Academic Journal
Evaluation of a Registered Nurse-Led Outpatient Paracentesis Service for Decompensated Cirrhosis: A Retrospective Review.
| Τίτλος: | Evaluation of a Registered Nurse-Led Outpatient Paracentesis Service for Decompensated Cirrhosis: A Retrospective Review. |
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| Συγγραφείς: | McDonald M; Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada., Fang C; Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada., Song C; Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada., Yim C; Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada., Hubley P; Collaborative Academic Practice, University Health Network, Toronto, Ontario, Canada., Cherepaha-Kantorovich I; Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada., Camaya S; Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada., Lee E; Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada. |
| Πηγή: | Journal of evaluation in clinical practice [J Eval Clin Pract] 2026 Sep; Vol. 32 (6), pp. e70578. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 9609066 Publication Model: Print Cited Medium: Internet ISSN: 1365-2753 (Electronic) Linking ISSN: 13561294 NLM ISO Abbreviation: J Eval Clin Pract Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford, England : Wiley-Blackwell, c1995- |
| Ιατρικοί όροι (MeSH): | Paracentesis*/nursing , Paracentesis*/methods , Paracentesis*/statistics & numerical data , Liver Cirrhosis*/therapy , Liver Cirrhosis*/complications , Liver Cirrhosis*/nursing , Ambulatory Care*/organization & administration , Practice Patterns, Nurses'*, Ascites/etiology ; Ascites/therapy ; Humans ; Retrospective Studies ; Female ; Male ; Middle Aged ; Aged ; Ontario |
| Περίληψη: | Background: Ascites is a common and debilitating complication of decompensated cirrhosis that frequently requires therapeutic paracentesis (TP) for symptom relief. Limited outpatient procedural capacity may contribute to avoidable hospital readmissions. The use of registered nurses (RNs) to perform TP remains uncommon, with few models described internationally. Objective: To evaluate the safety of an RN-led outpatient TP model and describe the potential geographic reach of patients accessing care at a Canadian tertiary liver clinic. Methods: A retrospective chart review was conducted of all outpatient TP procedures performed at Toronto General Hospital between 6 June 2022 and 28 February 2023. Procedures were performed either in the Medical Day Unit (MDU; performed by physicians/nurse practitioners) or in the Liver Clinic (LC) procedure room by trained RNs. The primary outcome was the occurrence of predefined procedure-related adverse events. Adverse events were identified through review of clinical documentation, including emergency department visits within the institutional health network and patient-reported events documented in the electronic medical record. A secondary analysis examined geographic patterns of access using patient residential postal codes. Results: A total of 124 patients underwent 580 TP procedures, of which 55.2% were performed by RNs. Alcohol-associated liver disease and metabolic dysfunction-associated steatotic liver disease were the most common underlying etiologies. No procedure-related complications were identified (0%; 95% CI: 0-0.52%). Most patients resided within the Greater Toronto Area; however, some travelled up to 360 km, often bypassing closer hospitals, to access outpatient services. Conclusions: An RN-led outpatient TP model demonstrated reassuring safety signals and contributed to expanded procedural capacity within an ambulatory liver programme. These findings support the feasibility of nurse-led procedural models as a strategy to improve access to care for patients with decompensated cirrhosis. Further evaluation is needed to assess the impact of this approach on healthcare utilisation and patient-reported outcomes. (© 2026 The Author(s). Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.) |
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| Contributed Indexing: | Keywords: ambulatory care; cirrhosis; paracentesis; registered nurse |
| Entry Date(s): | Date Created: 20260908 Date Completed: 20260908 Latest Revision: 20260910 |
| Update Code: | 20260910 |
| PubMed Central ID: | PMC13553018 |
| DOI: | 10.1111/jep.70578 |
| PMID: | 42709979 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1365-2753 |
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| DOI: | 10.1111/jep.70578 |