Abstract
Abstract Background An inflammatory bowel disease (IBD) surgical link nurse (SLN) role was introduced during the Covid -19 pandemic to improve monitoring and safety netting for IBD patients awaiting surgery. Objectives include maintaining a database and working with the MDT and scheduling team to prioritise and manage operating lists, and avoid patients being removed form waiting lists inappropriately. Bi-weekly meetings facilitate MDT review with surgical, nursing, and dietetic input allowing for timely therapeutic optimisation of advanced therapies, facilitate preoperative optimisation and coordinate care among the MDT and scheduling team, often including primary and secondary care outside of our trust as appropriate. The IBD SLN also undertakes virtual clinics and provides advice line support for patients awaiting surgery providing monitoring, reassurance, education, and empowerment. We wanted to capture clinical activity and outcomes from the SLN role, including utilisation of service, by reviewing the IBD surgical monitoring database for the previous 12 months. Methods Three referral systems for entering the patient to the IBD surgical link nurse monitoring database were reviewed. Direct referral from colorectal surgeons, patient-initiated referrals via the existing IBD advice line service, and the IBD email service acting as a referral system for primary care, other secondary care centres, multi-disciplinary team, and advanced therapy service to highlight to the IBD SLN patients who there are concerns about. All referrals are assessed and categorised by the IBD SLN and added to the IBD surgical monitoring database. Results Between October 2023 to September 2024, 208 referrals were received. The majority of referrals came from colorectal surgeons. 131 virtual support sessions have been conducted for pre-operative support and education. 74 patients underwent colorectal surgeries and 4 patients declined surgery. Currently, 122 patients are on the IBD surgical monitoring database for active monitoring. Patient feedback is being collected regarding their experiences of the service. Conclusion The IBD SLN role supports patients while awaiting surgery. The IBD SLN acts as a support and point of access for patients and family to discuss surgery and related issues. This role has improved communication between primary care and within the MDT. The IBD surgical monitoring database strengthens safety netting and avoids unnecessary delay or cancellation in surgeries. This comprehensive monitoring system and the SLN role helps provide timely surgical care, optimises waiting lists, facilitates efficient and equitable utilisation of theatre lists, and helps to avoid unnecessary outpatient and emergency department attendance.
Published Version
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