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    A safety audit of the first 10 000 intravitreal ranibizumab injections performed by nurse practitioners

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    URI
    http://hdl.handle.net/11287/593828
    Author
    Simcock, Peter
    Kingett, B.
    Mann, N.
    Reddy, V.
    Park, J.
    Date
    2014-10-01
    Journal
    Eye
    Type
    Journal Article
    Publisher
    Nature
    DOI
    10.1038/eye.2014.153
    Metadata
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    Abstract
    PURPOSE: To evaluate the safety of a nurse practitioner (NP)-delivered injection service for the treatment of wet age-related macular degeneration (wAMD) with ranibizumab. METHODS: An evaluation of medical staffing resources for providing an injection service for wAMD highlighted difficulties covering lists. An alternative strategy of an NP-delivered injection service was evaluated. Two suitable NPs with previous extensive experience in minor surgical procedures were identified. The department's senior vitreo-retinal consultant supervised the NP's training programme. A prospective safety audit was conducted for the first 5.5 years of the service. RESULTS: The NPs administered 10 006 injections in the first 5.5 years of the service (1 May 2008 to 8 October 2013). This represented 84.1% of the total injections performed during this period. Four patients developed presumed infectious endophthalmitis (1 was culture positive and 3 were culture negative). The incidence of post-injection endophthalmitis was 0.04%. There was no evidence of lens touch, retinal detachment, or systemic thrombo-embolic events. CONCLUSIONS: Carefully selected and well-trained NPs are capable of delivering a safe and effective wAMD injection treatment service. This work demonstrates how such a service can be established and provides safety data that other units can use as a benchmark when evaluating their own practice.
    Citation
    Eye (Lond). 2014 Oct;28(10):1161-4.
    Publisher URL
    http://dx.doi.org/10.1038/eye.2014.153
    Note
    This article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.
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    • 2014 RD&E publications
    • Ophthalmology (West of England Eye Unit)

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