[An approach to acute diseases using a nursing practice guide]. / Abordaje de la demanda de visitas espontáneas de un equipo de atención primaria mediante una guía de intervenciones de enfermería.

OBJECTIVE: To evaluate the health results of patients who make spontaneous visits when attended by nurses in a primary health care team and by applying a nursing practice guide. DESIGN: Cross-sectional, descriptive study. SETTING: Primary health care team from the Barcelona metropolitan area, Spain. PARTICIPANTS: Patients who request a spontaneous visit for the same day in the primary health care centre (PHC). INTERVENTION: A nursing practice guide was prepared in which health problems were classified into 3 groups according to seriousness and possibility of being resolved by the nursing staff: a) group 1, problems where the protocols allowed that the nurse could finalise the process; b) group 2, problems that might require emergency action; and c) group 3, problems that required an assessment of the level of seriousness. When the patient arrived at the PHC requesting an urgent visit, and the problem fell into group 1 it was dealt with by a nurse. RESULTS: There were 202 patients with health problems included in group 1.The mean age was 36.3 years (SD, 18.6 years).The most consulted health problems were musculo-skeletal (32.7%), followed by skin (22.3%), and the digestive system (22.3%). Of those, 63.9% of the problems were completely resolved and only 5.9% required visits by the out of hours doctor. DISCUSSION: The nursing practice guide meant that the nurse became the entrance door to the primary care system, with a high possibility of resolving health problems.

Abordaje de la demanda de visitas espontáneas de un equipo de atención primaria mediante una guía de intervenciones de enfermería / An Approach to Acute Diseases Using a Nursing Practice Guide

Objetivo. Evaluar los resultados de salud de los pacientes atendidos por profesionales de enfermería en la demanda de visitas espontáneas en un equipo de atención primaria, aplicando una guía de intervención de enfermería. Diseño. Estudio descriptivo, transversal. Emplazamiento. Un equipo de atención primaria del área metropolitana de Barcelona. Participantes. Pacientes que solicitan visita espontánea para el mismo día en el centro de atención primaria (CAP). Intervención. Se elaboró una guía de intervención de enfermería en la que los problemas de salud se clasificaron en 3 grupos según la gravedad y la posibilidad de resolución por parte de enfermería: a) grupo 1, problemas en los que la protocolización permitió que el personal de enfermería finalizara el proceso; b) grupo 2, problemas de posible intervención de urgencia, y c) grupo 3, problemas que requieren valorar el grado de gravedad. Cuando un paciente acudía al CAP solicitando una visita urgente, si el problema de salud pertenecía al grupo 1 fue atendido por personal de enfermería. Resultados. Se atendieron 202 pacientes cuyos problemas de salud pertenecían al grupo 1. La edad media fue de 36,3 años (DE = 18,6 años). Los problemas de salud más consultados fueron los del sistema musculosquelético (32,7%), seguidos de los de la piel (22,3%) y del sistema digestivo (22,3%). Se resolvieron completamente el 63,9% de los problemas, y únicamente un 5,9% requirió ser visitado por el médico de guardia. Discusión. La guía de intervenciones de enfermería permite que los profesionales de ésta sean una puerta de entrada en el sistema de atención primaria, con un alto poder de resolución de los problemas de salud

Objective. To evaluate the health results of patients who make spontaneous visits when attended by nurses in a primary health care team and by applying a nursing practice guide. Design. Cross-sectional, descriptive study. Setting. Primary health care team from the Barcelona metropolitan area, Spain. Participants. Patients who request a spontaneous visit for the same day in the primary health care centre (PHC). Intervention. A nursing practice guide was prepared in which health problems were classified into 3 groups according to seriousness and possibility of being resolved by the nursing staff: a) group 1, problems where the protocols allowed that the nurse could finalise the process; b) group 2, problems that might require emergency action; and c) group 3, problems that required an assessment of the level of seriousness. When the patient arrived at the PHC requesting an urgent visit, and the problem fell into group 1 it was dealt with by a nurse. Results. There were 202 patients with health problems included in group 1.The mean age was 36.3 years (SD, 18.6 years).The most consulted health problems were musculo-skeletal (32.7%), followed by skin (22.3%), and the digestive system (22.3%). Of those, 63.9% of the problems were completely resolved and only 5.9% required visits by the out of hours doctor. Discussion. The nursing practice guide meant that the nurse became the entrance door to the primary care system, with a high possibility of resolving health problems