Clinical outcomes and patients’ perceptions of nurse-led healthy lifestyle clinics

Abstract

BACKGROUND AND CONTEXT: The Nurse-Led Healthy Lifestyle Clinics focussed on lifestyle issues for patients with known health inequalities. Much of the nursing was educative and preventative care. This evaluation assessed patient experiences and opinions, as well as clinical outcomes. ASSESSMENT OF PROBLEM: Information came from clinical outcome data for 2850 individuals and 424 patient satisfaction surveys. Results: Patients were aged 0–95 years (45% between 40 and 59 years); 60% Pakeha/European, 31.4% Maori, 4.2% Pacific and 4.4% other ethnicities. Only 19% of claimants (approximately 40% were Maori or Pacific) came from quintile 5 addresses, suggesting the target population was not reached effectively. Ninety-four percent of patients had a better understanding of their diagnosis, medication and treatment plan, and were more motivated to self-manage their health needs. This increase in patient empowerment is a significant outcome of the project. Clinical outcome data showed no significant differences between first and last clinic visits for average weight, blood pressure, smoking, glycosylated haemoglobin levels, waist circumference or cardiovascular risk. Significant improvements were shown in the Dartmouth Primary Care Cooperative Information results for social activity, change in health, and overall health (n=89). STRATEGIES FOR IMPROVEMENT: More effective techniques to access the target population have been implemented, as has an extended period for review of clinical outcomes. LESSONS: More focussed evaluation of clinical outcomes is necessary to provide quantitative data on the clinics. The large percentage of patients who felt more empowered to self-manage their health needs suggests the clinics were effective in this area. KEYWORDS: Nurse-led clinics; life style; program evaluation; patient satisfaction; health status disparities

A qualitative evaluation of New Zealand consumers perceptions of general practice nurses

“…A number of studies have investigated patient satisfaction with nurse-led clinic interventions [15,16]. In their Australian paper, Mahomed et al [15] reported the development of a grounded theory of patients’ satisfaction from a larger study exploring a practice nurse-led model of chronic disease management.…”

“…In New Zealand, Marshall et al [16] reported data from an 8-item survey on consultation satisfaction related to healthy lifestyle clinics. These items focussed broadly on satisfaction with the consultation, exploring factors such as adequacy of the consultation room and impact of the education provided on confidence and health.…”

Effectiveness of registered nurses on patient outcomes in primary care: a systematic review

“…In thirteen studies, primary care RNs carried out the intervention independently without the support of other staff/providers [ 45 , 46 , 49 , 51 , 53 – 55 , 57 – 60 , 62 , 63 ], and in 10 studies, they carried out the intervention interdependently, in collaboration with health care providers (e.g., physicians, clinical pharmacy specialists [CPS], dieticians) or members of the research team (e.g., trial nurse facilitator) [ 43 , 44 , 47 , 48 , 50 , 52 , 56 , 61 , 64 , 65 ]. Three of these 10 studies involved evaluating RNs at the general practice-level and therefore are assumed to be evaluating an interdependent role involving support of other health care providers [ 47 , 61 , 64 ].…”

Nurses' perceptions of nurse-led healthy lifestyle clinics

“…Research has shown nurse-led clinics (NLCs) are effective in enhancing self-management of disease, 1,2 are an acceptable alternative to a general practitioner (GP) consultation, 3,4 provide equivalent care for minor conditions compared to GPs, 5 and are appreciated by patients for the extended time available for consults. 6 While NLCs have shown significant improvements in patient outcomes and perceptions of health care both overseas and in New Zealand, [7][8][9][10] there is limited information on nurses' experiences and opinions of their participation in NLCs. Phil-lips and colleagues 11 note, while not referring specifically to NLCs, the many nurses in their study who "expressed frustration at the limited clinical care they were able to provide in general practice".…”