UCC SONM 25 Year Book

UCC / School of Nursing and Midwifery

Patients have reported high levels of satisfaction with the service and are among Louise’s greatest advocates. Apart from the benefits of increased knowledge and understanding of their condition, patients value the structured support system that Louise provides them in managing their condition. The service that Louise provides allows for close monitoring and tight control of disease symptoms and therefore promoting improved quality of life and independence among this patient group. By creating a pathway at the point of access in ED, Louise expedites the patient’s journey though the overcrowded ED while opening up appropriate referrals to rheumatology outpatient services. Through close monitoring of disease activity, Louise identifies patients who would benefit from early allied health professional intervention. She has created direct referral pathways to physiotherapy, occupational therapy and nutrition and dietetics for patients. Louise has also fostered strong collaborative links with GPs to facilitate medication monitoring and flare management in the community thus supporting hospital avoidance. Patients also benefit from her collaboration with the rheumatology medical staff. While Louise’s service is relatively young, there is much evidence to suggest that her model and approach is and will be effective. It is estimated that if treatment targets are achieved there is a potential saving of €67,500 per year in newly diagnosed rheumatoid arthritis patients. Results from the treat to target cohort in Navan demonstrated 81.5 % of patients achieved remission at week 52 and resulted in a 30% reduction in need for biologic treatment. A RANP can provide virtual services to monitor the efficacy and safety of treatment for patients with stable disease realising savings of approximately €501,000 in patient related costs, while optimising methotrexate dosing can result in up to €123,000 in annual savings to individual centres for every 10 patients. Most importantly, Louise has to date demonstrated accessible, safe and effective care to a complex group of patients.

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