Nutrition advice in general practice: the role of general practitioners and practice nurses

2011 ◽  
Vol 17 (2) ◽  
pp. 202 ◽  
Author(s):  
Lana J. Mitchell ◽  
Lesley MacDonald-Wicks ◽  
Sandra Capra
Keyword(s):  
General Practice ◽  
Nutrition Education ◽  
General Practitioners ◽  
Private Practice ◽  
Best Practice ◽  
Online Survey ◽  
Efficient Manner ◽  
Practice Nurses ◽  
Best Practice Guidelines

General practice is an ideal setting to be providing nutrition advice; however, it is important that the role of general practitioners (GPs) and practice nurses in providing nutrition advice is acknowledged and defined. This article aims to discuss the role of GPs and practice nurses in the delivery of nutrition advice. Ten general practitioners and 12 practice nurses from a NSW urban Division of General Practice participated in questionnaires and a Lifescripts© implementation study, as well as their consenting patients receiving Lifescripts© (n = 13). An online survey was conducted with 90 Australian private practice dietitians. Semi-structured telephone interviews were conducted with 52 Australian private practice dietitians. The provision of basic nutrition advice is acknowledged to be part of the role of GPs and practice nurses, as they are the first point of contact for patients, allowing them to raise nutrition awareness. However, it is important that this advice is evidence based and able to be delivered in a time-efficient manner. Increased nutrition education and the availability of appropriate resources and nutrition-related best practice guidelines will assist in this process.

scholarly journals How COVID-19 has affected general practice consultations and income: general practitioner cross-sectional population survey evidence from Ireland

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e044685
Author(s):  
Robyn Homeniuk ◽  
Claire Collins
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Online Survey ◽  
Quality Care ◽  
Cross Sectional ◽  
Practice Nurses ◽  
Global Pandemic ◽  
Before And After ◽  
General Practices ◽  
The Impact

ObjectivesHow general practice is delivered in many countries has drastically changed due to the COVID-19 pandemic. This study aimed to answer the question of how general practice has changed in Ireland in response to COVID-19.DesignThe Irish College of General Practitioners surveyed its membership before and after the global pandemic hit Ireland using a cross-sectional online survey instrument.SettingThis study focuses on primary care, specifically general practice, in Ireland.ParticipantsIn February 2020 before the global pandemic, 526 general practices across Ireland submitted responses to the survey; 538 general practices responded to the second survey during the pandemic in June 2020. This covers 32% and 33% of practices in Ireland, respectively.Main outcome measuresThe type of consultations by general practitioners (GPs) and practice nurses in both surveys is the main outcome measure reported in this paper. Other changes such as the perceived change in attendance by certain patient groups and practice income are also reported.ResultsFace-to-face consultations significantly (p<0.001) decreased from a median of 26 (IQR 21.3–30) to a median of 8 (IQR 6–13). GP telemedicine consultations increased (p<0.001) from a median of 2.4 (IQR 0–5.3) to a median of 11.3 (IQR 6–19). The majority of practices (80.0%) reported reduced practice profit. Respondents reported a decline in non-COVID-19-related consultations among certain patient cohorts—92.0% for children under 6 years old; 79.5% for patients over 70 years.ConclusionsIt is likely that the way general practice is delivered will not return to as it was before the COVID-19 pandemic and increased telemedicine can be expected. However, it is necessary to assess the impact of this shift on patient health and to assess healthcare provider and patient experience to ensure continued high-quality care and patient safety.

scholarly journals Symbiotic relationships in patients' engagements with practice nurses

2021 ◽  
Author(s):  
◽  
Elsa Lally
Keyword(s):  
General Practice ◽  
Narrative Inquiry ◽  
General Practitioners ◽  
Professional Education ◽  
Well Being ◽  
Original Research ◽  
Practice Nurses ◽  
Symbiotic Relationships ◽  
Primary Health ◽  
Health And Well Being

<p>Practice nurses engaging with patients is a daily activity in general practice. However, there is little research to assess these relationships from a primary health care, general practice standpoint. The purpose of this new and original research was to explore from patients' perspectives what occurs in general practice, and to establish how the engagements patients have with practice nurses influences patients' health and well-being. The conceptualisation of symbiotic relationships between practice nurses, general practitioners receptionists and patients described in this study, shows how these relationships work in practice, and how they shaped patients' perspectives of their engagements in the general practice setting. Although each person’s role was independent and capable of existing without the other, a mutually beneficial close association was developed.  From the experiences of 15 patients from seven rural and urban general practices in New Zealand, using Narrative Inquiry methodology informed by life course theory and White’s (2010) dimensions of well-being, the co-constructed stories gathered from the participants were analysed applying a modification of McCormack’s (2001) multiple lens model. Findings from the individual participant stories revealed three major themes – general practice activity, health focused practice, and professional comforting. Each of these themes described aspects of the participants' relationships and engagements with practice nurses that contributed to their health and well-being. The co-constructed stories described participants' relationships and engagements, not only with practice nurses but also with general practitioners and receptionists. The presence of the (often unseen) overarching doctor and of practice nurses filling the gap in patients' care was evident. Patients described practice nurses as both support for the doctor and as autonomous practitioners. Ease of access to practice nurses significantly contributed to patients obtaining competent health promoting care. Particularly cogent were the findings that practice nurses directly contributed to patients' health and well-being through nurses' skilled compassion and skilled companionship. Nurses actively listened to patients' concerns, suggesting strategies to move patients forward, while at the same time, providing space for them to move at their own pace. Receptionists were viewed as the 'fronts people' of the practice who triaged patients' health concerns, making decisions relating to whom the patient consulted, the doctor or the nurse.  By building on existing theories in Narrative Inquiry methodology, data collection and analysis, this research makes an important contribution to nursing knowledge. It provides new perspectives about nurse-patient relationships, as well as other relationships within general practice. The research also demonstrates that while there has been a significant increase in collaboration between nurses and general practitioners over time, this collaboration is distinct from the symbiotic relationships described. The findings have implications for health professionals' everyday practice, and for Primary Health Organisations and District Health Boards when undertaking health professional education and funding reviews. Future research into patients' relationships with practice nurses, doctors and receptionists, and how these relationships contribute to patients' health and well-being is necessary.</p>

What practice nurses need to know about the NICE chronic kidney disease guidelines

2021 ◽  
Vol 32 (12) ◽  
pp. 468-472
Author(s):  
Peter Ellis
Keyword(s):  
Chronic Kidney Disease ◽  
General Practice ◽  
Kidney Disease ◽  
Kidney Function ◽  
Practice Nurse ◽  
Nice Guidelines ◽  
Practice Nurses ◽  
Health Related ◽  
The Uk

Chronic kidney disease is highly prevalent in the community. Peter Ellis looks at the role of the practice nurse in diagnosing and managing chronic kidney disease in general practice Chronic kidney disease (CKD) is defined as a reduction in kidney function, or damage to kidney structure, which has persisted for greater than 3 months and which is associated with other health-related issues. While there are many causes of CKD, the most prevalent in western societies, including the UK, are diabetes and hypertension. This article identifies the role of the practice nurse in applying the National Institute for Health and Care Excellence (NICE) guidelines for CKD.

Next steps for student supervision and assessment

2019 ◽  
Vol 30 (10) ◽  
pp. 496-500
Author(s):  
Shaun Heath
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Communities Of Practice ◽  
Student Nurses ◽  
Education Standards ◽  
Student Placement ◽  
Practice Nurses ◽  
Primary Care Settings ◽  
Student Supervision

Student nurses are the future of the profession. Shaun Heath explains how changes to the Nursing and Midwifery Council's education standards will effect those currently acting as mentors and how all practice nurses can get involved and contribute to student placement experiences This article explores the Nursing and Midwifery Council's 2018 education standards and how these will affect the role of general practice nurses in primary care settings. The differing roles found in the standards will be discussed, alongside how primary care and the emerging Primary Care Networks can support learners in general practice through communities of practice.

scholarly journals Nutrition Knowledge, Attitudes, and Confidence of Australian General Practice Registrars

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Caryl A. Nowson ◽  
Stella L. O’Connell
Keyword(s):  
General Practice ◽  
Cardiovascular Risk ◽  
Nutrition Education ◽  
Online Survey ◽  
Salt Intake ◽  
Nutrition Knowledge ◽  
Nutritional Knowledge ◽  
Dietary Recommendations ◽  
Nutrition Survey ◽  
Salt Reduction

Nutrition knowledge, attitudes, and confidence were assessed in General Practice Registrars (GPRs) throughout Australia. Of approximately 6,000 GPRs invited to complete a nutrition survey, 93 respondents (2%) completed the online survey, with 89 (20 males, 69 females) providing demographic and educational information. Fifty-one percent had graduated from medical school within the last two years. From a list of 11 dietary strategies to reduce cardiovascular risk, respondents selected weight loss (84%), reducing saturated fats (90%), a maximum of two alcoholic drinks/day (82%), and increasing vegetables (83%) as “highly appropriate” strategies, with only 51% indicating that salt reduction was “highly appropriate.” Two-thirds of registrars felt “moderately” (51%) or “very” confident (16%) providing nutrition advice. Most of them (84%) recalled receiving information during training, but only 34% recalled having to demonstrate nutritional knowledge. The results indicate that this group of Australian GPRs understood most of the key dietary recommendations for reducing cardiovascular risk but lacked consensus regarding the recommendation to reduce salt intake and expressed mixed levels of confidence in providing nutritional advice. Appropriate nutrition education before and after graduation is recommended for GPRs to ensure the development of skills and confidence to support patients to make healthy dietary choices and help prevent chronic diseases.

scholarly journals Impact of the Medicare Chronic Disease Management program on the conduct of Australian dietitians’ private practices

2015 ◽  
Vol 39 (2) ◽  
pp. 183 ◽  
Author(s):  
Sarah Jansen ◽  
Lauren Ball ◽  
Catherine Lowe
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Disease Management ◽  
Practice Guidelines ◽  
Private Practice ◽  
Best Practice ◽  
Chronic Disease Management ◽  
Business Practices ◽  
Best Practice Guidelines ◽  
To Receive

Objective This study explored private practice dietitians’ perceptions of the impact of the Australian Chronic Disease Management (CDM) program on the conduct of their private practice, and the care provided to patients. Methods Twenty-five accredited practising dietitians working in primary care participated in an individual semistructured telephone interview. Interview questions focussed on dietitians’ perceptions of the proportion of patients receiving care through the CDM program, fee structures, adhering to reporting requirements and auditing. Transcript data were thematically analysed using a process of open coding. Results Half of the dietitians (12/25) reported that most of their patients (>75%) received care through the CDM program. Many dietitians (19/25) reported providing identical care to patients using the CDM program and private patients, but most (17/25) described spending substantially longer on administrative tasks for CDM patients. Dietitians experienced pressure from doctors and patients to keep their fees low or to bulk-bill patients using the CDM program. One-third of interviewed dietitians (8/25) expressed concern about the potential to be audited by Medicare. Recommendations to improve the CDM program included increasing the consultation length and subsequent rebate available for dietetic consultations, and increasing the number of consultations to align with dietetic best-practice guidelines. Conclusions The CDM program creates challenges for dietitians working in primary care, including how to sustain the quality of patient-centred care and yet maintain equitable business practices. To ensure the CDM program appropriately assists patients to receive optimal care, further review of the CDM program within the scope of dietetics is required. What is known about the topic? The Australian CDM program is designed to facilitate patients to receive subsidised multidisciplinary care for CDM. Dietetics is the third most utilised allied health profession within the CDM program. What does this paper add? This paper demonstrates that dietitians experience challenges in providing services to patients using the CDM program, including pressure to keep fees down, high administrative load, difficulties accessing clear information on compliance requirements, and face barriers to providing best-practice care to patients with chronic disease. What are the implications for practitioners? Changes to the Australian CDM program are required to help dietitians provide health care in line with best-practice guidelines for CDM, and sustainable business practices.

scholarly journals What is the role of the Practice Nurse in the care of people living with dementia, or cognitive impairment, and their support person(s)? : A systematic review.

2020 ◽  
Author(s):  
Caroline Gibson ◽  
Dianne Goeman ◽  
Dimity Pond
Keyword(s):  
General Practice ◽  
Cognitive Impairment ◽  
Practice Nurse ◽  
Early Recognition ◽  
Dementia Care ◽  
Care Provision ◽  
Support Person ◽  
Practice Nurses ◽  
Nurse Role

Abstract Background: The potential value of expanding the Practice Nurse role to include the recognition and management of dementia has been acknowledged and Practice Nurses are well-positioned to provide comprehensive dementia information and support so that people living with dementia are better equipped to self-manage their health and live well with dementia. The purpose of this review was to systematically examine published Australian and international literature to identify the existing and potential roles of Practice Nurse’s involvement in the delivery of care to people living with dementia or cognitive impairment and their support person(s) and also describe the characteristics and effectiveness of nurse interventions in dementia models of care in general practice. Methods: We systematically reviewed the evidence for roles and characteristics of the Practice Nurse in the delivery of dementia care. A comprehensive literature search identified relevant original research published in English between January 2000 and January 2019 and available in full text. Thirteen articles were included. Results: Characteristics of roles, undertaken by nurses working in the general practice setting, which were potentially beneficial to people living with dementia and their support person were identified. These included increased patient accessibility to the Practice Nurse, early recognition and management of cognitive changes, care management and collaboration with the General Practitioner. Limitations of the provision of dementia care by Practice Nurses included a lack of definition of the role, inadequate dementia specific training, time constraints and poor communication with General Practitioners. Conclusions Further research is required to define and evaluate the scope of practice and characteristics of the Practice Nurse role in dementia care provision. Embedding in usual general practice care an evidence-based model of care describing the role of the Practice Nurse in dementia care provision has the potential to increase early recognition of cognitive impairment and more appropriate primary care management of dementia. Systematic Review registration number PROSPERO 2018 CRD42018088191

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