The impact of a glaucoma nurse specialist role on glaucoma waiting lists

Over the last two decades there has been an increasing demand on health care services. This has led to increased waiting lists and waiting times to access public hospital services. In ophthalmic practice an aging population and technological advances have been major contributors to this situation. The challenge for health care providers is how to manage waiting lists within the resources provided and targets set by Elective Services, a department of the Ministry of Health (MoH). The Ministerial Taskforce on Nursing (1998) highlighted that nurses are an underutilised resource. Subsequent to the Ministerial Taskforce, the availability of interim funding from Elective Services and a skilled speciality nursing workforce the Ophthalmology Department at a large metropolitan hospital was able to implement an advanced nursing role with respect to glaucoma management. Early diagnosis is important in reducing the risk of permanent visual impairment from primary open angle glaucoma; therefore the length of time to diagnosis can have long term implications for the patient. Patients for the 'nurse-led' glaucoma clinic were recruited from specific categories of glaucoma patients on the waiting list. An audit of the impact on the waiting list was undertaken periodically over a two year period. The audit following the introduction of the clinical nurse specialist clinic shows a marked reduction in waiting list numbers and length of time waiting for first specialist assessment for glaucoma. The implementation of this role proved to be successful and has subsequently become a permanent nurse specialist position in the ophthalmology department.