scholarly journals Organisational Factors Associated With Readiness to Implement a Preventive Intervention for Overweight and Obese Patients in Australian General Practice: a Mixed Methods Exploration From the HELP GP Trial.

2021 ◽  
Author(s):  
Sharon Parker ◽  
An Tran ◽  
Shoko Saito ◽  
Carmel McNamara ◽  
Elizabeth Denney-Wilson ◽  
...  
Keyword(s):  
General Practice ◽  
Weight Management ◽  
Practice Nurse ◽  
Preventive Intervention ◽  
Specific Capacity ◽  
Lifestyle Changes ◽  
Obese Patients ◽  
Intervention Delivery ◽  
Practice Nurses ◽  
Telephone Coaching

Abstract Background: Australian rates of obesity are increasing. General practice has a definite role to play in addressing obesity and preventing further chronic disease but relatively few encounters focus primarily on weight management. The HeLP GP trial assisted overweight and obese patients to make positive lifestyle changes to diet and physical activity and increase the capacity of practice nurses to deliver comprehensive weight management. The nurse led intervention comprised a health check and access to a lifestyle app and/or telephone coaching. Within this paper we describe the experience of implementing this intervention through the lens of organisational readiness with specific emphasis on the role of the practice nurse. Methods: Routinely collected research data, quantitative practice surveys, and qualitative field notes from research officers and facilitators were mapped against a recognised organisational readiness framework. Motivation to implement, general capacity and intervention-specific capacity were assessed. Results: The level of organisational readiness within the participating practices was observed to vary considerably, particularly the domain of intervention specific capacity. The level of practice nurse turnover negatively impacted the implementation of the intervention, affecting half of the intervention practices. Within this study we observed a general lack of practice-based support for the practice nurse regarding intervention delivery and varying levels of interest, skill, and confidence in delivering the program to patients. Nurses struggled to complete the health checks and subsequently to conduct timely follow up appointments. Risk assessment and referral to telephone coaching were generally not problematic, although we noted lower confidence with the setup of the lifestyle app and with instructing patients to use it.Conclusions: Using an organisational readiness checklist is valuable for determining specific capacity issues prior to commencing research but should also assess the capacity of those individuals responsible for the intervention. We found a lack of general ‘readiness’ inherent in the practice nurse role. If they are to fulfil their potential in supporting patients to reduce risk and adopt healthier life choices, our study indicates that more could be done to improve their workforce positioning and remuneration, which may, in turn, improve continuity of care, retention, and individual motivation.Trial registration:The HeLP GP trial is registered with the Australian and New Zealand Clinical Trials Registry (ANZCTR - ACTRN12617001508369). The trial was registered 26/10/2017 http://www.ANZCTR.org.au/ACTRN12617001508369.aspx

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.

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

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

Dysphagia: a guide for nurses in general practice

2020 ◽  
Vol 31 (4) ◽  
pp. 162-168
Author(s):  
Linda Nazarko
Keyword(s):  
Older Adults ◽  
General Practice ◽  
Practice Nurse ◽  
Population Ageing ◽  
Medical Problems ◽  
Practice Nurses ◽  
Swallowing Difficulties

Dysphagia is common in older adults. Linda Nazarko gives an overview of how practice nurses can support individuals living with dysphagia The practice nurse may encounter people who present with a variety of medical problems that are ultimately caused by swallowing difficulties. These difficulties may be acute or longstanding, severe or mild. The number of adults living with swallowing difficulties is set to rise in line with population ageing and the increasing levels of frailty and comorbidities that occur in older adults. This article aims to provide a guide to why dysphagia develops, how dysphagia is diagnosed and how the practice nurse can support individuals who are living with dysphagia.

scholarly journals Clinical academic careers for general practice nurses: a qualitative exploration of associated barriers and enablers

2021 ◽  
pp. 174498712110243
Author(s):  
Sarahjane Jones ◽  
Andrew Bradbury ◽  
Sue Shortland ◽  
Fraser Hewett ◽  
Karen Storey
Keyword(s):  
General Practice ◽  
Focus Group ◽  
Practice Nurse ◽  
Research Training ◽  
Academic Careers ◽  
Practice Nurses ◽  
Barriers And Enablers ◽  
Career Pathway ◽  
Professional Attributes ◽  
Organisational Factors

Background The delivery of research in healthcare in the UK is dependent on a subgroup of clinicians – clinical academics – who concurrently engage in clinical practice and academic activities. The need to increase access to such roles for general practice nurses has been identified, although the need for a robust career framework remains. Aims This study, with a qualitative interview and focus group design, aimed to explore the concept of clinical academic careers for general practice nurses by identifying barriers and enablers associated with pursuing and performing such roles. Methods General practice nurses ( n = 18) and general practitioners ( n = 5) engaged in either an audio -recorded interview or focus group. Verbatim transcripts were subjected to thematic analysis. Results Four themes were identified: awareness and understanding; career pathway; personal and professional attributes; and organisational factors. Awareness and understanding were generally poor. Participants suggested that the career pathway was unclear, although it was generally assumed that such roles were ‘out of reach’ and require a minimum of Master’s level education. An interest in research and the confidence to perform such duties were reported as the required personal and professional attributes. Organisational factors included the need for employers to understand the value and benefit of general practice nurse clinical academic roles, along with ensuring that the inevitable competing demands of such a role were appropriately managed. Conclusions This study highlights the difficulties faced by general practice nurses wishing to pursue a clinical academic career. Academia is seemingly placed on a pedestal, emphasising the need to embed research training early in nursing education to alter general practice nurse perceptions that clinical academic roles are unobtainable. The development of a robust career pathway for general practice nurse clinical academic roles may have a positive impact on the retention of experienced general practice nurses and attract newly qualified nurses. This research provides evidence as to the need for one.

scholarly journals Translating hunger training research to primary health: a qualitative study of nurse attitudes towards a novel weight management intervention

2020 ◽  
Vol 12 (1) ◽  
pp. 79
Author(s):  
Jennifer T. Gale ◽  
Aimee L. Ward ◽  
Willemijn E. de Bruin ◽  
Rachael W. Taylor ◽  
Michelle R. Jospe
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Weight Management ◽  
Eating Behaviour ◽  
Structured Interview ◽  
Practice Nurses ◽  
Management Intervention ◽  
Stakeholder Perspectives ◽  
The Impact ◽  
Weight Management Intervention

ABSTRACT INTRODUCTIONPractice nurses in general practice are ideally placed to deliver weight management treatments. Teaching people to eat according to their appetite, based on measurements of blood glucose (‘hunger training’), is known to lead to weight loss and improved eating behaviour. To effectively translate this research to primary care requires understanding of key stakeholder perspectives. AIMThe aim of this study was to explore the perspectives of practice nurses on the suitability of using hunger training as a weight management intervention in general practice. METHODSTen nurses trialled hunger training for 1 week, followed by a semi-structured interview where they were asked about their experience; perceived patient interest; enablers and barriers; and suggested changes to hunger training. RESULTSAll nurses were positive about hunger training and wanted to use it with their patients. They thought it was a useful method for teaching patients about eating according to their appetite, and the impact of food choices on glucose. Motivation was seen to be both an important potential barrier and enabler for patients. Other anticipated patient enablers included the educational value of hunger training and ease of the programme. Other barriers included lack of time and cost of equipment and appointments. For most nurses, 1 week of following hunger training was sufficient training to deliver the intervention. Suggested refinements included adding nutrition advice to the booklet, incorporating other health goals and enabling social support. DISCUSSIONThese findings suggest that hunger training could be translated to primary care with minor modifications.

scholarly journals What is the role of the PN 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

Practice nurse involvement in general practice clinical care: policy and funding issues need resolution

2014 ◽  
Vol 38 (3) ◽  
pp. 301 ◽  
Author(s):  
Hossein Haji Ali Afzali ◽  
Jonathan Karnon ◽  
Justin Beilby ◽  
Jodi Gray ◽  
Christine Holton ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Chronic Conditions ◽  
Practice Nurse ◽  
Clinical Care ◽  
Cost Effective ◽  
Clinical Role ◽  
Practice Nurses ◽  
General Practices ◽  
Diabetes And Obesity

In Australia, primary care-based funding initiatives have been implemented to encourage general practices to employ practice nurses. The aim of this paper is to discuss limitations of the current funding and policy arrangements in enhancing the clinical role of practice nurses in the management of chronic conditions. This paper draws on the results of a real-world economic evaluation, the Primary Care Services Improvement Project (PCSIP). The PCSIP linked routinely collected clinical and resource use data to undertake a risk-adjusted cost-effectiveness analysis of increased practice nurse involvement in clinical-based activities for the management of diabetes and obesity. The findings of the PCSIP suggested that the active involvement of practice nurses in collaborative clinical-based activities is cost-effective, as well as addressing general practice workforce issues. Although primary healthcare organisations (e.g. Medicare Locals) can play a key role in supporting enhanced practice nurse roles, improvements to practice nurse funding models could further encourage more efficient use of an important resource. What is known about the topic? There is evidence that the increased involvement of practice nurses in clinical-based activities in the management of patients with chronic conditions (e.g. diabetes and obesity) is cost-effective. The Australian Government has implemented financial incentives to encourage general practices to recruit nurses and to expand nursing roles within collaborative models of care. There is currently insufficient engagement of practice nurses in clinical care. What does this paper add? This paper summarises evidence regarding the value of an enhanced practice nurse role in Australian general practice, and discusses refinements to current funding arrangements for practice nurses. What are the implications for practitioners? Delegating clinical role (e.g. patient education and monitoring clinical progress) to practice nurses in the management of patients with chronic conditions can improve clinical outcomes without adversely affecting general practice business models.

Sign in / Sign up

Export Citation Format

Share Document