Views of GPs and practice nurses on support needed to respond to pandemic influenza: a qualitative study

2011 ◽  
Vol 35 (1) ◽  
pp. 111 ◽  
Author(s):  
Christopher Pearce ◽  
Marianne Shearer ◽  
Christine Phillips ◽  
Sally Hall ◽  
Marjan Kljakovic ◽  
...  

Introduction. Five years ago Australia, and the world, placed itself on heightened alert for pandemic influenza, based on concerns about the potential spread of the avian influenza virus. This prompted a flurry of preparation activity involving general practice, with information from various sources; government, colleges and divisions of general practice. Method. To assess how general practitioners and practice nurses perceive this information, practice nurses and general practitioners were interviewed as part of a larger project exploring the role of the Australian general practice sector in an influenza pandemic. Results were validated by two focus groups and scenario sessions. Findings. Participants perceived that non-government organisations rarely gave useful information during a pandemic outbreak. Local divisions were perceived as having a practical and useful role, providing hands-on support to practices during a pandemic outbreak. Our participants did not perceive any coordination in the delivery of information sent by all the organisations involved in a pandemic response and therefore rejected our second hypothesis. Conclusions. More planning needs to go into the coordinated response of the general practice sector to a pandemic, and such a response should include the support of local Divisions, both as a conduit for information and to assist practices to develop response plans. What is known about the topic? Response to a pandemic will require a coordinated response between primary and secondary care, public and private sectors. What does this paper add? Outlines the support needs for general practice to respond effectively, in particular highlighting the important role Divisions can play. What are the implications for practitioners? Planning for a pandemic should include Divisions of general practice as an integral element of the response, both as a conduit for information and to assist practices to develop response plans.

2011 ◽  
Vol 16 (3) ◽  
Author(s):  
M Keramarou ◽  
S Cottrell ◽  
M R Evans ◽  
C Moore ◽  
R E Stiff ◽  
...  

In the United Kingdom, the influenza A(H1N1)2009 pandemic had a distinct two-wave pattern of general practice consultations for influenza-like illness (ILI). We describe the epidemiology of the influenza pandemic in Wales between April and December 2009 using integrated data from a number of independent sources: GP surveillance, community virology surveillance, hospital admissions and deaths, and media enquiries monitoring. The first wave peaked in late July at 100 consultations per 100,000 general practice population and attracted intensive media coverage. The positivity rate for the A(H1N1)2009 influenza did not exceed 25% and only 44 hospitalisations and one death were recorded. By contrast, the second wave peaked in late October and although characterised by lower ILI consultation rates (65 consultations per 100,000 general practice population) and low profile media activity, was associated with much higher positivity rates for pandemic influenza A(H1N1)2009 (60%) and substantially more hospital admissions (n=379) and deaths (n=26). The large number of ILI-related consultations during the first wave in Wales probably reflected the intensive media activity rather than influenza virus circulating in the community. Data from community surveillance schemes may therefore have considerably overestimated the true incidence of influenza. This has implications for the future interpretation of ILI surveillance data and their use in policy making, and underlines the importance of using integrated epidemiological, virological and hospital surveillance data to monitor influenza activity.


2021 ◽  
Author(s):  
◽  
Elsa Lally

<p>Practice nurses engaging with patients is a daily activity in general practice. However, there is little research to assess these relationships from a primary health care, general practice standpoint. The purpose of this new and original research was to explore from patients' perspectives what occurs in general practice, and to establish how the engagements patients have with practice nurses influences patients' health and well-being. The conceptualisation of symbiotic relationships between practice nurses, general practitioners receptionists and patients described in this study, shows how these relationships work in practice, and how they shaped patients' perspectives of their engagements in the general practice setting. Although each person’s role was independent and capable of existing without the other, a mutually beneficial close association was developed.  From the experiences of 15 patients from seven rural and urban general practices in New Zealand, using Narrative Inquiry methodology informed by life course theory and White’s (2010) dimensions of well-being, the co-constructed stories gathered from the participants were analysed applying a modification of McCormack’s (2001) multiple lens model. Findings from the individual participant stories revealed three major themes – general practice activity, health focused practice, and professional comforting. Each of these themes described aspects of the participants' relationships and engagements with practice nurses that contributed to their health and well-being. The co-constructed stories described participants' relationships and engagements, not only with practice nurses but also with general practitioners and receptionists. The presence of the (often unseen) overarching doctor and of practice nurses filling the gap in patients' care was evident. Patients described practice nurses as both support for the doctor and as autonomous practitioners. Ease of access to practice nurses significantly contributed to patients obtaining competent health promoting care. Particularly cogent were the findings that practice nurses directly contributed to patients' health and well-being through nurses' skilled compassion and skilled companionship. Nurses actively listened to patients' concerns, suggesting strategies to move patients forward, while at the same time, providing space for them to move at their own pace. Receptionists were viewed as the 'fronts people' of the practice who triaged patients' health concerns, making decisions relating to whom the patient consulted, the doctor or the nurse.  By building on existing theories in Narrative Inquiry methodology, data collection and analysis, this research makes an important contribution to nursing knowledge. It provides new perspectives about nurse-patient relationships, as well as other relationships within general practice. The research also demonstrates that while there has been a significant increase in collaboration between nurses and general practitioners over time, this collaboration is distinct from the symbiotic relationships described. The findings have implications for health professionals' everyday practice, and for Primary Health Organisations and District Health Boards when undertaking health professional education and funding reviews. Future research into patients' relationships with practice nurses, doctors and receptionists, and how these relationships contribute to patients' health and well-being is necessary.</p>


2013 ◽  
Vol 19 (2) ◽  
pp. 150 ◽  
Author(s):  
Diann S. Eley ◽  
Elizabeth Patterson ◽  
Jacqui Young ◽  
Paul P. Fahey ◽  
Chris B. Del Mar ◽  
...  

The Australian government’s commitment to health service reform has placed general practice at the centre of its agenda to manage chronic disease. Concerns about the capacity of GPs to meet the growing chronic disease burden has stimulated the implementation and testing of new models of care that better utilise practice nurses (PN). This paper reports on a mixed-methods study nested within a larger study that trialled the feasibility and acceptability of a new model of nurse-led chronic disease management in three general practices. Patients over 18 years of age with type 2 diabetes, hypertension or stable ischaemic heart disease were randomised into PN-led or usual GP-led care. Primary outcomes were self-reported quality of life and perceptions of the model’s feasibility and acceptability from the perspective of patients and GPs. Over the 12-month study quality of life decreased but the trend between groups was not statistically different. Qualitative data indicate that the PN-led model was acceptable and feasible to GPs and patients. It is possible to extend the scope of PN care to lead the routine clinical management of patients’ stable chronic diseases. All GPs identified significant advantages to the model and elected to continue with the PN-led care after our study concluded.


2016 ◽  
Vol 22 (6) ◽  
pp. 559
Author(s):  
Christina Aggar ◽  
Jacqueline G. Bloomfield ◽  
Cynthia Stanton ◽  
Catherine Baynie ◽  
Christopher J. Gordon

Practice managers are often involved in the employment of practice nurses and are likely to have a significant role in future transition programs in general practice. Therefore, the aim of the study was to explore practice managers’ expectations of new graduate registered nurses working in general practice. A nation-wide web-based electronic survey distributed by the Australian Association of Practice Management was used to collect demographic data and practice managers’ expectations of new graduate nurses directly transitioning into general practice in their first year of practice. The sample was broadly representative of the Australian state and territory population numbers. Respondents were predominantly female with postgraduate qualifications. The findings of this study highlight that practice managers who currently work with practice nurses would be supportive of graduate registered nurses in general practice in their first year with preceptor support. The results of this study have important implications for nursing workforce development and it is recommended that such initiatives are widely introduced with appropriate financial support.


2011 ◽  
Vol 17 (2) ◽  
pp. 202 ◽  
Author(s):  
Lana J. Mitchell ◽  
Lesley MacDonald-Wicks ◽  
Sandra Capra

General practice is an ideal setting to be providing nutrition advice; however, it is important that the role of general practitioners (GPs) and practice nurses in providing nutrition advice is acknowledged and defined. This article aims to discuss the role of GPs and practice nurses in the delivery of nutrition advice. Ten general practitioners and 12 practice nurses from a NSW urban Division of General Practice participated in questionnaires and a Lifescripts© implementation study, as well as their consenting patients receiving Lifescripts© (n = 13). An online survey was conducted with 90 Australian private practice dietitians. Semi-structured telephone interviews were conducted with 52 Australian private practice dietitians. The provision of basic nutrition advice is acknowledged to be part of the role of GPs and practice nurses, as they are the first point of contact for patients, allowing them to raise nutrition awareness. However, it is important that this advice is evidence based and able to be delivered in a time-efficient manner. Increased nutrition education and the availability of appropriate resources and nutrition-related best practice guidelines will assist in this process.


2011 ◽  
Vol 32 (1) ◽  
pp. 29
Author(s):  
Alex Dierig ◽  
Gulam Khandaker ◽  
Robert Booy

Influenza is generally an acute, self-limiting, febrile illness without further complications in the majority of people. However, it can be associated with severe morbidity and mortality and the burden of the disease on society is likely to be underestimated. In 2009 an outbreak of H1N1 influenza A virus infection was detected in Mexico with further cases soon observed worldwide. Subsequently, in June 2009, the first influenza pandemic of the 21st century due to influenza A (H1N1) was declared by the World Health Organization (WHO). There were many uncertainties regarding the virulence, clinical symptoms and epidemiological features of this newly evolved influenza A strain. Over time, many similarities, but also some differences between the pandemic H1N1 influenza A and seasonal influenza were identified. We recently performed a systematic review of the literature, looking at articles published between 1 April 2009 and 31 January 2010, to identify the epidemiological and clinical features of the pandemic H1N1 influenza. In this current article we compare our findings with others from the international literature. There was more severe impact on young and healthy adults, children, pregnant women and the obese. Clinical features in general were similar between seasonal and pandemic influenza; however, there were more gastrointestinal symptoms associated with pandemic H1N1 influenza. Shortness of breath was characteristic of more severe pH1N1 2009 infection with a higher possibility of being admitted to an intensive care unit (ICU).


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