Primary Care Nurses (primary + care_nurse)

Distribution by Scientific Domains
Distribution within Medical Sciences


Selected Abstracts


Dementia and the Over-75 Check: the role of the primary care nurse

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2000
Heather Trickey BSc MSc (Med)
Abstract Primary care nurses are very likely to provide a substantial part of the routine care for patients with dementia. In order to examine the knowledge and attitudes of the primary care nurses who undertake the Over-75 Check, towards assessing and managing patients with symptoms of dementia, and to assess their level of support for a clinical practice guideline, a postal questionnaire survey was undertaken of primary care nurses responsible for the Over-75 Check in 209 general practices in Gloucester, Avon and Somerset. The questionnaire ascertained some demographic information about the nurses, their training and the practice routine for the Over-75 Check. It also included a case vignette describing a typical presentation of dementia at an Over-75 Check. A 65% response rate was achieved. Only one-fifth of respondents ever used formal validated cognitive tests as part of the Over-75 Check. In response to the vignette, nearly 10% took no action at all and a further 25% simply referred the patient on. Amongst the remainder there was considerable variation regarding the tasks considered to be within their remit. The respondents strongly supported the introduction of guidelines. Given the variation in professional responsibilities between practices, it is proposed that a clinical practice guideline covering diagnosis, assessment and management of dementia should address the practice as a whole rather than be targeted to specific professionals. The guideline should prompt professionals carrying out an Over-75 Check to recognize symptoms of dementia and raise awareness of the range of tasks which need to be undertaken in confirming diagnosis, assessing needs and managing patients. Results from this study suggest that improved training and increased autonomy for primary care nurses would improve access to services for these patients and their carers. [source]


The Supervised Methadone and Resettlement Team nurse: an effective approach with opiate-dependent, homeless people

INTERNATIONAL NURSING REVIEW, Issue 2 2001
W. Mistral BSC.
Abstract Homelessness and substance misuse have risen dramatically over the past 30 years in the UK. The role of the primary care nurse has been signalled as important in working with people who have drug and alcohol problems, and for improving the general health of homeless people. This article focuses on the role of the primary care nurse in a Supervised Methadone and Resettlement Team (SMART). The team works in central Bristol, in southwest England, with people who are homeless and using illegal opiates. The aim of this report is to provide descriptive information that demonstrates the value of the primary care nurse, working in a multiagency partnership, in dealing with the problems of this homeless population, many of whom have problems associated with illicit drug use. Client outcomes from a small sample of homeless persons are also described. [source]


Dementia and the Over-75 Check: the role of the primary care nurse

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2000
Heather Trickey BSc MSc (Med)
Abstract Primary care nurses are very likely to provide a substantial part of the routine care for patients with dementia. In order to examine the knowledge and attitudes of the primary care nurses who undertake the Over-75 Check, towards assessing and managing patients with symptoms of dementia, and to assess their level of support for a clinical practice guideline, a postal questionnaire survey was undertaken of primary care nurses responsible for the Over-75 Check in 209 general practices in Gloucester, Avon and Somerset. The questionnaire ascertained some demographic information about the nurses, their training and the practice routine for the Over-75 Check. It also included a case vignette describing a typical presentation of dementia at an Over-75 Check. A 65% response rate was achieved. Only one-fifth of respondents ever used formal validated cognitive tests as part of the Over-75 Check. In response to the vignette, nearly 10% took no action at all and a further 25% simply referred the patient on. Amongst the remainder there was considerable variation regarding the tasks considered to be within their remit. The respondents strongly supported the introduction of guidelines. Given the variation in professional responsibilities between practices, it is proposed that a clinical practice guideline covering diagnosis, assessment and management of dementia should address the practice as a whole rather than be targeted to specific professionals. The guideline should prompt professionals carrying out an Over-75 Check to recognize symptoms of dementia and raise awareness of the range of tasks which need to be undertaken in confirming diagnosis, assessing needs and managing patients. Results from this study suggest that improved training and increased autonomy for primary care nurses would improve access to services for these patients and their carers. [source]


The influence of HIV/AIDS on the practice of primary care nurses in Jordan: Rhetoric and reality

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 5 2005
Hani Nawafleh PhD(Cand)
The role of nurses in raising community awareness about HIV/AIDS is well-reported. However, little is known about the practice of Jordanian nurses and the role they play in the prevention and control of HIV/AIDS. This interpretive ethnographic study sought to illuminate the role of primary care nurses and examine the influence of HIV/AIDS on their practice. The study was undertaken in Jordan in three rural and three urban primary health-care centres. Data collection included participant observation, key informant interviews and document analysis. These data informed the development of descriptive ethnographic accounts that allowed for the subsequent identification of common and divergent themes reflective of factors recognized as influencing the practice of the nurse participants. The findings indicate that the rhetoric offered by all levels of administration and endorsed in policy is not reflective of the reality of practice. Poor resources and educational preparation, a limited nursing skill mix and access to professional development, lack of nursing leadership and role models, cultural beliefs and geographic isolation are factors that reduced the capacity of the primary care nurses to raise awareness and, therefore, influence the prevention and control of HIV/AIDS. [source]


Effectiveness of planning hospital discharge and follow-up in primary care for patients with chronic obstructive pulmonary disease: research protocol

JOURNAL OF ADVANCED NURSING, Issue 6 2010
Eva Abad-Corpa
abad-corpa e., carrillo-alcaraz a., royo-morales t., pérez-garcía m.c., rodríguez-mondejar j.j., sáez-soto a. & iniesta-sánchez j. (2010) Effectiveness of planning hospital discharge and follow-up in primary care for patients with chronic obstructive pulmonary disease: research protocol. Journal of Advanced Nursing,66(6), 1365,1370. Abstract Title.,Effectiveness of planning hospital discharge and follow-up in primary care for patients with chronic obstructive pulmonary disease: research protocol. Aim., To evaluate the effectiveness of a protocolized intervention for hospital discharge and follow-up planning for primary care patients with chronic obstructive pulmonary disease. Background., Chronic obstructive pulmonary disease is one of the main causes of morbidity and mortality internationally. These patients suffer from high rates of exacerbation and hospital readmission due to active problems at the time of hospital discharge. Methods., A quasi-experimental design will be adopted, with a control group and pseudo-randomized by services (protocol approved in 2006). Patients with pulmonary disease admitted to two tertiary-level public hospitals in Spain and their local healthcare centres will be recruited. The outcome variables will be readmission rate and patient satisfaction with nursing care provided. 48 hours after admission, both groups will be evaluated by specialist coordinating nurses, using validated scales. At the hospital, a coordinating nurse will visit each patient in the experimental group every 24 hours to identify the main caregiver, provide information about the disease, and explain treatment. In addition, the visits will be used to identify care problems and needs, and to facilitate communication between professionals. 24 hours after discharge, the coordinating nurses will inform the primary care nurses about patient discharge and nursing care planning. The two nurses will make the first home visit together. There will be follow-up phone calls at 2, 6, 12 and 24 weeks after discharge. Discussion., The characteristics of patients with this pulmonary disease make it necessary to include them in hospital discharge planning programmes using coordinating nurses. [source]


Development and Validation of Quality Indicators for Dementia Diagnosis and Management in a Primary Care Setting

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2010
Marieke Perry MD
OBJECTIVES: To construct a set of quality indicators (QIs) for dementia diagnosis and management in a primary care setting. DESIGN: RAND modified Delphi method, including a postal survey, a stakeholders consensus meeting, a scientific expert consensus meeting, and a demonstration project. SETTING: Primary care. PARTICIPANTS: General practitioners (GPs), primary care nurses (PCNs), and informal caregivers (ICs) in postal survey and stakeholders consensus meeting. Eight national dementia experts in scientific consensus meeting. Thirteen GPs in the demonstration project. MEASUREMENTS: Mean face validity and feasibility scores. Compliance rates using GPs' electronic medical record data. RESULTS: The initial set consisted of 31 QIs. Most indicators showed moderate or good face validity and feasibility scores. Consensus panels reduced the preliminary set used in the demonstration project to 24 QIs. The overall compliance to the QIs was 45.3%. Discriminative validity of the set was good; significant differences in adherence were found between GPs with high and low levels of patients aged 65 and older in their practice, with and without PCNs, and with positive and negative attitudes toward dementia (all P<.05). Based on the demonstration project, one QI was excluded. The final set consisted of 23 QIs; 15 QIs contained innovative quality criteria on collaboration between GPs and PCNs, referral criteria, and assessment of caregivers' needs. CONCLUSION: This new set of dementia QIs is feasible, reliable, and valid and can be used to improve primary dementia care. Because of the innovative quality criteria, the set is complementary to the existing dementia QIs. [source]


Hypertension guideline implementation: experiences of Finnish primary care nurses

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2008
Seija Alanen MNSc
Abstract Rationale, aims and objectives, Evidence-based guidelines on hypertension have been developed in many western countries. Yet, there is little evidence of their impact on the clinical practices of primary care nurses. Method, We assessed the style of implementation and adoption of the national Hypertension Guideline (HT Guideline) in 32 Finnish health centres classified in a previous study as ,disseminators' (n = 13) or ,implementers' (n = 19). A postal questionnaire was sent to all nurses (n = 409) working in the outpatient services in these health centres. Additionally, senior nursing officers were telephoned to enquire if the implementation of the HT Guideline had led to a new division of labour between nurses and doctors. Results, Questionnaires were returned from 327 nurses (80.0%), while all senior nursing officers (n = 32) were contacted. The majority of nurses were of the opinion that the HT Guideline has been adopted into clinical practice. The recommendations in the HT Guideline were adopted in clinical practice with varying success, and slightly more often in implementer health centres than in disseminator health centres. Nurses in implementer health centres more often agreed that multiple channels had been used in the implementation (P < 0.001). According to senior nursing officers the implementation of the HT Guideline had led to a new division of labour between nurses and doctors in about a half of the health centres, clearly more often in implementer health centres (P < 0.001). Conclusions, The HT Guideline was well adopted into clinical practice in Finland. The implementation of the HT Guideline had an impact on clinical practices, and on creating a new division of labour between nurses and doctors. [source]


Building the capacity for evidence-based clinical nursing leadership: the role of executive co-coaching and group clinical supervision for quality patient services

JOURNAL OF NURSING MANAGEMENT, Issue 2 2007
BA (Hons), JO ALLEYNE DProf
Aim, The general aims of this article were to facilitate primary care nurses (District Nurse Team Leaders) to link management and leadership theories with clinical practice and to improve the quality of the service provided to their patients. The specific aim was to identify, create and evaluate effective processes for collaborative working so that the nurses' capacity for clinical decision-making could be improved. Background, This article, part of a doctoral study on Clinical Leadership in Nursing, has wider application in the workplace of the future where professional standards based on collaboration will be more critical in a world of work that will be increasingly complex and uncertain. This article heralds the type of research and development activities that the nursing and midwifery professions should give premier attention to, particularly given the recent developments within the National Health Service in the United Kingdom. The implications of: Agenda for Change, the Knowledge and Skills Framework, ,Our Health, Our Care, Our Say' and the recent proposals from the article Modernising Nursing Career, to name but a few, are the key influences impacting on and demanding new ways of clinical supervision for nurses and midwives to improve the quality of patient management and services. Method, The overall approach was based on an action research using a collaborative enquiry within a case study. This was facilitated by a process of executive co-coaching for focused group clinical supervision sessions involving six district nurses as co-researchers and two professional doctoral candidates as the main researchers. The enquiry conducted over a period of two and a half years used evidence-based management and leadership interventions to assist the participants to develop ,actionable knowledge'. Group clinical supervision was not practised in this study as a form of ,therapy' but as a focus for the development of actionable knowledge, knowledge needed for effective clinical management and leadership in the workplace. Findings, ,,Management and leadership interventions and approaches have significantly influenced the participants' capacity to improve the quality of services provided to their patients. ,,Using various techniques, tools, methods and frameworks presented at the sessions increased participants' confidence to perform. ,,A structured approach like the Clinical Nursing Leadership Learning and Action Process (CLINLAP) model makes implementing change more practical and manageable within a turbulent care environment. The process of Stakeholder Mapping and Management made getting agreement to do things differently much easier. Generally it is clear that many nurses and midwives, according to the participants, have to carry out management and leadership activities in their day-to-day practice. The traditional boundary between the private, the public and the voluntary sector management is increasingly becoming blurred. Conclusion, It is conclusive that the district nurses on this innovative programme demonstrated how they were making sense of patterns from the past, planning for the future and facilitating the clinical nursing leadership processes today to improve quality patient services tomorrow. Their improved capacity to manage change and lead people was demonstrated, for example, through their questioning attitudes about the dominance of general practitioners. They did this, for example, by initiating and leading case conferences with the multi-disciplinary teams. It became evident from this study that to use group clinical supervision with an executive co-coaching approach for the implementation and to sustain quality service demand that ,good nursing' is accepted as being synonymous with ,good management'. This is the future of ,new nursing'. [source]