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A nurse-led palpitations clinic: a 2-year experience
P A Scott1, P Appleford, T G Farrell
1Department of Cardiology, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK.
Postgraduate Medical Journal
|January 13, 2010
Summary
Nurse-led clinics can effectively assess low-risk palpitations patients, but require careful management to avoid delays for high-risk individuals. This ensures timely cardiology referrals for those needing specialist care.
Area of Science:
- Cardiology
- Nursing
- Healthcare Management
Background:
- Palpitations are a common patient complaint.
- Traditional cardiology outpatient services face capacity challenges.
- Nurse-led clinics offer potential solutions for managing specific patient groups.
Purpose of the Study:
- To evaluate the effectiveness and safety of a nurse-led clinic for assessing patients presenting with palpitations.
- To determine the diagnostic yield and patient outcomes within this specialized clinic setting.
Main Methods:
- A prospective descriptive study was conducted at a UK district general hospital.
- Patients referred with palpitations, excluding those with high-risk features or known arrhythmias, were assessed.
- Standard protocols included ECG, ambulatory ECG monitoring, and cardiologist consultation.
Main Results:
- 389 patients were assessed over 15 months, with a mean referral-to-assessment time of 38 days.
- Symptomatic extrasystoles (42%) and sinus rhythm (22%) were the most frequent diagnoses.
- Significant arrhythmias were found in 15% of patients; 13% required subsequent cardiology referral, including 20 high-risk cases who faced delays.
Conclusions:
- Nurse-led clinics can be a suitable alternative for low-risk palpitations patients.
- Unforeseen inclusion of high-risk patients led to significant assessment delays.
- A clear pathway for rapid assessment of high-risk patients is essential before implementing such services.
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