Nurse-led clinic

A nurse led clinic is any outpatient clinic that is run or managed by registered nurses, usually nurse practitioners or Clinical Nurse Specialists in the UK. Nurse led clinics have assumed distinct roles over the years, and examples exist within hospital outpatient departments, public health clinics and independent practice environments.

A broad definition of a nurse led clinic defines these clinics based on what nursing activities are performed at the site. Nurses within a nurse led clinic assume their own patient case loads, provide an educative role to patients to promote health, provide psychological support, monitor the patient's condition and perform nursing interventions. Unlike many clinics which exist in the United States, Ontario's clinics have been met with some criticism from the Ontario Medical Association and some family physicians who view nurse led clinics to be unproven innovations in primary care. Nurse led clinics typically focus on chronic disease management: conditions where regular follow up and expertise is required, but also where a patient may not necessarily need to see a physician at every visit. This may include a specific task such as giving patient education, assessment and management of cardiovascular risks, managing blood pressure, exacerbations of COPD and overall disease management.

Nurse led clinics have a brief history of evaluation in scientific literature. A related study also found that nurse led clinics were more effective than conventional care in controlling hypertension for adult patients with Type II Diabetes and uncontrolled hypertension. Generally, it was found that most patients experienced improved outcomes following nurse led clinic consultation, with the best improvement rates found for wound care and continence clinics. Randomised controlled trials in rheumatology have demonstrated that nurse led clinics are effective in controlling disease activity in people with rheumatoid arthritis. In addition, three studies have demonstrated cost effectiveness on this model of care in Denmark, the Netherlands and the UK. Many nurse led clinics have also been associated with enhanced patient satisfaction with care. This has also been shown in rheumatology nurse led clinics. In the UK, nurse led care has been established in many chronic conditions such as diabetes, COPD and musculoskeletal disorders. Treatment guidelines in rheumatoid arthritis for example, specify the role of the nurse in managing the disease

The evidence for the effectiveness of nurse led intervention is growing and increasingly supported by randomised controlled trials and systematic reviews.