Community Health Centre Ljubljana, Ljubljana, Slovenia.
Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
J Clin Nurs. 2017 Dec;26(23-24):5025-5032. doi: 10.1111/jocn.14002. Epub 2017 Oct 8.
To determine the possible associations between higher levels of selected quality indicators and the characteristics of providers.
In 2011, an ongoing project on a new model of family medicine practice was launched in Slovenia; the family physicians' working team (a family physician and a practice nurse) was extended by a nurse practitioner working 0.5 full-time equivalents. This was an example of a personalised team approach to managing chronic patients.
We included all family medicine practices in the six units of the Community Health Centre Ljubljana which were participating in the project in December 2015 (N = 66). Data were gathered from automatic electronic reports on quality indicators provided monthly by each practice. We also collected demographic data.
There were 66 family medicine teams in the sample, with 165 members of their teams (66 family physicians, 33 nurse practitioners and 66 practice nurses). Fifty-six (84.4%) of the family physicians were women, as were 32 (97.0%) of the nurse practitioners, and 86 (95.5%) of the practice nurses. Multivariate analysis showed that a higher level of the quality indicator "Examination of diabetic foot once per year" was independently associated with nurse practitioners having attended additional education on diabetes, duration of participation in the project, age and years worked since graduation of nurse practitioners, working in the Center unit and not working in the Bezigrad unit.
Characteristics of team members are important in fostering quality management of chronic patients. Nurse practitioners working in new model family practices need obligatory, continuous professional education in the management of chronic patients.
The quality of care of chronic patients depends on the specific characteristics of the members of the team, which should be taken into account when planning quality improvements.
确定选择的质量指标较高水平与提供者特征之间的可能关联。
2011 年，在斯洛文尼亚启动了一个关于家庭医学实践新模式的持续项目；家庭医生的工作团队（一名家庭医生和一名执业护士）由一名全职工作 0.5 当量的执业护士扩展而来。这是一种管理慢性病患者的个性化团队方法的范例。
我们纳入了 2015 年 12 月参与该项目的卢布尔雅那社区卫生中心六个单位的所有家庭医学诊所（N=66）。数据来自每个诊所每月提供的自动电子质量指标报告。我们还收集了人口统计数据。
样本中有 66 个家庭医学团队，团队成员有 165 人（66 名家庭医生、33 名执业护士和 66 名执业护士）。56 名（84.4%）家庭医生为女性，32 名（97.0%）执业护士为女性，86 名（95.5%）执业护士为女性。多变量分析表明，质量指标“每年检查一次糖尿病足”的水平较高与执业护士接受过糖尿病额外教育、参与项目的时间长短、年龄、执业护士毕业年限、在中心工作而不在贝日格拉德工作有关。
团队成员的特征对于促进慢性病患者的质量管理很重要。在新模式家庭实践中工作的执业护士需要接受强制性、持续的慢性病管理专业教育。
慢性病患者的护理质量取决于团队成员的特定特征，在规划质量改进时应考虑这些特征。
