N009 The knowledge gained by a novice Inflammatory Bowel Disease nurse in the first year of service in comparison to experienced IBD nurses knowledge.
L. Cronin*1, J. Hughes1, R. Grafton1, P. Leach2, H. Lewis2, K. Moss2, J. Andrews1
1Royal Adelaide Hospital, Inflammatory Bowel Disease Service, Adelaide, Australia, 2Flinders Medical Centre, Inflammatory Bowel Disease Service, Bedford Park, Australia
The IBD nurse (IBDN) specialist role in Australia is relatively new; however there is an increasing demand for this type of service, as outcomes for Inflammatory Bowel Disease (IBD) patients have been proven to be superior where IBDNs are available. The IBD Unit at the Royal Adelaide Hospital has 2 experienced IBDNs (expIBDN), starting in 2008 and 2011 respectively. In January 2014 a new IBDN was appointed. A non-gastroenterology trained nurse was employed from a background of Burns nursing. The challenge was to up skill the novice IBDN (novIBDN) without formal IBDN education being readily or locally accessible.
Education was provided as follows:
° On the job education from the expIBDNs and IBD medical staff (sitting in on IBD clinic with the Unit Head, attending MDT meetings, listening in to "virtual" clinic)
° Attendance at several IBD conferences and evening lectures
° Self-directed learning
Questionnaires relating to IBD knowledge were completed by the novIBDN on her first day of employment and again 11 months later. The questionnaires used comprised: CCKnow and Leong which test general IBD knowledge and the CCPKnow which specifically assesses IBD-specific pregnancy-related knowledge. ExpIBDNs (from Royal Adelaide Hospital and Flinders Medical Centre - n=4) completed the same questionnaires (once only).
All 4 expIBDNs scored 100% on the Leong questionnaire, as did the novIBDN both at initial and repeat testing. On the CCKnow questionnaire, experienced IBDNs scored between 10-12/12 (mean 11.5/12; 96%) and the novice scored 100% at both time points. On the CCPKnow, expIBDNs scored between 15-17/17 (mean 15.8; 93%), whilst the novIBDN scored 12/17 (71%) at baseline and 17/17 (100%) at follow-up.
The novIBDN also reported clear improvement in self-perceived IBD knowledge and specifically noted: confidence in being able to independently handle the blood monitoring schedule (for patients on thiopurines and biologics); greater confidence in biologic initiations, safety monitoring, prescribing restrictions and pre-screening; and a growing independence in handing helpline calls.
Current IBD knowledge questionnaires are insufficiently sensitive to assess differential IBD awareness in registered nurses in Australia, except for the CCPKnow, which specifically addresses pregnancy/fertility issues. This emphasises that pregnancy/fertility are areas of poor general medical/nursing knowledge outside of IBD units. On the job training in a specialty IBD unit delivers clear gains in knowledge and confidence in IBDNs over a year, however, formal educational assessments and training modules should be developed to ensure quality and consistency of practice standards.