Primary Child Health Care by Family Nurse Practitioners
This study analyzes the child health care role of four family nurse practitioners (FNPs) serving 990 families with 1,300 children in a rural clinic 30 miles from a hospital base. In a 12-month program they were trained to give primary care, using standing orders, to all family members. Respiratory infections, well child care, psychogenic problems, allergic conditions and injuries comprised 75.5% of pediatric cases. The FNPs managed 70.3% of all cases without physician consultation. Respiratory infections, well child care and gastrointestinal problems which comprised 57% of all cases were managed with a combined consultation rate of 14.3%. The physician maintained primary responsibility for the management of 3% of all cases. Review of medical records revealed that 93% of the cases were managed properly by the FNPs. The positive experience reported in this study indicates that the FNP role should be developed as one method of providing primary health care.