AB0997 Day Care Hospital Patient Attendance Circuit in Rheumatology: Introduction of A Nurse Consultation
Authors: E. Guerrero, I. Aramburu, N. Rivera, M.L. Garcia, E. Galindez, I. Torre, F. Garcia, J. Blanco, O. Fernandez, I. Calvo, E. Ruiz Lucea
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Day care hospital (DCH) in rheumatology attends patients who need intravenous (IV) treatments, mainly biological therapy (BT), and other proceedings that cannot be made in the clinic but don9t require hospitalization.The administration of BT demands a security monitoring prior to the administration that is made usually by the rheumatologist, which involves clinic overloading. The introduction of a protocolized nurse consultation (PNC)with the application of a security check-list would reduce the number of consultations without risks for the patient. <h3>Objectives</h3> To analyze the number of consultations and events registered after the introduction of a PNC in rheumatology DCH <h3>Methods</h3> Introduction of PNC in DCH with modification of the patient circuit from april 2015 in patients who receive BT as usual therapy (infliximab, abatacept, golimumab and tocilizumab). After the first consultation the patient is alternatively directed to the PNC (even consults) where the nurse applies the security check-list, provides the BT following the protocol, gives the activity questionnaires and records events, and the medical consultation (odds consults) where the rheumatologist carries out the anamnesis, physical examination, blood analysis and complementary tests review and treatment modifications. Retrospective review of patients, proceedings, consultations and events registered at DCH of Rheumatology over 2015 in a tertiary hospital after the introduction of a PNC in April 2015. Statistical analysis was made with SAS System for windows,v 9.2. <h3>Results</h3> Over 2015, 116 patients were attended in DCH: 49 rheumatoid arthritis (42,2%), 29 spondilytis (25,1%), 16 connective diseases (13,8%), 8 vasculitis (6,9%), 10 psoriastic arthritis (8,6%) and 4 juvenile arthritis (3,4%). Usual TB treatment received was: infliximab in 59, tocilizumab in 48, abatacept in 6 and golimumab in 3 patients. Over the period January- March/ April-December the following treatments were received: infliximab 72/ 214, tocilizumab 80/ 189, abatacept 8/ 36, and golimumab 3/ 21. 819 consultations were made: 610 medical (74,48%) (203 January-March and 407 April-December) and 209 nursery (25,52%) (April–December). 22 events were registered in the PNC (10,5%) that required telephone consultation with the rheumatologist: 6 common cold, 5 fever, 3 chills, 1 urinary disturbance, 2 dental removal, 2 arthritis, 1 skin eruption, 1 hypoglycemia, 1 peripheral edema), and five of them forced to the interruption of the treatment (2 urinary tract infections and 3 respiratory infections), giving the patient a new date in the medical consultation, without relevant secondary effects or complications for the patient. <h3>Conclusions</h3> The introduction of a Protocolized Nurse Consultation in Day Care Hospital in Rheumatology allows reduction in medical consultations number without relevant events in treatment administration or risks for the patient. <h3>Disclosure of Interest</h3> None declared