Helvie C O
Old Dominion University, Norfolk, Virginia, USA.
Nurs Case Manag. 1999 Jul-Aug;4(4):201-10.
Nursing opportunities have expanded beyond the traditional bedside role. Nurses serve in a variety of roles such as administrators, teachers, or primary care givers in a variety of settings. The role of primary care giver is a more recent role; it involves relatively independent nursing practice with clients who have acute or chronic illnesses. Client groups may include the elderly in high rise buildings, mothers and children at schools, or homeless and low-income populations at homeless shelters. This care is often provided in a nursing center. Nursing centers are nurse-managed centers in which nurses are accountable and responsible for care of clients; they are the primary provider of care and the one most seen by clients. Case managers may be in a position to refer patients to nursing centers or to work directly with nurse practitioners in nursing centers. However, questions about the primary care provided in nursing centers must be addressed for healthcare providers, insurance companies, and patients to be confident in the efficacy of this delivery system. Is the primary care comprehensive? Is it of high quality? Is it cost effective? Is it satisfactory to clients? These and other questions about the primary care provided in nursing centers must be answered to effect political and other changes needed to fulfill the role of nursing centers envisioned by early leaders of the movement. This article addresses questions related to the efficacy of primary care provided in nursing centers by family nurse practitioners. After defining efficacy, the discussion focuses on the components identified and studied in one nursing center and includes information on opportunities for case managers to utilize nursing centers for referral and appropriate follow-up of their patients.
护理机会已超越传统的床边护理角色。护士在各种环境中担任多种角色，如管理人员、教师或初级护理人员。初级护理人员这一角色是较新出现的；它涉及对患有急性或慢性疾病的患者进行相对独立的护理实践。患者群体可能包括高层建筑中的老年人、学校中的母亲和儿童，或无家可归者收容所中的无家可归者和低收入人群。这种护理通常在护理中心提供。护理中心是由护士管理的中心，护士对患者的护理负责；它们是护理的主要提供者，也是患者最常接触的对象。病例管理人员可能会将患者转介到护理中心，或直接与护理中心的执业护士合作。然而，对于医疗服务提供者、保险公司和患者而言，要对这一提供系统的效果有信心，就必须解决有关护理中心提供的初级护理的问题。初级护理是否全面？质量是否高？是否具有成本效益？患者是否满意？必须回答这些以及其他有关护理中心提供的初级护理的问题，以便实现该运动早期领导者所设想的护理中心的作用所需的政治和其他变革。本文探讨了家庭执业护士在护理中心提供的初级护理效果相关的问题。在定义了效果之后，讨论集中在一个护理中心确定和研究的组成部分，并包括病例管理人员利用护理中心对其患者进行转介和适当随访的机会的信息。
