N-ECCO Consensus statements on the European nursing roles in caring for patients with Crohn's disease or ulcerative colitis

N-ECCO (Nurses-European Crohn's & Colitis Organisation) has been an active member of ECCO since 2007, with the purpose of providing nurse education and the opportunity for nurses to network internationally. N-ECCO aims through its activity to improve nurses' knowledge of Inflammatory Bowel Disease (IBD), share best practice and thus improve the quality of care accessed across Europe by patients with IBD. It has long been acknowledged in N-ECCO that nurses across Europe perform and provide varying roles in caring for patients with IBD, given the country-specific variances in role, title, salary and level of training. The intentions of the N-ECCO Consensus statements are to identify the positioning of nurses (adult and paediatric) in the care of patients with IBD and to provide a consensus on the ideal standard of minimum care that patients with IBD might expect, irrespective of the level of nurse training, title or country. The ‘ideal’ standard of nursing care was deemed an accurate measure and appropriate by the group in order to provide a standard for all nurses working with people with IBD. The N-ECCO Committee agreed the need for the consensus statements on the nurses' role in June 2011. Following the Standard Operating Procedure (SOP) of ECCO (www.ecco-ibd.eu/) a proposal for guidelines, along with draft contents for the statements, was submitted to the Governing Board. This was approved in November 2011, with a recommendation to conduct a survey to gain a clear understanding of the current situation of nurses within Europe in caring for patients with IBD. The survey was developed and refined within the N-ECCO committee in time for N-ECCO February 2012, when all attending nurse delegates were asked to complete it. Results of this survey will be published separately. There was an official call from the ECCO Office for nursing participants to be involved in the N-ECCO Consensus in March 2012. Fifteen nurses were selected by the N-ECCO Committee, following self-nomination, given that they all had adequate experience of nursing in the field of IBD. In April 2012, nurses were allocated into one of four working groups to reflect adequate country variances, with each group chaired by a N-ECCO Committee member. Between April & June 2012, each Consensus group was given a defined section of work, based on the draft content at that time: Fundamental IBD Nursing Advanced IBD Nursing Nursing care for particular situations (e.g. fatigue, pregnancy, incontinence) The Benefit of an IBD Nurse. Each group performed an electronic literature search using PubMed (1996–2010), MEDLINE (1966–2010) and EMBASE (1980–2010), via the OVID platform. The search was conducted from the inception of the databases to November 2012. The literature review deployed the recommended grades and levels of evidence according to the Oxford Centre for Evidence Based Medicine1 as per the ECCO SOP. Nursing studies tend to be qualitative, focusing on exploring patient's issues and experiences, so it is important to acknowledge that the Oxford system of grading evidence gives greater weight to empirical evidence and does not rate qualitative research highly. Although there are grading systems specific to qualitative research, these do not form part of ECCO's SOP and were therefore avoided. In June 2012, a one day meeting took place with all consensus group members present to discuss the evidence and to draft preliminary statements based on the literature. Between June & September 2012, each group finalised their statements and supporting text. This was in turn reviewed at the N-ECCO Committee Meeting in October 2012. A further one day meeting took place in November 2012 to vote on each individual N-ECCO Consensus statement. Each of the 26 Consensus statements were voted upon and, in line with the ECCO SOP, agreed by greater than 80% of the groups' vote. Further to this meeting an editorial board consisting of four group members (M. O'Connor, P. Bager, J. Duncan, J. Gaarenstroom, L. Younge) refined the supporting text for the corresponding author and each of the Consensus statements. The Consensus statements have been divided into three sections: Fundamental Inflammatory Bowel Disease Nursing Advanced Inflammatory Bowel Disease Nursing The Perspectives of IBD Nursing. Fundamental IBD Nursing identifies the basic nursing care required to address the needs of patients with IBD. The Consensus group suggests that these needs can be addressed by nurses working in various settings. The statements within this section also pertain to those working at an as the Consensus group acknowledged that nursing care & were developed and refined with experience in nursing The section on Advanced IBD Nursing to those nurses with are nursing The statements within this section to identify the role of the the in care and of of patients with IBD, also the to this level of nursing The section on the Perspectives of IBD Nursing the of IBD nurses and identifies that there is evidence within literature to the of IBD nurses in in with patients with IBD working in need to have basic knowledge of the the Crohn's and and the of of the and of the and in the of IBD is recommended Inflammatory Bowel Disease is an given to the of Crohn's and are the Although the of IBD are it is as an by a of and or as the or IBD in or and a and is to the and in the it can to the and or the or The is and to the and of and to The and of activity the of the and It in the by the The is with of activity of according to and weight and and can as an can to a or to the of the the also form and and or and can be and for IBD to and will be for of patients and to of at in their and can in with active or in the of following of active in and and are in IBD. or of or can and with of the and and and the of and and of activity and knowledge of all nurses to patients with their and for The of or in the of IBD is by the and of the and and by individual as and of recommended are in current ECCO consensus and can also be for with a or might be for for and or and is for and be to and can improve quality of in patients with and patients with of can A is the need for a have for quality of is for It is recommended that nurses with a basic knowledge of IBD the Advanced IBD nurse or according to caring for patients with IBD need an of the of the of and the of IBD on of In to as and fatigue, IBD patients There be the and of the an of a on and by from or a is or a and a evidence suggests that to of people with IBD experience not to with are as is and be thus can be with patients than the call to and the need to of that patients with IBD that they the of the The nurse can provide and be in a to to and of in the of an is quality of is by IBD in and so in the can be of or to or be appropriate for patients levels of the have not been in issues as fatigue, and can also with IBD that their on of and In a in with of patients with IBD had time in the to their IBD and that their IBD had an in this patients that their is not or with as that they were a to discuss important to with people with experience with it is to with a a a can provide important and can provide for or an important role in providing accurate and for those with a or with of Nursing for all patients and is of the to patients with IBD to the and of the for IBD patients their needs and appropriate to care and the of in is a in nursing when the patient's to and to or and be to There is literature on the role in for patients with IBD. of in practice for the patient's of and and from that might of the for IBD are and in situations is on the to care to a the nurse to the needs and of the individual patients with IBD, and to and to the in meeting those this and to Advanced IBD or nurses with the is in or patients in their to the is a need to an and active role, and be to provide and is a of the nursing role, with and an important part in meeting the needs of the IBD on and with The caring and they from IBD nurses is important to their In the individual will have an with care is an important in and and an is It can be to the to to have an than a role in their care and with for the patient's their Nursing by patients are and involved at of need to that patients at various with the of their This can the the with IBD and and their can their to needs to be in a that be or are recommended to In the of nurses can those developed by country specific IBD Advanced IBD nurses have the to provide to patients their IBD, all nurses need be active with knowledge to basic on of for appropriate to are members of the IBD and of IBD, of IBD, and and The nurse can provide by patients to their issues can be in a and patients the opportunity to be to and The nurse their of as Advanced IBD or can be In IBD, nurses have a role in and This can best be by working in with the care and is defined as the of in the as a the and or the or have been as important for the of or of of and of the by the and their to systems or of of one of the for all care for patients with IBD. 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