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dc.contributor.authorBubb, L
dc.contributor.authorMathews, D
dc.contributor.authorOehring, D
dc.contributor.authorHarper, RA
dc.date.accessioned2022-02-08T12:18:59Z
dc.date.issued2021-12
dc.identifier.issn0950-222X
dc.identifier.issn1476-5454
dc.identifier.urihttp://hdl.handle.net/10026.1/18667
dc.description.abstract

AIMS: A local service evaluation was conducted in order to compare clinical assessment measures and management decisions between an ophthalmic nurse practitioner and a reference standard glaucoma consultant, for patients referred into secondary care with suspected Chronic Open Angle Glaucoma or Ocular Hypertension. METHODS: One hundred patients were selected. A clinical pathway incorporating the assessment methods recommended by National Institute for Health and Care Excellence (NICE) Glaucoma update 2017 (NG81) was delivered by a single ophthalmic nurse practitioner and the reference standard glaucoma consultant. Clinical findings and outcomes were recorded, with both practitioners being masked to each other's findings. Agreement was determined employing Cohen's kappa, measuring inter-rater agreement allowing for chance agreement. RESULTS: Agreement was observed as follows: Visual field assessment (kappa k = 0.806, 95% CI 0.661-0.951); Optical Coherence Tomography evaluation (kappa k = 0.648, 95% CI 0.507-0.798); C:D Ratio assessment (Cronbach's alpha α = 0.96, 95% CI 0.88-0.94); Diagnosis (kappa k = 0.874, 95% CI 0.818-0.914); and Treatment planning (kappa κ = 0.844, 95% CI 0.733-0.955). In three cases the nurse practitioner judged the optic nerve to appear normal, where the reference standard examiner detected glaucoma and commenced treatment. CONCLUSION: This service evaluation demonstrates how an ophthalmic nurse practitioner with appropriate theoretical knowledge and practical training, can develop skills to reach a high level of agreement in patient assessment and management for those patients with suspected glaucoma. Within the limitations of a single centre and single practitioner evaluation, our findings provide evidence that this model of capacity expansion ought to merit wider consideration in secondary care glaucoma services.

dc.format.extent3258-3265
dc.format.mediumPrint-Electronic
dc.languageen
dc.language.isoen
dc.publisherSpringer Nature [academic journals on nature.com]
dc.subjectGlaucoma
dc.subjectGlaucoma, Open-Angle
dc.subjectHumans
dc.subjectNurse Practitioners
dc.subjectOcular Hypertension
dc.subjectVisual Fields
dc.titleOphthalmic nurse practitioner assessment of glaucoma: evaluating agreement within an initiative to enhance capacity in glaucoma clinics
dc.typejournal-article
dc.typeArticle
plymouth.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/33495567
plymouth.issue12
plymouth.volume35
plymouth.publication-statusPublished
plymouth.journalEye
dc.identifier.doi10.1038/s41433-021-01394-4
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/School of Health Professions
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/Institute of Health and Community
plymouth.organisational-group/Plymouth/Research Groups/Plymouth Institute of Health and Care Research (PIHR)
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
dc.publisher.placeEngland
dcterms.dateAccepted2021-01-05
dc.rights.embargodate9999-12-31
dc.identifier.eissn1476-5454
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1038/s41433-021-01394-4
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2021-12
rioxxterms.typeJournal Article/Review


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