Benign paroxysmal positional vertigo nurse-led follow-up clinic

Abstract

Patients with benign paroxysmal positional vertigo (BPPV) often require multiple appointments for treatment with Epley manoeuvres. Waiting times for medical follow up can be very long. To reduce waiting times and increase availability of ENT outpatients' appointments, a nurse-led dizziness clinic (NLDC) to follow up BPPV patients was established. Prospective audit of 99 consecutive patients attending the NLDC, at which patients are assessed and treated, was conducted. Non-responders are redirected for further medical review. 99 patients were seen in 200 appointments in the NLDC from July 2007 to May 2009. The mean time to NLDC was 16 days. 67 patients were discharged from the NLDC free of symptoms. Cost analysis revealed savings of £3,800. A survey of NLDC attendees revealed that the care they received was rated as excellent, very good or good by 92% of patients. In conclusion, the NLDC is an innovation which increases availability of ENT outpatient appointments. This is acceptable to patients and is a natural extension of the roles of ENT nurse practitioners which could be implemented in other ENT departments.

Economic burden of vertigo: a systematic review

“…The 16 studies covered seven countries: the USA (seven studies [32–34, 36, 38, 42, 44];), the UK (three studies [41, 45, 47];), Germany (three studies [37, 40, 46];), Canada (one study [39];), Norway (one study [43];) and a multicentre study [35] from which we selected the data referring to the developed countries in Europe, namely the Czech Republic, Germany, Hungary, and Slovenia. Health care providers were primary care [47], emergency department in four studies [33, 34, 39, 42], and hospital in three studies [36, 41, 44]. Two studies covered more than one sector of the health care system [35, 37]; and five studies applied a population-based approach [32, 38, 40, 45, 46].…”

“…Regarding the type of the vertigo, addressed diseases and symptoms ranged from unspecified patient-reported dizziness [46] to verified vestibular diseases such as uni- or bilateral vestibular deficiency (UVD, BVD) [36, 44], MD [45], and BPPV [41]. Most of the studies covered a range of central and peripherial vestibular vertigo [40], including undiagnosed vertigo [32–35, 38, 39, 42, 43, 47]; and including functional vertigo as well [37].…”

Reducing the follow‐up rates over three consecutive specialist registrar trainees placements

“…This could be implemented to help reduce clinician led follow-up rates. 9 Clinical applicability of the study This study demonstrates the potential that consultants have in improving the follow-up rates of their trainees. Tech-niques utilised include written guidelines presented to the trainee before commencing their attachment, training and feedback during the clinic, reviewing trainee's clinic letters and giving oral and written feedback.…”

“…We have found trainees may not be aware of such a service, particularly when starting their post and are less likely to send stable mastoid cavities or ears requiring regular dewaxing to such clinics. A nurse‐led dizziness clinic has also shown to be an effective tool in reducing waiting times for patients. These clinics treated diagnosed benign paroxysmal positional vertigo which may require multiple appointments.…”

“…Nurses were trained to perform Dix Hallpike's test and Epley's manoeuvre, achieving a 95% rate of symptom resolution. This could be implemented to help reduce clinician led follow‐up rates …”