Background: Telephone nursing in primary healthcare has been suggested as a solution to the increased demand for easy access to healthcare, increased number of patients with complex problems, and lack of general practitioners. Registered nurses' assessments may also be of great importance for antibiotic prescriptions according to guidelines. The aim of this study was to describe registered nurses' views of telephone nursing work with callers contacting primary healthcare centres regarding respiratory tract infections. Methods: A descriptive, qualitative study was performed through interviews with twelve registered nurses in Swedish primary healthcare. Results: The overarching themes for registered nurses' views on telephone nursing were captured in two themes: professional challenges and professional support. These included three and two categories respectively: Communicate for optimal patient information; Differentiate harmless from severe problems; Cope with caller expectations; Use working tools; and Use team collaboration. Optimal communication for sufficiently grasping caller symptoms and assess whether harmful or not, without visual input, was underlined. This generated fear of missing something serious. Professional support used in work, were for example guidelines and decision support tool. Colleagues and teamwork collaboration were requested, but not always offered, support for the interviewed registered nurses.
Background: Telephone nursing in primary healthcare has been suggested as a solution to the increased demand for easy access to healthcare, increased number of patients with complex problems, and lack of general practitioners. Registered nurses’ assessments may also be of great importance for antibiotic prescriptions according to guidelines. The aim of this study was to describe registered nurses’ views of telephone nursing work with callers contacting primary healthcare centres regarding respiratory tract infections.Methods: A descriptive, qualitative study was performed through interviews with twelve registered nurses in Swedish primary healthcare. Results: The overarching themes for registered nurses’ views on telephone nursing were captured in two themes: professional challenges and professional support. These included three and two categories respectively: Communicate for optimal patient information; Differentiate harmless from severe problems; Cope with caller expectations; Use working tools; and Use team collaboration. Optimal communication for sufficiently grasping caller symptoms and assess whether harmful or not, without visual input, was underlined. This generated fear of missing something serious. Professional support used in work, were for example guidelines and decision support tool. Colleagues and teamwork collaboration were requested, but not always offered, support for the interviewed registered nurses.Conclusions: The study deepens the understanding of telephone nursing as an important factor for decreasing respiratory tract infection consultations with general practitioners, thus contributing to decreased antibiotic usage in Sweden. To cope with the challenges of telephone nursing in primary healthcare centres, it seems important to systematically introduce the use of the available decision support tool, and set aside time for inter- and intraprofessional discussions and feedback. The collegial support and team collaboration asked for is likely to get synergy effects such as better work environment and job satisfaction for both registered nurses and general practitioners. Future studies are needed to explore telephone nursing in primary healthcare centres in a broader sense to better understand the function and the effects in the complexity of primary healthcare.
Background Smoking is still common among teenagers and young adults, and about every third young smoker states that he/she wants to quit smoking. There are no obvious evidence-based methods for tobacco cessation for young adults, and therefore, the same methods are used for adolescents and adults. The aim was to study adolescents’ and young adult’s experiences and views about what support they would like for smoking cessation. Methods A qualitative content study using a descriptive and exploratory design was conducted. Young smokers 16 - 29 years old (n=25) were interviewed in five focus groups in southern Sweden. Data were analyzed by content analysis. Results The results illuminate young people’s suggestions to develop a model for tobacco cessation. Four themes emerged; Finding your own motivation – a prerequisite for taking the first step towards giving up smoking. Existing support rejected - existing apps, support by SMS, and self-help brochures did not appeal to the adolescents. Agreement between friends – To sign an agreement between two friends, which included a fee for relapses. Supportive environment - To organize the model with duo groups and give adapted support, and create the opportunity to win simple prizes to celebrate achieved interim goals. Conclusions The participants suggested that the model for tobacco cessation should contain adult support and involve an agreement between friends, as well as have elements of celebration and competition. The challenge will be to implement this model into environments where they live.
Background: Triage by registered nurses (RN) during office hours may be of great importance for the prescription of antibiotics according to guidelines. This, however, has hardly ever been the focus of scientific study. The aim of this study was to describe RNs' views on telephone consulting work with patients calling primary health care centers for respiratory tract infections.Methods: A descriptive and qualitative study was performed through interviews with twelve RNs in Sweden. Results: The RNs saw their daily work as a continuous challenge and reported that support structures were insufficient. The themes challenge and support were built on five categories. These were: the triage, assessment over the phone and to manage expectations, evidence-based knowledge and professional collaboration. The RN had to differentiate urgent cases from self-care advice, with a fear of maybe missing something serious. They described the difficulties in assessing both the symptoms and the person calling, relying only on what they were told, as well as managing patients’ expectations with special reference to patients with other cultural backgrounds. The RN described insufficient possibilities to keep up with an evidence-based knowledge, where decision support and guidelines were only partly known and used, while continuous medical education was not prioritized. Furthermore, professional collaboration was described as unstructured.Conclusions: The telephone triage in primary care health centres regarding common problems seems to be an invisible task, both for researchers, policy makers and the RNs themselves. The consequences may be decreased patient safety, occupational stress, and an increased workload for the RNs. Systematic work is needed to strengthen the different support structures.
Background : Telephone nursing in primary healthcare has been suggested as a solution to the increased demand for easy access to healthcare, increased number of patients with complex problems, and lack of general practitioners. Registered nurses’ assessments may also be of great importance for antibiotic prescriptions according to guidelines. The aim of this study was to describe registered nurses’ views of telephone nursing work with callers contacting primary healthcare centres regarding respiratory tract infections. Methods : A descriptive, qualitative study was performed through interviews with twelve registered nurses in Swedish primary healthcare. Results : The overarching themes for registered nurses’ views on telephone nursing were captured in two themes: professional challenges and professional support. These included three and two categories respectively: Communicate for optimal patient information; Differentiate harmless from severe problems; Cope with caller expectations; Use working tools; and Use team collaboration. Optimal communication for sufficiently grasping caller symptoms and assess whether harmful or not, without visual input, was underlined. This generated fear of missing something serious. Professional support used in work, were for example guidelines and decision support tool. Colleagues and teamwork collaboration were requested, but not always offered, support for the interviewed registered nurses. Conclusions : The study deepens the understanding of telephone nursing as an important factor for decreasing respiratory tract infection consultations with general practitioners, thus contributing to decreased antibiotic usage in Sweden. To cope with the challenges of telephone nursing in primary healthcare centres, it seems important to systematically introduce the use of the available decision support tool, and set aside time for inter- and intraprofessional discussions and feedback. The collegial support and team collaboration asked for is likely to get synergy effects such as better work environment and job satisfaction for both registered nurses and general practitioners. Future studies are needed to explore telephone nursing in primary healthcare centres in a broader sense to better understand the function and the effects in the complexity of primary health care.
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