The role and experiences of advanced nurse practitioners working in out of hours urgent care services in a primary care setting

2018 ◽  
Vol 25 (2) ◽  
pp. 18-23
Author(s):  
Jacci Yuill
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Care Setting ◽  
Primary Care Setting ◽  
Urgent Care ◽  
Out Of Hours ◽  
Care Services

scholarly journals Evaluation of an unscheduled care model delivered by advanced nurse practitioners in a primary-care setting

2019 ◽  
Vol 24 (8) ◽  
pp. 696-709
Author(s):  
Calum F Leask ◽  
Heather Tennant
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Care Setting ◽  
Primary Care Setting ◽  
Home Visits ◽  
Rejection Rate ◽  
Service Level ◽  
Average Score ◽  
Unscheduled Care ◽  
Viable Solution

Background Considering new models of delivery may help reduce increasing pressures on primary care. One potentially viable solution is utilising Advanced Practitioners to deliver unscheduled afternoon visits otherwise undertaken by a General Practitioner (GP). Aims Evaluate the feasibility of utilising an Advanced Nurse Practitioner (ANP) to deliver unscheduled home visits on behalf of GPs in a primary care setting. Methods Following a telephone request from patients, ANPs conducted unscheduled home visits on behalf of GPs over a six-month period. Service-level data collected included patient-facing time and outcome of visits. Practice staff and ANPs participated in mind-mapping sessions to explore perceptions of the service. Results There were 239 accepted referrals (total visiting time 106.55 hours). The most common outcomes for visits were ‘medication and worsening statement given’ (107 cases) and ‘self-care advice’ (47 cases). GPs were very satisfied with the service (average score 90%), reporting reductions in stress and capacity improvements. Given the low referral rejection rate, ANPs discussed the potential to increase the number of practices able to access this model, in addition to the possibility of utilising other practitioners (such as paramedics or physiotherapists) to deliver the same service. Conclusions It appears delivering unscheduled care provision using an ANP is feasible and acceptable to GPs.

Understanding the Fontan Procedure in Congenital Heart Disease Patients and the Importance of Early Hepatology Referrals: A Case Study

2018 ◽  
Vol 11 (2) ◽  
pp. 95-99
Author(s):  
Alice Chan
Keyword(s):  
Primary Care ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Nurse Practitioners ◽  
Congenital Heart ◽  
Care Setting ◽  
Primary Care Setting ◽  
Fontan Procedure ◽  
Early Screening

Background: Patients with congenital heart disease are surviving into adulthood because of new surgeries developed over the recent decades. One surgery is the Fontan procedure, which is used in patients with only one functioning ventricle. Although it has been saving lives, in the recent years multiple complications have been noted. Objective: To discuss the Fontan procedure and inform nurse practitioners in the primary care setting the importance of early screening and referral because of increasing number of liver complications in these patients. This case study highlights the dilemmas a patient with the Fontan procedure faces as a young adult. Methods: Evidence-based articles from the PubMed and Embase databases were used to support the case study. Results: Patients with the low-pressure Fontan circulation are under chronic passive congestion and have known liver complications such as liver fibrosis, cirrhosis, and protein-losing enteropathy. This can lead to a high-risk dual organ heart–liver transplant. Conclusions: Early screening and referral to a hepatologist are critical in these patients. Implications for Nursing: Since patients with congenital heart disease often present to the primary care setting, nurse practitioners in this area should understand the Fontan procedure and its associated complications so they can effectively manage these patients.

scholarly journals Mindfulness and the primary care provider

2020 ◽  
Author(s):  
◽  
Alyson Wlasoff
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Care Setting ◽  
Primary Care Setting ◽  
Primary Care Providers ◽  
Mindfulness Practice ◽  
Successful Implementation ◽  
Care Providers ◽  
Mindfulness Interventions ◽  
Reducing Stress

Primary care providers (PCPs), including nurse practitioners and primary care physicians, experience significant occupational stress, putting them at risk for chronic stress and burnout. Burnout rates are high amongst PCPs, and results in negative health effects that can impact the personal life of the PCP, as well as professional outcomes and patient care. Mindfulness has been shown to reduce anxiety and burnout symptoms, and improve healthcare provider well-being. Using an integrative literature review methodology outlined by Whittemore and Knafl, this paper explores if a mindfulness practice can reduce stress and burnout symptoms for PCPs. The results are discussed within the context of a primary care setting in Canada. Relevant literature was searched and a selected sample of ten primary research articles was selected for further analysis. Results suggest that mindfulness interventions are effective for reducing stress and burnout symptoms for PCPs, but access to these interventions may be a barrier to successful implementation of a mindfulness practice. In a primary care setting in Canada, PCPs are encouraged to attend mindfulness interventions and incorporate learned components into their practice, thereby increasing patient-centered care. Recommendations for reducing stress and burnout symptoms for PCPs are discussed, and specific strategies for successful implementation of mindfulness interventions are provided.

scholarly journals Prescriptions of antibiotics in out-of-hours primary care setting in Reykjavik capital area

2020 ◽  
Vol 38 (3) ◽  
pp. 265-271
Author(s):  
Holmfridur Asta Palsdottir ◽  
Jon Steinar Jonsson ◽  
Emil L. Sigurdsson
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Out Of Hours

Evolution of a health navigator model of care within a primary care setting: a case study

2013 ◽  
Vol 37 (4) ◽  
pp. 523 ◽  
Author(s):  
Fiona Doolan-Noble ◽  
Danielle Smith ◽  
Robin Gauld ◽  
Debra L. Waters ◽  
Anthony Cooke ◽  
...  
Keyword(s):  
Primary Care ◽  
New Zealand ◽  
Service Provision ◽  
Cancer Care ◽  
Care Setting ◽  
Patient Navigation ◽  
Primary Care Setting ◽  
Rural Setting ◽  
Care Services

Objective. Patient navigation originated as an approach for reducing disparities in cancer care and consequent health outcomes. Over time navigator models have evolved and been used to address various health issues in differing contexts. This case study outlines the evolution, purpose and effects of a lay-led health navigator model in a deprived, sparsely populated, New Zealand rural setting, where primary care services are frequently understaffed and routinely overstretched. Methods. Routinely collected service utilisation data, survey results and health navigator interview data were utilised to illustrate the client group the service works with, why primary care refer to the service, as well as lessons learned from implementation to ongoing service provision. Results. Those referred to the navigator service generally represented the most vulnerable in the community. Survey respondents, overall, were highly satisfied with the service. Navigators identified barriers and facilitators to implementation, as well as ongoing obstacles and enablers to service provision. Conclusions. This lay-led navigator service provided support to a group of unwell individuals, with few resources and multiple barriers to negotiate, and has effectively engaged with health and social care services, while overcoming various barriers and obstacles to its establishment and ongoing operation. What is known about the topic? Patient navigation models of care were first employed in the 1990s, as a strategy to increase the uptake of cancer screening among disadvantaged women. They have since expanded across the cancer care continuum, but despite favourable findings, information regarding their potential in other settings is limited. What does this paper add? This paper provides a perspective on lay-led navigation services within a rural New Zealand primary care setting. The views of primary care professionals regarding the role and value of the service are provide, as is a summary of the key lessons learnt over the implementation, establishment and ongoing service delivery phases of the programme. What are the implications for practitioners? This case study proposes that lay-led navigation services can provide practical support to primary care; assisting it to meet the needs of patients living with multiple chronic conditions and social challenges.

scholarly journals Making care more patient centered; experiences of healthcare professionals and patients with multimorbidity in the primary care setting

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sanne Jannick Kuipers ◽  
Anna Petra Nieboer ◽  
Jane Murray Cramm
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Care Setting ◽  
Healthcare Professionals ◽  
Primary Care Setting ◽  
Care Delivery ◽  
Care Needs ◽  
Patient Centered ◽  
Improvement Program ◽  
Improvement Programs

Abstract Background The present study describes how primary care can be improved for patients with multimorbidity, based on the evaluation of a patient-centered care (PCC) improvement program designed to foster the eight PCC dimensions (patient preferences, information and education, access to care, physical comfort, coordination of care, continuity and transition, emotional support, and family and friends). This study characterizes the interventions implemented in practice as part of the PCC improvement program and describes the experiences of healthcare professionals and patients with the resulting PCC delivery. Methods This study employed a mixed-methods design. Semi-structured interviews were conducted with nine general practitioners and nurse practitioners from seven primary care practices in Noord-Brabant, the Netherlands, that participated in the program (which included interventions and workshops). The qualitative interview data were examined using thematic analysis. A longitudinal survey was conducted with 138 patients with multimorbidity from these practices to assess perceived improvements in PCC and its underlying dimensions. Paired sample t tests were performed to compare survey responses obtained at a 1-year interval corresponding to program implementation. Results The PCC improvement program is described, and themes necessary for PCC improvement according to healthcare professionals were generated [e.g. Aligning information to patients’ needs and backgrounds, adapting a coaching role]. PCC experiences of patients with multimorbidity improved significantly during the year in which the PCC interventions were implemented (t = 2.66, p = 0.005). Conclusion This study revealed how primary PCC can be improved for patients with multimorbidity. It emphasizes the importance of investing in PCC improvement programs to tailor care delivery to heterogenous patients with multimorbidity with diverse care needs. This study generates new perspectives on care delivery and highlights opportunities for its improvement according to the eight dimensions of PCC for patients with multimorbidity in a primary care setting.

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