A randomized controlled trial of nurses vs. doctors in the resolution of acute disease of low complexity in primary care

Iglesias, Begoña; Ramos, Francisca; Serrano, Beatriz; Fàbregas, Mireia; Sánchez, C.; García, Maria José; Cebrian, Hèlia Marta; Aragonés, Rosa; Casajuana, J.; Esgueva, Neus

doi:10.1111/jan.12120

Cited by 37 publications

(80 citation statements)

References 29 publications

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“…In the same way, research in Spain shows that nurses trained in the delivery of non-complex primary care have essentially the same rate of success in treating health problems as doctors (Begoña et al, 2013). …”

Section: Discussionmentioning

confidence: 97%

Nurses in France

Jović

Bianchi

Decouflet³

et al. 2015

Global Qualitative Nursing Research

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In France, medical practitioners are aware that the practice of the delivery of primary care by nurses occurs in other countries. However, there is disagreement about how to implement this practice. This aspect of the issue of front line care has not yet been studied in France. In this article, our aim is to identify to what extent the delivery of primary care by nurses is considered acceptable by doctors and nurses working in hospital emergency departments and in public and private health centers. The results of our research provide a picture of opinions that exist among doctors and nurses. These opinions highlight practices that are outside the current regulations and present perspectives, which range from conditionally in favor to unfavorable. Such opinions contribute to our knowledge because they are derived from the professionals directly involved and describe what is acceptable in this particular context.

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Section: Discussionmentioning

confidence: 97%

Nurses in France

Jović

Bianchi

Decouflet³

et al. 2015

Global Qualitative Nursing Research

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“…En consonancia, existen estudios previos sobre la capacidad de resolución y la seguridad de la enfermera ante estos problemas, 18,19 e incluso otros que equiparan la atención entre enfermeras y médicos de familia, a nivel nacional e internacional, pudiendo mencionar España, Australia, Canadá, Reino Unido, Dinamarca o China. [20][21][22][23][24][25][26] Asimismo, la asociación encontrada entre las necesidades psicosociales y los motivos de asistencia, fruto del enfoque disciplinar que aporta la enfermera en su valoración, 27 resultan clave para la asistencia una vez que podrían reducir reiteradas demandas de asistencia, evitables o improcedentes, como las debidas a: incumplimiento o manejo inefectivo del tratamiento en el dolor, manejo inefectivo de los dispositivos sanitarios o respuestas inadecuadas de afrontamiento ante problemas sociales y en pacientes asintomáticos/sin patología urgente. En este orden, la identificación de estas necesidades psicosociales permitiría la planificación estandarizada de cuidados e, incluso, considerar la valoración de estas necesidades como indicador de calidad para la asistencia de estos pacientes.…”

Section: Discussionunclassified

Actividad y seguridad de la enfermera de urgencias a domicilio para patologías leves

et al. 2014

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Resumen AbstractObjetivos: Explorar la asistencia urgente a domicilio proporcionada por una enfermera sin médico presencial y compararla con la de los equipos con médicos. Metodología: Estudio transversal, con pacientes del Distrito Málaga atendidos por una enfermera de enero 2012 a marzo 2013 y por equipos con médico en 2012. Se hizo un análisis descriptivo, Chi cuadrado y regresiones logísticas multivariantes. Resultados: 641 pacientes atendió la enfermera. Los motivos fueron Cervico-Dorso-Lumbo-ciatalgia (13.9%), Mareos/vértigo (9.5%), Sin patología (8.4%), Hiper/hipotensión arterial (7.8%), etc. Tres pacientes, por hipertensión o agitación, precisaron equipo médico 24 horas después. El equipo médico atendió 7430 motivos similares de 21226 demandas. El incumplimiento y manejo inefectivo del tratamiento se asoció a demandas por dolor no oncológico, hipo/hipertensión e hipo/hiperglucemia. El manejo inefectivo de dispositivos sanitarios y las respuestas inadecuadas de afrontamiento se asociaron a demandas sin patología. Conclusión: La asistencia urgente a domicilio por una enfermera y médico no presencial es segura y eficiente, preámbulo ideal para la práctica avanzada. Palabras clave: Atención Prehospitalaria. Urgencias prehospitalarias. Urgencias extrahospitalarias. Urgencias. Dispositivo de cuidados críticos y urgencias. Enfermera de práctica avanzada. ACTIVITY AND SAFETY OF THE EMERGENCY NURSE ATTENDING MINOR PATHOLOGIES AT HOMEObjetives: To explore the emergency nursing practice at home with a physician on the phone and to compare it with emergency medical teams' activity. Methods: Cross-sectional study, including patients from Málaga District attended by a nurse from January 2012 to March 2013, and by medical teams in 2012. Statistical analysis included descriptive data analysis, Chi-squared test and multivariate logistic regression. Results: 641 patients were attended by the nurse. The causes were: Cervical-Back-sciatica pain (13.9%), dizziness/vertigo (9.5%), No pathology (8.4%), High/Low blood pressure (7.8%), etc. Three patients, with high blood pressure or restlessness, required attention by the medical team 24 hours later. The medical team attended 7,430 similar causes from a 21,226 in total. Noncompliance or ineffective treatment management were associated to non-oncologic pain, high/low blood pressure and hypo/hyperglycaemia. Ineffective management of medical devices and inadequate coping responses were associated to demands without pathology. Conclusion: Emergency nursing practice at home, with a physician on the phone, is safe and efficient, preface of the advanced practice.

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“…Nurses were also found to prescribe fewer drugs than general practitioners. However overall satisfaction with the visit was similar for both health care professionals [37].…”

Section: Pragmatic Process and Outcome Measuresmentioning

confidence: 95%

Assessing the Quality of Patient Centred Consultations

Pawlikowska¹,

Marcinowicz²

2015

J Nurs Care

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The consultation is key to health care delivery, and the pursuit of excellence in consultations enables health care practitioners to activate their knowledge in the service of patients. Effective consulting, alongside increasing patient involvement in the assessment of the quality of their own care is a contemporary imperative.There are many ways to approach the assessment of quality, and patient centred outcomes are valued, but sometimes difficult to define and operationalize. Bearing in mind the emphasis in nursing on holistic patient cantered care it seems appropriate to focus on this concept. The Patient Enablement Instrument (PEI) offers an approach to investigate consultations between patients and health care professionals on a patient centred model. Keywords: Patient enablement instrument (PEI); Patient; Health care ContextThere is a burgeoning deficit of health care professionals world-wide [1], it is therefore important to understand how they can best deliver patient care. The consultation is the pivotal interchange of delivery between health care professional and patient, so it is vital to optimise its quality. Increasing patient involvement in their own care, and its evaluation, is an also an important feature of health service development. Donabedian [2] has conceptualised effectiveness into technical and interpersonal aspects: the latter will be the main focus here.According to Nelson [3], best practice in nursing is a "directive, evidence-based, and quality-focused concept" used in educational, administrative, clinical and theoretical/conceptual domains. Moreover best practice is more than just evidence-based because good quality care is optimized according to contemporary standards and values, and in this way is also contextualized.A systematic review by Köberich and Farin [4] defined patientcentered nursing care as "the degree to which the patient's wishes, needs and preferences are taken into account by nurses when the patient requires professional nursing care. " They consider patientcentered nursing care as "a process influencing nursing-sensitive patient outcomes that is affected by several nurse-and context-related factors (such as nurses' attitudes towards patient-centeredness and the organization of nursing care)".Kitson et al. [5] contrasted the perspectives of those active in the delivery of health care: health policy stakeholders and nurses perceive patient-centered care more broadly than medical professionals. They found that doctors tend to focus on the relationship with the patient and the decision-making process within the consultation. This narrative review of key health policy, medical and nursing work on patient-centered care, identified patient participation, the relationship between the patient and the healthcare professional, and the context of care delivery as core themes.Evidence has accumulated that robust primary care "helps prevent illness and death … (and) is associated with a more equitable distribution of health in populations, a finding that holds in both cros...

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A randomized controlled trial of nurses vs. doctors in the resolution of acute disease of low complexity in primary care

Abstract: Nurses trained specifically to resolve acute health problems of low complexity give comparable quality of care to that provided by general practitioners in terms of resolution of the problem 15 days after the visit and in patient satisfaction with the visit.

Cited by 37 publications

References 29 publications

Nurses in France

Nurses in France

Actividad y seguridad de la enfermera de urgencias a domicilio para patologías leves

Assessing the Quality of Patient Centred Consultations

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