Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
Research, Education, Development & Innovation, Primary Health Care, Vänersborg, Region Västra Götaland, Sweden.
BMC Health Serv Res. 2024 Nov 1;24(1):1338. doi: 10.1186/s12913-024-11643-3.
To effectively utilize available healthcare resources, integrated care models are recommended. According to such model's, registered nurses have the potential to increase patient access to health care services and alleviate organizational workload. Studies on acute home consultation assessments by registered nurses are sparse. The aim was to describe the reasons and actions for unscheduled same-day face-to-face registered nurse consultation at home offered to patients calling the national telephone helpline for healthcare in Sweden (SHD 1177), according to the integrated Collaborative Health Care model.
A descriptive cross-sectional study was designed. Data from registered nurses (n = 259) working within the Collaborative Health Care model, who performed unscheduled consultations at home (n = 615) using a data collection tool from 2017 to 2018 were collected.
Among the 615 unscheduled home consultations performed by registered nurses, > 50% of the patients were managed at home as their health problems were not deemed as requiring a same-day referral to a clinic when assessed by the registered nurses. The most frequent health problems and reasons for contact were urinary tract problems, followed by medical and surgical conditions. Social factors, including living alone, impacted referral. Those living with a partner received care at home to a greater extent than those who lived alone.
An integrated model for healthcare involving registered nurses direct assessment, action and accountability seems to be an efficient option for providing integrated care at home and reducing acute clinic visits.
为了有效利用现有的医疗保健资源，建议采用综合护理模式。根据该模式，注册护士有可能增加患者获得医疗保健服务的机会，并减轻组织的工作量。有关注册护士进行急性家庭咨询评估的研究很少。本研究旨在根据综合协作式医疗保健模式，描述根据患者拨打瑞典全国医疗保健热线（SHD 1177）来电，向在家中接受预约的患者提供的非计划性当日面对面注册护士咨询的原因和行动。
本研究采用描述性的横断面研究设计。收集了 2017 年至 2018 年期间，在协作式医疗保健模式下工作的注册护士（n=259）进行的 615 次非计划性家庭咨询的数据，使用数据收集工具进行收集。
在注册护士进行的 615 次非计划性家庭咨询中，超过 50%的患者被认为其健康问题无需在当天转介到诊所，因此可以在家庭中得到管理。最常见的健康问题和联系原因是尿路感染，其次是医疗和外科疾病。社会因素，包括独居，影响了转介。与伴侣同住的患者比独居的患者更有可能在家中得到护理。
涉及注册护士直接评估、行动和责任的综合医疗保健模式似乎是提供家庭综合护理和减少急性诊所就诊的有效选择。
