Nurse-Led Skin Surgery

1. Nurse-Led Skin Surgery Selene Daly Dermatology Clinical Nurse Specialist Sligo General Hospital

2. Service Description • Service where Punch Biopsies, Elliptical excisions and Curettage are carried out by the Dermatology Clinical Nurse Specialist • Punch BX. And excisions are carried out where Skin Ca. is suspected or undiagnosed rashes exist • Curettage is carried out on warts and benign lesions • 3 main steps, Anaesthesia- procedure -haemostasis

3. Driver for Role Expansion • Up to 40% of dermatology referrals have a surgical aspect (British Association of Dermatology 1994) • Since the early 1990’s the British Association of Dermatologists along with the Royal College of Physicians have recommended that trained nursing staff, accustomed in assisting with Dermatological procedures, should play an important part in delivering quality patient care and expertise • 90% increase in MM over the last 10 years (Irish Cancer Society) • 185% increase in MM, 195% increase BCC/SCC by 2030 (National Cancer Registry) • 3 fold increase in Local Dermatology Surgical cases over the last 5 years • 12-18 month waiting list for Dermatology

4. Supports • Dermatology Consultant • Dermatology Nurses in the U.K. and Ireland • Guideline formation – Medical S.M./ DON • Nursing Practice Development/NCNM • Accreditation/Quality Control • HMC

5. Development of New Skills/ Competencies • Lectures on Surgical Technique • Completion of Clinical Portfolio • Review of Local Surgical Services • OSCE

8. Benefits • Patients having surgery performed by an accredited practioner • Speeds up patient diagnosis • Cost effective for patients and H.S.E.

9. Thank You for Listening Selene Daly Dermatology Clinical Nurse Specialist Sligo General Hospital