Transcript Diapositiva 1 - Primary care

Outcomes of nurse visits for
unscheduled patients in primary care
Casado I**
Brugués A*; Pavón P**; Sancho L**; Laserna
C**; Torres D**; Fernandez M; Malo A**;
Gascon J.***
* Nurse. CON. Chief Officer Nurse CASAP
** Nurse "Can Bou" CASAP
*** Clerk "Can Bou" CASAP
Purpose
To evaluate the outcomes of nurse attention of
unscheduled patients in a primary health care
team, following a clinical guideline designed for
nurses.
Theory
Primary health care teams in Catalonia include GPs,
pediatricians, nurses and clerks.
To enhance accessibility, nurses improve their
knowledge and skills, undertaking an extended role in
the management of acute health problems.
We use this approach for unscheduled visits for past 6
years, improving delivery of care by the entire team
and allowing nurses to handle minor illnesses and GPs
to dedicate more time to complicated patients.
Methods
Design: Cross-sectional descriptive study in primary
care team from the metropolitan area.
Description: The Primary Care Team “Can Bou” serves
a population of 27,000 inhabitants in the metropolitan
area of Barcelona.
The sample size with an expected prevalence of 64%
resolution, a confidence level of 95% and an accuracy
of 0.04 needs a sample of 594 individuals.
Methods
Participants: random sample of 594 patients that demanded
same day consultation from May 2011 until January 2012 for:
vomiting
diarrhea
toothache
upper respiratory
symptoms
back pain
sore throat
wounds
minor trauma
(contusions)
Variables:
 Age and sex
 Resolution of the problem (yes / no)
 Interventions
 Prescription
 Hospital referrals
 Administrative triage accuracy
 Waiting time
lower urinary symptoms
burns
panic attacks
emergency
contraception
Findings
Age and sex
Findings
Reason for medical consultation
Findings
• Resolution
26.06 %
Nurse resolution
Referral to the doctor
73.94%
Findings
• Nurse resolution
upper respiratory
symptoms 57%
wounds and burns
90,2%
panic attacks 62,5%
emergency
contraception 83,3%
minor trauma 63,3%
toothache 83,3%
sore throat 68,3%
lower urinary
symptoms 75%
vomiting, diarrhea
81,5%
back pain 75%
Findings
• Non resolution
Findings
• Interventions
Findings
• Prescription
IBUPROFEN 26%
MISCELLANEOUS
34%
AMOXICILLIN
CLAVULANIC 4%
PARACETAMOL 18%
AMOXICILLIN 5%
METOCLOPRAMIDE DICLOFENAC 8%
5%
Findings
The accuracy of the
indication and referral by the
administrative staff was
90.28%.
Nurse intervention resolution
degree is 74%
The average waiting time to
be visited was 9.11 minutes
Discussion
• Health problems and the degree of resolution is similar
to studies of our environment.
• Health advice is the most frequent intervention followed
the prescription; the drug most prescribed is ibuprofen.
• There is a high concordance with the administrative staff
triage
¡Muchas gracias!
Moltes gràcies!
Thank you very much!
Merci Beaucoup!
Muito Obrigado!
Grazie Mille!
Mulţumesc Foarte Mult!
Ezkerrik Azko!
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