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Review of a paediatric inflammatory bowel disease service during the pandemic and the impact of the CNS role

22 July 2021
8 min read
Volume 30 · Issue 14

Abstract

Background:

Inflammatory bowel disease (IBD) is a chronic relapsing and remitting condition. The COVID-19 pandemic has severely disrupted provision of medical care across the world. IBD clinical nurse specialists (CNSs) played a pivotal role in the care of children with IBD during the pandemic national lockdown and in the recovery phase. This article aims to look at the impact of COVID-19 on the paediatric IBD service in one children's hospital and the effect on the IBD CNSs' workload.

Method:

A retrospective review of clinical notes and the service's IBD database from January 2019 to September 2020.

Results:

There was a significant increase in the number of email and telephone contacts to the IBD CNS team during lockdown. There was an increase in virtual clinics, and an increase in new IBD patients coming to the service, but a reduction in the number of face-to-face consultant clinics.

Conclusion:

COVID-19 has disrupted medical services to children with IBD and led to a reduction in face-to-face activities but has also led to a significant increase in virtual activities. CNSs have taken up a wider role to cover patient care during a time of both medical and nursing redeployment.

Inflammatory bowel disease (IBD) is an umbrella term covering two main conditions, Crohn's disease and ulcerative colitis (Levine et al, 2014). The aetiology of IBD is as yet unknown, but genetics, environment, gut microbiome and the individual's immune system are thought to have a role in its development (Zhang and Li, 2014). IBD can affect both children and adults and commonly presents with gastrointestinal (GI) manifestations such as diarrhoea, urgency to pass stools, blood and mucous in the stools, abdominal pain and fatigue. There are also extra-intestinal manifestations that can affect organs outside the GI tract such as skin, joints and eyes (Vavricka et al, 2015). IBD is characterised by relapsing and remitting symptoms that can lead to periods of unexpected symptom exacerbation. Although there is no cure, many patients with IBD are on long-term medications to help control the inflammation and, therefore, their symptoms. Many medications used to treat IBD can modulate the immune system and most children take more than one medicine to achieve and maintain clinical remission (Rosen et al, 2015).

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