Lukewich Julia, Edge Dana S, VanDenKerkhof Elizabeth, Williamson Tyler, Tranmer Joan
1Assistant Professor,School of Nursing,Memorial University of Newfoundland,Newfoundland,Canada.
2Associate Professor,School of Nursing, Faculty of Health Sciences,Queen's University,Kingston,Ontario,Canada.
Prim Health Care Res Dev. 2018 Nov;19(6):622-628. doi: 10.1017/S1463423618000257. Epub 2018 Apr 15.
Various organizational-level attributes are being implemented in primary healthcare to improve healthcare delivery. There is a need to describe the distribution and nature of these attributes and explore differences across practices.AimThe aim of this study was to better understand organizational attributes of primary care teams, focusing specifically on team composition, nursing roles, and strategies that support chronic disease management.
We employed a cross-sectional survey design. Team composition, nursing roles, availability of health services, and chronic disease management activities were described using the 'Measuring Organizational Attributes of Primary Health Care Survey.'FindingsA total of 76% (n=26 out of 34) of practice locations completed the survey, including family health teams (FHT; n=21) and community health centers (CHC; n=4). Nurse practitioners (NPs) and registered nurses (RNs) were the most common non-physician providers, and CHCs had a greater proportion of non-physician providers than FHTs. There was overlap in roles performed by NPs and RNs, and registered practical nurses engaged in fewer roles compared with NPs and RNs. A greater proportion of FHTs had systematic chronic disease management services for hypertension, depression and Alzheimer's disease compared with CHC practices. The 'Measuring Organizational Attributes of Primary Health Care Survey' was a useful tool to highlight variability in organizational attributes across PHC practices. Nurses are prominent within PHC practices, engaging in a wide range of roles related to chronic disease management, suggesting a need to better understand their contributions to patient care to optimize their roles.
在初级医疗保健中正在实施各种组织层面的属性，以改善医疗服务的提供。有必要描述这些属性的分布和性质，并探讨不同医疗机构之间的差异。
本研究的目的是更好地了解初级保健团队的组织属性，特别关注团队组成、护理角色以及支持慢性病管理的策略。
我们采用了横断面调查设计。使用“初级卫生保健组织属性测量调查”来描述团队组成、护理角色、卫生服务的可及性以及慢性病管理活动。
共有76%（34个中的26个）的医疗机构完成了调查，包括家庭健康团队（FHT；21个）和社区健康中心（CHC；4个）。执业护士（NP）和注册护士（RN）是最常见的非医师提供者，与家庭健康团队相比，社区健康中心的非医师提供者比例更高。执业护士和注册护士所履行的角色存在重叠，与执业护士和注册护士相比，注册实用护士履行的角色较少。与社区健康中心相比，更大比例的家庭健康团队针对高血压、抑郁症和阿尔茨海默病提供了系统的慢性病管理服务。“初级卫生保健组织属性测量调查”是一个有用的工具，可突出初级卫生保健机构组织属性的差异。护士在初级卫生保健机构中很突出，参与了与慢性病管理相关的广泛角色，这表明有必要更好地了解他们对患者护理的贡献，以优化他们的角色。
