Developing a nurse-led holistic clinic and assessment pathway

Roberts, Shelagh; Webster, Charles; Valentine-Gray, Dawn; Mew, Carol; Gow, Gwen; Johnson, Janet H.; Lennon, E.; Myers, Mandy; Dearden, Diane; Kirwan, John R.; Jamison, Laura

doi:10.7748/cnp2009.10.8.8.34.c7308

Cited by 3 publications

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“…As noted in other studies, this evaluation indicates patients clearly perceive improved health care for them in the nurse-led clinics. [8][9][10] However, it is difficult to verify the range of improvements from the clinical outcomes data and, as has been shown by Gonzalez et al, the duration of any improvements may also be questionable. 11 Unfortunately the project was also less successful than expected at engaging patients with known health inequalities and options to improve this are presented.…”

Section: Acknowledgementsmentioning

confidence: 99%

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

Marshall

Floyd²,

Forrest³

2011

J Prim Health Care

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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 095 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

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Section: Acknowledgementsmentioning

confidence: 99%

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

Marshall

Floyd²,

Forrest³

2011

J Prim Health Care

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“…There is compelling evidence suggesting that nurses may not be prepared for integration of spiritual assessment and care in their basic nursing education preparation (van Leeuwen, Tiesinga, Middel, Post, & Jochemsen, 2008). There is reportedly a tendency for APNs not to assess spirituality as a dimension of life either because of lack of provider confidence or fear of intruding on a personal and private domain (Ledger, 2005; Roberts et al, 2009). For example, the APN may not ask questions that assess the patient's entire experience but rather may focus on a diagnosis or symptoms related to a diagnosis.…”

Section: Origins Of Holistic Care and Linkages To Spiritualitymentioning

confidence: 99%

The APN role in holistic assessment and integration of spiritual assessment for advance care planning

Chrash

Mulich

Patton

2011

Journal of the American Academy of Nurse Practitioners

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Purpose: Provide advanced practice nurses (APNs) with tools and guidance on spiritual assessment for advance care planning(ACP); to review the literature on the connectedness between spiritual assessment and ACP; and to discuss implications for the APN in application of these concepts with a case study. Data sources: Selected research and clinical articles. Conclusions: There is a disconnect between what patients have expressed as their wishes regarding end‐of‐life care (EOLC) and what occurs. Spiritual beliefs and values impact patients' and families' decisions regarding EOLC, but if not discussed in advance, most wishes, especially dying at home, do not occur. Implications for practice: Incorporating spiritual assessment in a holistic assessment, it is possible to assist patients and families prior to crisis in sorting out patients' wishes with respect to EOLC during clinic visits. With the use of a simple mnemonic to guide spiritual assessment, the APN can bridge the gap between what the patient wants and what care is received at end of life.

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Typical stable angina in a nurse-led chest pain assessment unit

Denn¹,

Noonan²,

Condon³

2017

British Journal of Cardiac Nursing

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Advanced physical assessment is a core component of the cardiac nursing role. This article focuses on the assessment of a patient referred with ‘typical’ symptoms of a stable angina. This care study highlights the significance of effective-nurse led physical assessment in the accurate identification of patients who require urgent cardiac attention. It demonstrates how a physical assessment and detailed history-taking during a nurse consultation identified that a patient needed a rapid, detailed evaluation by a consultant.

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Developing a nurse-led holistic clinic and assessment pathway

Cited by 3 publications

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

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

The APN role in holistic assessment and integration of spiritual assessment for advance care planning

Typical stable angina in a nurse-led chest pain assessment unit

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Developing a nurse-led holistic clinic and assessment pathway

Cited by 3 publications

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

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

The APN role in holistic assessment and integration of spiritual assessment for advance care planning

Typical stable angina in a nurse-led chest pain assessment unit

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

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