A program of nurse algorithm-guided care for adult patients with acute minor illnesses in primary care

Attention to patients with acute minor-illnesses requesting same-day consultation represents a major burden in primary care. The workload is assumed by general practitioners in many countries. A number of reports suggest that care to these patients may be provided, at in least in part, by nurses. Ho...

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Bibliographic Details
Published in:	BMC family practice Vol. 14; no. 1; p. 61
Main Authors:	Fabrellas, Núria, Sánchez, Carmen, Juvé, Eulàlia, Aurin, Eva, Monserrat, Dolors, Casanovas, Esther, Urrea, Magali
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 16-05-2013 BioMed Central
Subjects:	Acute Disease - nursing Administració dels serveis d'infermeria Adolescent Adult Algorithms Appointments and Schedules Atenció primària Case Management Clinical Competence Cross-Sectional Studies Electronic Health Records Hospitals Humans Infermeria en l'atenció primària Medical research Medicine, Experimental Middle Aged Nurse Practitioners - standards Nurse Practitioners - statistics & numerical data Nurses Nursing Assessment Nursing services administration Patient Acceptance of Health Care - statistics & numerical data Patient satisfaction Practice Patterns, Nurses' - statistics & numerical data Primary care Primary health care Primary Health Care - methods Primary Health Care - standards Primary nursing Program Evaluation Referral and Consultation - statistics & numerical data Skin Spain Studies Technology application Time Management Spain
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Summary:	Attention to patients with acute minor-illnesses requesting same-day consultation represents a major burden in primary care. The workload is assumed by general practitioners in many countries. A number of reports suggest that care to these patients may be provided, at in least in part, by nurses. However, there is scarce information with respect to the applicability of a program of nurse management for adult patients with acute minor-illnesses in large areas. The aim of this study is to assess the effectiveness of a program of nurse algorithm-guided care for adult patients with acute minor illnesses requesting same-day consultation in primary care in a largely populated area. A cross-sectional study of all adult patients seeking same day consultation for 16 common acute minor illnesses in a large geographical area with 284 primary care practices. Patients were included in a program of nurse case management using management algorithms. The main outcome measure was case resolution, defined as completion of the algorithm by the nurse without need of referral of the patient to the general practitioner. The secondary outcome measure was return to consultation, defined as requirement of new consultation for the same reason as the first one, in primary care within a 7-day period. During a two year period (April 2009-April 2011), a total of 1,209,669 consultations were performed in the program. Case resolution was achieved by nurses in 62.5% of consultations. The remaining cases were referred to a general practitioner. Resolution rates ranged from 94.2% in patients with burns to 42% in patients with upper respiratory symptoms. None of the 16 minor illnesses had a resolution rate below 40%. Return to consultation during a 7-day period was low, only 4.6%. A program of algorithms-guided care is effective for nurse case management of patients requesting same day consultation for minor illnesses in primary care.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	1471-2296 1471-2296
DOI:	10.1186/1471-2296-14-61