Nurse practitioner management of acute in-hours home visit or assessment requests: a pilot study
Nurse practitioner management of acute in-hours home visit or assessment requests: a pilot study
复制标题
DOI：
10.3399/bjgp09x394798
复制
发表时间：
2009-01-01
影响因子：
5.9
通讯作者：
Robinson, Susan I.
中科院分区：
文献类型：
--
作者：
Edwards, Martin;Bobb, Carol;Robinson, Susan I.
背景全科医生往往认为家访的要求，作为一个耗时的方面，一般做法。新的一般医疗服务合同规定解除家访的责任，尽管没有移交护理的模式。其中一种模式可以是雇用执业护士来管理此类请求。执业护士可以有效地替代全科医生在管理同一天在小时内的紧急护理手术，但他们的作用，在管理所有这些要求，包括那些需要家访，尚未assessed.AimTo探讨的可行性和临床管理结果的执业护士管理同一天的护理要求，包括那些需要家访，为拟议的随机对照试验提供信息。研究设计非随机对照试验。设置一个大型全科诊所（14 600例患者）在南伦敦。方法护士执业评估和管理所有相同的-在6个月的时间里，每周2天的日托请求与另外2天的普通家庭医生管理进行了比较。临床管理结果数据从患者记录和由执业护士和全科医生完成的数据收集表中收集。病人和工作人员的满意度进行了评估，通过questionnaire.ResultsThe护士执业更有可能比全科医生评估病人的人，不太可能单独给出建议，更有可能发出处方。有没有任何其他临床管理成果或患者满意度的护士执业和全科医生之间的显着差异，但是，在这个试点study.ConclusionNurse执业管理急性小时护理请求，包括家访的患者满意度问卷的应答率是poor，在实践中似乎是可行的，值得进一步评估。
BackgroundGPs often perceive home-visit requests as a time-consuming aspect of general practice. The new general medical services contract provides for practices to be relieved of responsibility for home-visits, although there is no model for the transfer of care. One such model could be to employ nurse practitioners to manage such requests. Nurse practitioners can effectively substitute for GPs in managing same-day in-hours emergency care in the surgery, but their role in managing all such requests, including those requiring home visits, has not been assessed.AimTo explore the feasibility and clinical management outcomes of nurse practitioner management of same-day care requests, including those requiring home visits, to inform a proposed randomised controlled trial.Design of studyNon-randomised comparative trial.SettingOne large general practice (14 600 patients) in south London.MethodNurse practitioner assessment and management of all same-day care requests for 2 days per week was compared with normal GP management on another 2 days, over a 6-month period. Clinical management outcome data were collected from patient records and from data-collection forms completed by a nurse practitioner and GPs. Patient and staff satisfaction was assessed by questionnaire.ResultsThe nurse practitioner was more likely than GPs to assess patients in person, less likely to give advice alone, and more likely to issue a prescription. There was no significant difference between the nurse practitioner and GPs regarding any other clinical management outcomes or patient satisfaction; however, the response rate of the patient satisfaction questionnaire in this pilot study was poor.ConclusionNurse practitioner management of acute in-hours care requests, including home visits, appears feasible in practice and merits further assessment.