors, Mr Simon Paterson-Brown and Mr Richard McGregor, said: “With the immense financial strain and staffing problems facing the NHS, it is essential we look seriously at how we can improve the whole working environment for all those delivering frontline surgical care.

“This is a team effort and action needs to involve everyone in the team,” they said. “While lack of additional resources is clearly one of the problems, it is also about much better use of current resources and changing how we do things to become more efficient and more productive.”

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