Jones K, Gilbert P, Little J, Wilkinson K
Oxford Terrace Medical Group, Gateshead.
Br J Gen Pract. 1998 Jun;48(431):1303-6.
Demand for consultations in primary care has risen recently, necessitating a change in working practices. As part of this process, the possible contribution of practice nurses in the telephone assessment of home visit requests merits attention.
To survey the views of our patients encountering our nurse triage system for home visit requests, set up in June 1995, and to plot its effect on the routine visiting workload of our doctors and thus their availability at the surgery.
The outcome of each request was categorized as: doctor to visit (DV), surgery consultation with doctor (SC), nurse advice given and accepted (NA), or call passed to doctor for advice (DA). Frequency data from September 1995 to December 1996 were recovered. Questionnaires for self-completion were sent to all those requesting a routine weekday house call during two four-week periods in 1995 and 1996.
Analysable activity data revealed 1764 house call requests, with 41% DV, 18% SC, 24% NA, and 8% DA. In the first survey, 121 questionnaires were sent out and 84 returned (69% response rate) and, in the second, the corresponding figures were 113, 85, and 75%. About 80% of responders reported that they were satisfied with the help received from the nurse.
Nurse triage of house call requests has led to more efficient care for our patients, as we have increased the availability of surgery consultations by reducing the number of house calls made by our general practitioners.
近期基层医疗保健中的会诊需求有所增加,因此工作方式需要改变。在此过程中,执业护士在电话评估家访请求方面的潜在作用值得关注。
调查我们的患者对1995年6月设立的家访请求护士分诊系统的看法,并评估其对医生常规出诊工作量的影响,进而评估对他们在诊所出诊时间的影响。
将每个请求的结果分类为:医生出诊(DV)、到诊所与医生会诊(SC)、接受护士建议(NA)或转接给医生咨询(DA)。收集了1995年9月至1996年12月的频率数据。在1995年和1996年的两个为期四周的时间段内,向所有在工作日请求常规上门问诊的患者发送了自填式问卷。
可分析的活动数据显示有1764次上门问诊请求,其中41%为医生出诊,18%为到诊所会诊,24%为接受护士建议,8%为转接给医生咨询。在第一次调查中,共发放问卷121份,回收84份(回复率69%);在第二次调查中,相应数字分别为113份、85份和75%。约80%的受访者表示对从护士那里得到的帮助感到满意。
对上门问诊请求进行护士分诊为我们的患者带来了更高效的护理,因为我们通过减少全科医生的出诊次数,增加了诊所会诊的可预约时间。