scholarly journals The Role of Nurses in Primary Care Reform: “The Wheel and Hub of Health Care System”

2017 ◽  
Vol 15 (1) ◽  
Author(s):  
Nina Mamishi
Keyword(s):  
Primary Care ◽  
Registered Nurses ◽  
Healthcare System ◽  
Primary Healthcare ◽  
National Level ◽  
Healthcare Providers ◽  
Effect Change ◽  
Primary Care Settings ◽  
Primary Care Reform ◽  
The Right

The current focus in Canadian healthcare system is on improving efficiencies and quality of care. Therefore, primary healthcare is receiving further attention. It is the right moment to highlight the value that registered nurses can bring to collaborative practice in primary care settings. Since nurses are the largest group of healthcare providers in Canada being present throughout the system, thy are ideally positioned to effect change at the national level. The purpose of this paper is to highlight the value that nurses bring to primary healthcare system to discuss how integrating registered nurses into family practice will optimize primary healthcare.  

scholarly journals O direito à saúde na atenção básica no MERCOSUL: a fraternidade como possibilidade de garantia de direitos sociais / The Right to Primary Healthcare in MERCOSUL: the Fraternity as a Possibility of Social Rights Guarantee

2019 ◽  
Vol 6 (2) ◽  
pp. 33-43
Author(s):  
Sandra Regina Martini ◽  
Maria Isabel Barros Bellini
Keyword(s):  
Primary Care ◽  
Primary Healthcare ◽  
International Organization ◽  
Social Rights ◽  
Economic Policies ◽  
Time Limits ◽  
Access To Primary Care ◽  
The Right ◽  
Dividing Line

ABSTRACTThis article discusses health as a fundamental and universal right therefore not limited to border demarcation, races and / or any other indicator . The analysis Locus is MERCOSUL- international organization between Brazil, Argentina , Paraguay and Uruguay established in 1991 to facilitate the integration of economic policies between these countries, it is associated with Chile and Bolivia. Discusses the importance of resizing the limits of law in today's society , for which the "frontier" is at the same time limits and possibilities between these to promote access to primary care as a bridge to the execution of other social rights thus breaking with traditional dimensions of the border or transfrontier idea where the right ended at the dividing line between one country and another.RESUMENEste artigo aborda a saúde como direito fundamental e universal portanto não limitado a demarcação de fronteiras, raças e/ou qualquer outro indicador. O Lócus de análise é o MERCOSUL -organização internacional entre Brasil, Argentina, Paraguai e Uruguai criada em 1991 para facilitar a integração de políticas econômicas entre estes países, tem como associados o Chile e Bolívia. Discute a importância de redimensionar os limites do direito na sociedade atual, para a qual a “fronteira” representa, ao mesmo tempo limites e possibilidades entre estas o de promover o acesso à atenção básica como uma ponte para a efetivação de outros direitos sociais rompendo assim com as dimensões tradicionais da ideia de fronteira ou transfronteira onde o direito terminava na linha divisória entre um país e outro. Tem como pressupostos teóricos o Direito Vivo e a Metateoria do Direito Fraterno e  aposta no pressuposto da fraternidade como uma possibilidade de agregação e superação das divisões postas pelas fronteiras.

District nurses’ and registered nurses’ training in and use of motivational interviewing in primary care settings

2013 ◽  
Vol 23 (15-16) ◽  
pp. 2284-2294 ◽  
Author(s):  
Ann-Sofi Östlund ◽  
Barbro Wadensten ◽  
Elisabeth Häggström ◽  
Marja-Leena Kristofferzon
Keyword(s):  
Primary Care ◽  
Motivational Interviewing ◽  
Registered Nurses ◽  
Primary Care Settings ◽  
District Nurses

scholarly journals The effects of Enhanced Primary Healthcare interventions on primary care providers job satisfaction

2019 ◽  
Author(s):  
Wen Jun Wong ◽  
Aisyah Mohd Norzi ◽  
Swee Hung Ang ◽  
Chee Lee Chan ◽  
Faeiz Syezri Adzmin Jaafar ◽  
...  
Keyword(s):  
Primary Care ◽  
Job Satisfaction ◽  
Primary Healthcare ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Intervention Group ◽  
Well Being ◽  
Primary Care Providers ◽  
Care Providers ◽  
Post Intervention

Abstract Background In response to address the rising burden of cardiovascular risk factors, Malaysian government has implemented Enhanced Primary Healthcare (EnPHC) interventions in July 2017 at public clinics level. Healthcare providers (HCPs) play crucial roles in healthcare service delivery and health system reform can influence HCPs’ job satisfaction. However, studies evaluating HCPs’ job satisfaction following primary care transformation remain scarce in low- and middle-income countries. This study aims to evaluate the effects of EnPHC interventions on HCPs. Methods This is a quasi-experimental study conducted in 20 intervention and 20 matched control clinics. We surveyed all healthcare providers who were directly involved in patient management. A self-administered questionnaire which included six questions on job satisfaction were distributed at baseline (April and May 2017) and post-intervention (March and April 2019). Difference-in-differences analysis was used in the multivariable linear regression model in which we adjusted for providers and clinics characteristics to detect the changes in job satisfaction following EnPHC interventions. Results A total of 1042 and 1215 HCPs responded at baseline and post-intervention respectively. At post-intervention, the intervention group reported higher level of stress and change in score between two groups was -0.14 (β= -0.139; 95% CI -0.266,-0.012; p =0.032). In subgroup analysis, nurses from intervention group experienced increase in work stress following EnPHC interventions (β= -0.223; 95% CI -0.419,-0.026; p =0.026). Additionally, the same group also responded that they were less likely to perceive their profession as well-respected at post-intervention (β= -0.175; 95% CI -0.331,-0.019; p =0.027). Conversely, allied health professionals from intervention group were more likely to report a good balance between work and effort (β= 0.386; 95% CI 0.033,0.738; p =0.032) after implementing EnPHC interventions. Conclusions Our findings suggest that EnPHC interventions had resulted in some untoward effect on HCPs’ job satisfaction. Job dissatisfaction can have detrimental effects on the organisation and healthcare system. Therefore, provider experience and well-being should be considered before introducing healthcare delivery reforms to avoid overburdening of HCPs.

“We Had to Keep Pushing”: Caregivers' Perspectives on Autism Screening and Referral Practices of Black Children in Primary Care

2018 ◽  
Vol 56 (5) ◽  
pp. 321-336 ◽  
Author(s):  
Sarah Dababnah ◽  
Wendy E. Shaia ◽  
Karen Campion ◽  
Helen M. Nichols
Keyword(s):  
Primary Care ◽  
Primary Healthcare ◽  
Racial Bias ◽  
Healthcare Providers ◽  
Black Children ◽  
Autism Spectrum ◽  
Theory Approach ◽  
Early Intervention Services ◽  
Primary Healthcare Providers

Abstract Black children with autism spectrum disorder (ASD) are diagnosed later than their White peers, are more likely to be misdiagnosed, and are less likely to receive early intervention services or a developmental evaluation by three years old. Using a grounded theory approach, we solicited the perspectives of parents and other primary caregivers of Black children with ASD on barriers and facilitators to ASD screening and referrals in primary care. A socioeconomically diverse sample of 22 female caregivers participated. Four themes emerged. First, while some caregivers noted their child's primary healthcare providers facilitated a timely ASD diagnosis, other participants reported these providers ignored early concerns about child developmental delays. Second, many participants felt racial bias negatively impacted caregiver-primary healthcare provider interactions. Third, legal/custodial issues slowed caregivers' abilities to follow up on referrals from their primary healthcare providers. Finally, caregivers described denial, shame, and stigma relating to ASD in the Black community as possible factors for delayed follow up to referrals. Differences based on socioeconomic status are discussed. Efforts to improve family-centered, culturally relevant care for all Black caregivers raising children with or at-risk for ASD are needed, particularly for those families experiencing the multiple effects of poverty.

Healthcare system encounters before COPD diagnosis: a registry-based longitudinal cohort study

Thorax ◽  
2019 ◽  
Vol 75 (2) ◽  
pp. 108-115 ◽  
Author(s):  
Kate M Johnson ◽  
Amir Khakban ◽  
Stirling Bryan ◽  
Don D Sin ◽  
Mohsen Sadatsafavi
Keyword(s):  
Primary Care ◽  
Healthcare System ◽  
Linear Models ◽  
Case Definition ◽  
Chronic Obstructive ◽  
Primary Care Visit ◽  
Outpatient Services ◽  
Obstructive Pulmonary Disease ◽  
Primary Care Settings ◽  
Copd Diagnosis

BackgroundThere is high interest in strategies for improving early detection of chronic obstructive pulmonary disease (COPD). These strategies often rely on opportunistic encounters between patients with undiagnosed COPD and the healthcare system; however, the frequency of these encounters is currently unknown.MethodsWe used administrative health data for the province of British Columbia, Canada, from 1996 to 2015. We identified patients with COPD using a validated case definition, and assessed their visits to pharmacists, primary care and specialist physicians in the 5 years prior to the initial diagnosis of COPD. We used generalised linear models to compare the rate of outpatient visits between COPD and non-COPD comparator subjects matched on age, sex and socioeconomic status.ResultsWe assessed 112 635 COPD and non-COPD pairs (mean 68.6 years, 51.0% male). Patients with COPD interacted with pharmacists most frequently in the 5 years before diagnosis (mean 14.09, IQR 4–17 visits/year), followed by primary care (10.29, IQR 4–13 visits/year) and specialist (8.11, IQR 2–11 visits/year) physicians. In the 2 years prior to diagnosis, 72.1% of patients with COPD had a respiratory-related primary care visit that did not result in a COPD diagnosis. Compared with non-COPD subjects, patients with COPD had higher rates of primary care (rate ratio (RR) 1.40, 95% CI 1.39 to 1.41), specialist (RR 1.35, 95% CI 1.34 to 1.37) and pharmacist (RR 1.62, 95% CI 1.60 to 1.63) encounters.ConclusionsPatients with COPD used higher rates of outpatient services before diagnosis than non-COPD subjects. Case detection technologies implemented in pharmacy or primary care settings have opportunities to diagnose COPD earlier.

scholarly journals Influencers on deprescribing practice of primary healthcare providers in Nova Scotia: An examination using behavior change frameworks

2020 ◽  
Vol 4 ◽  
pp. 239920262092250
Author(s):  
Natalie Kennie-Kaulbach ◽  
Rachel Cormier ◽  
Olga Kits ◽  
Emily Reeve ◽  
Anne Marie Whelan ◽  
...  
Keyword(s):  
Primary Care ◽  
Nova Scotia ◽  
Behavior Change ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
System Level ◽  
Care Providers ◽  
Behavior Change Wheel ◽  
Primary Healthcare Providers

Background: Deprescribing is a complex process requiring consideration of behavior change theory to improve implementation and uptake. Aim: The aim of this study was to describe the knowledge, attitudes, beliefs, and behaviors that influence deprescribing for primary healthcare providers (family physicians, nurse practitioners (NPs), and pharmacists) within Nova Scotia using the Theoretical Domains Framework version 2 (TDF(v2)) and the Behavior Change Wheel. Methods: Interviews and focus groups were completed with primary care providers (physicians, NPs, and pharmacists) in Nova Scotia, Canada. Coding was completed using the TDF(v2) to identify the key influencers. Subdomain themes were also identified for the main TDF(v2) domains and results were then linked to the Behavior Change Wheel—Capability, Opportunity, and Motivation components. Results: Participants identified key influencers for deprescribing including areas related to Opportunity, within TDF(v2) domain Social Influences, such as patients and other healthcare providers, as well as Physical barriers (TDF(v2) domain Environmental Context and Resources), such as lack of time and reimbursement. Conclusion: Our results suggest that a systematic approach to deprescribing in primary care should be supported by opportunities for patient and healthcare provider collaborations, as well as practice and system level enhancements to support sustainability of deprescribing practices.

Presenting primary care teams to the public: a qualitative exploration of general practice websites

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697049
Author(s):  
Helen Anderson ◽  
Joy Adamson ◽  
Yvonne Birks
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Nurse Practitioners ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Patient Choice ◽  
Healthcare Team ◽  
Sufficient Information ◽  
The Public ◽  
Professional Groups

BackgroundIncreasing demand and expanded primary care provision, coupled with a reduced GP workforce present challenges for primary care. New workforce models aim to reduce general practitioner workload by directing patients to a variety of alternative clinicians. Concurrently, the principle of patient choice in relation to healthcare providers has gained prominence. It is, therefore, necessary to provide patients with sufficient information to negotiate access to appropriate primary healthcare professionals.AimTo explore how practice websites present three exemplar healthcare professional groups (GPs, advanced nurse practitioners [ANPs], and practice nurses [PNs]) to patients and the implications for informing appropriate consultation choices.MethodQualitative thematic analysis of a sample of general practice websites. 79 accessible websites from a district in England were thematically analysed in relation to professional representation and signposting of the three identified professional groups.ResultsInformation about each group was incomplete, inconsistent and sometimes inaccurate across the majority of general practice websites. There was a lack of coherence and strategy in representation and direction of website users towards appropriate primary healthcare practitioners.ConclusionLimited and unclear representation of professional groups on general practice websites may have implications for the direction of patients to the wider clinical healthcare team. Patients may not have appropriate information to make choices about consulting with different healthcare practitioners. This constitutes a missed opportunity to signpost patients to appropriate clinicians and enhance understanding of different professional roles. Potential for websites to disseminate information to the public is not being maximised.

scholarly journals The role of the registered nurse in the marketing of primary healthcare services, as part of health promotion

Curationis ◽  
2006 ◽  
Vol 29 (1) ◽  
Author(s):  
M Rail ◽  
SM Meyer
Keyword(s):  
Registered Nurses ◽  
Primary Healthcare ◽  
Human Subjects ◽  
Health Sector ◽  
Healthcare Services ◽  
Primary Research ◽  
Product Price ◽  
The Right ◽  
Behaviour Changes

Existing literature on the marketing of primary healthcare services was reviewed to determine the role of registered nurses in this regard. The systematic review included “— five searches and ensured wide coverage of the results of available primary research studies on the topic. The results were summarised and the role of registered nurses in the marketing of primary healthcare services was identified. Primary research sources on the topic included textbooks on marketing by experts in the field and relevant journal articles by authorities on healthcare marketing. The data were analysed and four main categories identified. To ensure the trustworthiness of the research, Lincoln and Guba’s (1981:215-216) criteria, as explained by Krefting (1991:217), were applied. Because the population consisted of only literature, ethical considerations concerning human subjects were irrelevant. Results indicated that the basic commercial marketing principles (the so-called 4Ps - product, price, place, and promotion) could be adapted for the health sector. The conclusion was that registered nurses could contribute to the marketing of primary healthcare services by communicating with the community (promotion) and by ensuring effective service (product) delivery at the right price and place. Registered nurses could influence the community’s perceptions of health care and facilitate behaviour changes, thereby promote health. The implementation of the findings and recommendations of this research could create a new awareness among registered nurses of their role in the marketing of primary healthcare services in South Africa and improve their skills in this regard.

Burnout and its Association with Musculoskeletal Pain among Primary Care Providers

2017 ◽  
Vol 61 (1) ◽  
pp. 1010-1014 ◽  
Author(s):  
Xuanxuan Zhang ◽  
Mark C. Schall ◽  
Richard Sesek ◽  
Sean Gallagher ◽  
Jesse Michel
Keyword(s):  
Primary Care ◽  
Musculoskeletal Pain ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
Care Providers ◽  
Cross Sectional ◽  
Body Regions ◽  
Increased Risk ◽  
The Right

Burnout is a growing concern among primary care providers (PCPs). The condition may lead to diminished quality of patient care as well as reduced quality of life. Although self-reported musculoskeletal pain is common among healthcare providers, the relationship between burnout and musculoskeletal pain among PCPs has been studied very little. We describe a cross-sectional pilot survey conducted among 38 PCPs (MDs, DOs, PAs, and NPs) in the Midwestern United States. Self-reported feelings of burnout and musculoskeletal pain in different body regions were analyzed using regression models. Results suggested that increasing number of hours worked per day, severity of pain in the neck / shoulder area, and severity of pain in the right wrist were associated with an increased risk of burnout. On the contrary, burnout decreased with increasing age. The findings suggest that additional research is needed to understand the risk factors for burnout among PCPs, particularly during the early stages of their career.

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