Assessing the effectiveness of advanced nurse practitioners undertaking home visits in an out of hours urgent primary care service in England

2018 ◽  
Vol 27 (2) ◽  
pp. 450-458 ◽  
Author(s):  
Davina Collins
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Care Service ◽  
Home Visits ◽  
Primary Care Service ◽  
Out Of Hours

Role of out of hours primary care service in limiting inappropriate access to emergency department

2017 ◽  
Vol 13 (4) ◽  
pp. 549-555 ◽  
Author(s):  
Andrea Posocco ◽  
Maria Paola Scapinello ◽  
Irene De Ronch ◽  
Francesco Castrogiovanni ◽  
Gianluca Lollo ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Care Service ◽  
Primary Care Service ◽  
Out Of Hours

PP19 Primary care streaming in emergency departments- contexts and mechanisms associated with perceived effectiveness outcomes: a realist evaluation

2021 ◽  
Vol 38 (9) ◽  
pp. A9.1-A9
Author(s):  
Michelle Edwards ◽  
Alison Cooper ◽  
Freya Davies ◽  
Andrew Carson Stevens ◽  
Adrian Edwards ◽  
...  
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Emergency Departments ◽  
Patient Flow ◽  
Care Service ◽  
Realist Evaluation ◽  
Primary Care Service ◽  
Evaluation Methodology ◽  
Service Development ◽  
Service Models

BackgroundRecent policy has encouraged emergency departments (EDs) to deploy nurses to stream patients from the ED front door to GPs working in a separate GP service operating within or alongside an ED. We aimed to describe mechanisms relating to effectiveness of streaming in different primary care service models identified in EDs. We explored perceptions of whether patients were perceived to be appropriately streamed to emergency care, primary care, other hospital services or community primary care services; and effects on patient flow (waiting times and length of stay in the ED); and safe streaming outcomes.MethodsWe used realist evaluation methodology to explore perceived streaming effectiveness. We visited 13 EDs with different primary care service models (purposively selected across England & Wales; 8 streamed primary care patients to a primary care clinician) and carried out observations of triage/streaming and patient flow and interviews with key members of staff (consultants, GPs, nurses). Field notes and audio-recorded interviews were transcribed and analysed by creating context, mechanism and outcome configurations to refine and develop theories relating to streaming effectiveness.ResultsWe identified five contexts (nurses’ knowledge and experience, streaming guidance, teamwork and communication, operational management and strategic management) that facilitated mechanisms that influenced the effectiveness of streaming (streaming to an appropriate service, patient flow, delivering safe care). We integrated a middle range psychological theory (cognitive continuum theory) with our findings to recommend a focus for training nurses in streaming and service improvements.ConclusionsWe identified key mechanisms relating to the effectiveness of primary care streaming in different models of service. We recommend a collaborative approach to service development, guidance and training (including input from ED clinicians and primary care clinicians) and a range of training strategies that are suitable for less experienced junior nurses and more experienced senior nurses and nurse practitioners.

scholarly journals Daytime use of general practice and use of the Out-of-Hours Primary Care Service for patients with chronic disease: a cohort study

2014 ◽  
Vol 15 (1) ◽  
Author(s):  
Lone Flarup ◽  
Grete Moth ◽  
Morten Bondo Christensen ◽  
Mogens Vestergaard ◽  
Frede Olesen ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Cohort Study ◽  
Chronic Disease ◽  
Care Service ◽  
Primary Care Service ◽  
Out Of Hours

scholarly journals From Doctor to Nurse Triage in the Danish Out-of-Hours Primary Care Service: Simulated Effects on Costs

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Grete Moth ◽  
Linda Huibers ◽  
Peter Vedsted
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Care Service ◽  
Primary Care Service ◽  
Nurse Training ◽  
Out Of Hours ◽  
Face To Face ◽  
Administrative Costs ◽  
The Cost ◽  
Nurse Triage

Introduction. General practitioners (GP) answer calls to the Danish out-of-hours primary care service (OOH) in Denmark, and this is a subject of discussions about quality and cost-effectiveness. The aim of this study was to estimate changes in fee costs if nurses substituted the GPs. Methods. We applied experiences from The Netherlands on nurse performance in the OOH triage concerning the number of calls per hour. Using the 2011 number of calls in one region, we examined three hypothetical scenarios with nurse triage and calculated the differences in fee costs. Results. A new organisation with 97 employed nurses would be needed. Fewer telephone consultations may result in an increase of face-to-face contacts, resulting in an increase of 23.6% in costs fees. Under optimal circumstances (e.g., a lower demand for OOH services, a high telephone termination rate, and unchanged GP fees) the costs could be reduced by 26.2% though excluding administrative costs of a new organisation. Conclusion. Substituting GPs with nurses in OOH primary care may increase the cost in fees compared to a model with only GPs. Further research is needed involving more influencing factors, such as costs due to nurse training and running the organisation.

scholarly journals Paediatric contacts with the UK out-of-hours primary care service and contact outcomes: a regional service evaluation

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
George Edwards ◽  
Rachel Brettell ◽  
Chris Bird ◽  
Helen Hunt ◽  
Dan Lasserson ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Service ◽  
Service Evaluation ◽  
Primary Care Service ◽  
Out Of Hours ◽  
Regional Service ◽  
The Uk

scholarly journals Course of Uncomplicated Acute Gastroenteritis in Children Presenting to Out-of-hours Primary Care

2021 ◽  
Author(s):  
Anouk AH Weghorst ◽  
Irma J Bonvanie ◽  
Gea A Holtman ◽  
Michiel R de Boer ◽  
Marjolein Y Berger
Keyword(s):  
Primary Care ◽  
Acute Gastroenteritis ◽  
Care Service ◽  
Primary Care Service ◽  
Symptom Duration ◽  
Out Of Hours ◽  
Typical Symptom ◽  
Follow Up Study ◽  
Increased Risk

Abstract Background: The aim of this article is to describe the courses of vomiting, diarrhea, fever, and clinical deterioration, in children with uncomplicated gastroenteritis at presentation. This study was performed as a 7-day prospective follow-up study in an out-of-hours primary care service. The course of vomiting, diarrhea, and fever was analyzed by generalized linear mixed modeling. Because young children (≤12 months) and children with severe vomiting are at increased risk of dehydration, the potentially more complicated courses of these groups are described separately. The day(s) most frequently associated with deterioration and the symptoms present in children who deteriorated during follow-up were also described.Results: In total, 359 children presented with uncomplicated acute gastroenteritis to the out-of-hours primary care service. Of these, 31 (8.6%) developed a complicated illness and needed referral or hospitalization. All symptoms decreased within 5 days in most children (>90%). Vomiting and fever decreased rapidly, but diarrhea decreased at a somewhat slower pace, especially among children aged 6–12 months. Children who deteriorated during follow-up had a higher frequency of vomiting at presentation and higher frequencies of vomiting and fever during follow-up.Conclusions: The frequency of vomiting, not its duration, appears to be the more important predictor of deterioration. When advising parents, it is important to explain the typical symptom duration and to focus on alarm symptoms. Clinicians should be vigilant for children with higher vomiting frequencies at presentation and during follow-up because these children are more likely to deteriorate.

Substitution of general practitioners by nurse practitioners in out-of-hours primary care home visits: A quasi-experimental study

2020 ◽  
Vol 104 ◽  
pp. 103445
Author(s):  
Marleen Smits ◽  
Yvonne Peters ◽  
Sander Ranke ◽  
Erik Plat ◽  
Miranda Laurant ◽  
...  
Keyword(s):  
Primary Care ◽  
Experimental Study ◽  
General Practitioners ◽  
Nurse Practitioners ◽  
Care Home ◽  
Home Visits ◽  
Out Of Hours ◽  
Quasi Experimental
Sign in / Sign up

Export Citation Format

Share Document