Alvin Wei Jun Teo1, Tyler Hyungtaek Rim1,2, Chee Wai Wong1, Andrew Shih Hsiang Tsai1, Nazurah Loh1, Thiyagarajan Jayabaskar1, Tien Yin Wong1,2, Chui Ming Gemmy Cheung1,2, Ian Yew San Yeo3,4. 1. Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. 2. Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore. 3. Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. ian.yeo.y.s@singhealth.com.sg. 4. Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore. ian.yeo.y.s@singhealth.com.sg.
Abstract
BACKGROUND: To describe the design, implementation, and evaluation of a nurse-led intravitreal injection (NL-IVT) programme in a Singapore tertiary eye hospital. METHODS: Patients requiring anti-vascular endothelial growth factor (VEGF) IVT were recruited. Implementation and evaluation were done in the Singapore National Eye Centre, a tertiary centre. To assess safety, nurse injectors recorded details of procedures performed and complications for an 8-month period from February 2019. To evaluate patient experience, we used a modified patient questionnaire and recorded both patients' waiting time and IVT procedure duration. A retrospective audit of IVTs before and after the introduction of NL-IVT was performed from January 2017 to September 2019. Cost difference between NL-IVT and standard doctor-led (DL) IVT was evaluated. RESULTS: A total of 8599 NL-IVTs were performed. No cases of severe complication were detected in the follow-up. A total of 135 patients who received NL-IVT and DL-IVT were surveyed. General satisfaction, interpersonal manner, financial aspect, time spent with injector, and staff competence were higher in NL-IVTs than in DL-IVTs (p < 0.05). There were no differences in terms of technical quality and communication. For 934 patients, waiting time was significantly shorter in NL-IVT (3.6 ± 10.3 min) compared with DL-IVTs (35.3 ± 32.3 min); on average, 19.7 min were saved through NL-IVT (p < 0.01). The cost difference per IVT between NL-IVT and DL-IVT is estimated at 286 SGD (163 GBP). CONCLUSION: With a well-designed training programme, NL-IVT is a safe, acceptable, and cost savings procedure. With increasing demand for IVT, NL-IVT provides an alternative model of care for healthcare systems globally.
BACKGROUND: To describe the design, implementation, and evaluation of a nurse-led intravitreal injection (NL-IVT) programme in a Singapore tertiary eye hospital. METHODS:Patients requiring anti-vascular endothelial growth factor (VEGF) IVT were recruited. Implementation and evaluation were done in the Singapore National Eye Centre, a tertiary centre. To assess safety, nurse injectors recorded details of procedures performed and complications for an 8-month period from February 2019. To evaluate patient experience, we used a modified patient questionnaire and recorded both patients' waiting time and IVT procedure duration. A retrospective audit of IVTs before and after the introduction of NL-IVT was performed from January 2017 to September 2019. Cost difference between NL-IVT and standard doctor-led (DL) IVT was evaluated. RESULTS: A total of 8599 NL-IVTs were performed. No cases of severe complication were detected in the follow-up. A total of 135 patients who received NL-IVT and DL-IVT were surveyed. General satisfaction, interpersonal manner, financial aspect, time spent with injector, and staff competence were higher in NL-IVTs than in DL-IVTs (p < 0.05). There were no differences in terms of technical quality and communication. For 934 patients, waiting time was significantly shorter in NL-IVT (3.6 ± 10.3 min) compared with DL-IVTs (35.3 ± 32.3 min); on average, 19.7 min were saved through NL-IVT (p < 0.01). The cost difference per IVT between NL-IVT and DL-IVT is estimated at 286 SGD (163 GBP). CONCLUSION: With a well-designed training programme, NL-IVT is a safe, acceptable, and cost savings procedure. With increasing demand for IVT, NL-IVT provides an alternative model of care for healthcare systems globally.
Authors: Monica M Michelotti; Salwa Abugreen; Simon P Kelly; Jiten Morarji; Debra Myerscough; Tina Boddie; Ann Haughton; Natalie Nixon; Brenda Mason; Evangelos Sioras Journal: Clin Ophthalmol Date: 2014-04-15
Authors: John P Ansah; Victoria Koh; Dirk F de Korne; Steffen Bayer; Chong Pan; Jayabaskar Thiyagarajan; David B Matchar; Ecosse Lamoureux; Desmond Quek Journal: Ann Acad Med Singapore Date: 2018-01 Impact factor: 2.473
Authors: Yu Qiang Soh; Nathalie Pei Yu Chiam; Andrew Shih Hsiang Tsai; Gemmy Chui Ming Cheung; Tien Yin Wong; Ian Yew San Yeo; Edmund Yick Mun Wong; Anna Cheng Sim Tan Journal: Transl Vis Sci Technol Date: 2020-07-17 Impact factor: 3.283