[Evaluation of Nurse Demand Management in Primary Care]. / Evaluación de la gestión enfermera de la demanda en atención primaria.

OBJECTIVE: to evaluate the health outcomes of nurse demand management on unscheduled patients in a Primary Care Centre, following a clinical guide designed by the whole primary care team. DESIGN: Cross-sectional study. SETTING: A primary care team from Castelldefels. Barcelona, Spain. PARTICIPANTS: A random sample of 558 patients requesting a consultation for the same day in a Primary Care setting, attended between May 1st, 2011 and January 31st, 2012. INTERVENTION: The guide includes 23 health problems that can be dealt by a nurse autonomously, 18 of them possibly requiring an emergency intervention, and shared decision with the physician. Each health problem is divided into three sections: a) a brief definition of the problem; b) an intervention algorithm; and c) nursing diagnoses of North American Nursing Diagnosis Association for each health problem and a description of the possible nursing interventions. RESULTS: We studied 558 patients with a mean age of 42.5 years old (SD 17.7). The most commonly consulted problems were upper respiratory tract symptoms (19.4%), followed by nausea/vomiting (16.5%), and burns/wounds (12.5%). 73.3% of the problems were resolved autonomously by a nurse. 65,8% of the patients attended received health advice. DISCUSSION: Nurse demand management has shown to be highly effective at handling the conditions attended, while it provides a high percentage of health advice and education during consultations.

Evaluación de la gestión enfermera de la demanda en atención primaria / Evaluation of Nurse Demand Management in Primary Care

OBJETIVO: Evaluar los resultados de la gestión enfermera de la demanda de pacientes no programados en el centro de atención primaria, siguiendo un circuito y una guía clínica diseñada y consensuada por el equipo. DISEÑO: Estudio descriptivo transversal. PARTICIPANTES: Muestra aleatoria de 558 pacientes que demandaron consulta el mismo día, atendidos entre el 1 mayo de 2011 y el 31 de enero de 2012. Intervención: La guía desarrollada describe 23 problemas de salud de posible resolución autónoma por parte de la enfermera y 18 de posible intervención de urgencia, con una resolución compartida con el médico. Cada problema de salud está dividido en 3 apartados: a) breve definición del problema; b) algoritmo de actuación y; c) posibles diagnósticos enfermeros de la North American Nursing Diagnosis Association más habituales para cada problema de salud y las posibles intervenciones de enfermería. RESULTADOS: Los 558 pacientes estudiados presentaron una edad media de 42,5 (DE: 17,7) años. El motivo de consulta que se atendió con mayor frecuencia fueron los síntomas respiratorios de vías altas (19,4%), seguidos de las diarreas/vómitos (16,5%) y heridas/quemaduras (12,5%). La enfermera resolvió un 73,3% de los casos atendidos. El 65,8% de los pacientes atendidos recibió consejos de salud y los fármacos más indicados fueron los analgésicos y antiinflamatorios (56%). DISCUSIÓN: La gestión enfermera de la demanda ha demostrado presentar una alta resolución de las afecciones atendidas, aportando a la vez un porcentaje elevado de consejos de salud y de educación sanitaria en las visitas atendidas

OBJECTIVE: to evaluate the health outcomes of nurse demand management on unscheduled patients in a Primary Care Centre, following a clinical guide designed by the whole primary care team. DESIGN: Cross-sectional study. SETTING: A primary care team from Castelldefels. Barcelona, Spain. PARTICIPANTS: A random sample of 558 patients requesting a consultation for the same day in a Primary Care setting, attended between May 1st, 2011 and January 31st, 2012. Intervention: The guide includes 23 health problems that can be dealt by a nurse autonomously, 18 of them possibly requiring an emergency intervention, and shared decision with the physician. Each health problem is divided into three sections: a) a brief definition of the problem; b) an intervention algorithm; and c) nursing diagnoses of North American Nursing Diagnosis Association for each health problem and a description of the possible nursing interventions. RESULTS: We studied 558 patients with a mean age of 42.5 years old (SD 17.7). The most commonly consulted problems were upper respiratory tract symptoms (19.4%), followed by nausea/vomiting (16.5%), and burns/wounds (12.5%).73.3% of the problems were resolved autonomously by a nurse.65,8% of the patients attended received health advice. DISCUSSION: Nurse demand management has shown to be highly effective at handling the conditions attended, while it provides a high percentage of health advice and education during consultations