T he coronavirus pandemic has resulted in dramatic changes to the delivery of patient care in all settings . Primary care has had the biggest shift from face-to-face appointments to virtual consultations . In primary care in the UK , dermatology accounts for 13 million general practice consultations , and 5.5 % are referred for specialist advice . 1 Primary care nurses need to feel confident about conducting a virtual dermatology consultation effectively , and to assess , manage and support patients with selfmanagement advice . Dermatology is a visual specialty ; primary care nurses need to try to see the patient ’ s skin or use tools to help the patient describe how their skin feels . Virtual consulting can be good for handling chronic skin conditions , for example acne , eczema , psoriasis , rosacea and vitiligo . Acute dermatology and new conditions can be triaged virtually , for example skin infections , and hair and nail conditions . Primary care nurses can include specialist nurses in consultations about , for example , tissue viability with leg ulcers and wound care . But some dermatology conditions cannot be managed with virtual consultations . In our service , dermatology patients who have genital dermatoses are generally booked into a face-to-face appointment and seen in person as images of intimate areas may be problematic . Here are 10 practical tips for a virtual dermatology consultation , from preparation to closing the consultation .
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Julie Van Onselen is a lecturer practitioner in dermatology at the Dermatology Education Partnership and the University of Stirling |
1 Prepare
2 Gather
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your patient A virtual consultation requires preparation . First , ensure the practice and nurse are comfortable with the technology . Text messaging is useful to advise the patient whether the consultation will be via a phone call or video link and to tell them they need a smartphone , tablet or laptop with a reliable internet connection . Double-check the patient can link to a video call – if not confirm the consultation will be by phone . Ask the patient to have all their skin treatments at hand , including prescription items and anything else they use on their skin . Consider sending questionnaires beforehand , for example the patient-orientated eczema measurement ( POEM ) 2 to assess symptoms over the last week and the dermatology life quality index ( DLQI ) 3 to assess effects on quality of life . Patients can also be asked beforehand to keep a diary of symptoms . Analogue scales are useful : for example , on a scale of 1-10 , how red or sore is your skin today compared with last week ? Or how itchy is your skin today ?
images and assessment information beforehand Every dermatology virtual consultation should be accompanied by images , which will need to be
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nursinginpractice . com Winter 2021 |