Nursing Practice in Primary Care and Patients’ Experience of Care

Abstract

Purpose: Nurses are identified as a key provider in the management of patients in primary care. The objective of this study was to evaluate patients’ experience of care in primary care as it pertained to the nursing role. The aim was to test the hypothesis that, in primary health care organizations (PHCOs) where patients are systematically followed by a nurse, and where nursing competencies are therefore optimally used, patients’ experience of care is better. Method: Based on a cross-sectional analysis combining organizational and experience of care surveys, we built 2 groups of PHCOs. The first group of PHCOs reported having a nurse who systematically followed patients. The second group had a nurse who performed a variety of activities but did not systematically follow patients. Five indicators of care were constructed based on patient questionnaires. Bivariate and multivariate linear mixed models with random intercepts and with patients nested within were used to analyze the experience of care indicators in both groups. Results: Bivariate analyses revealed a better patient experience of care in PHCOs where a nurse systematically followed patients than in those where a nurse performed other activities. In multivariate analyses that included adjustment variables related to PHCOs and patients, the accessibility indicator was found to be higher. Conclusion: Results indicated that systematic follow-up of patients by nurses improved patients’ experience of care in terms of accessibility. Using nurses’ scope of practice to its full potential is a promising avenue for enhancing both patients’ experience of care and health services efficiency.

Changing nursing practice within primary health care innovations: the case of advanced access model

“…A supportive organizational environment in terms of resources, strategies (e.g., training that meets the needs of nurses) and tools (collective prescriptions for faster processing of prescriptions) to enhance collaborative practice play an important role in creating enabling conditions for reorganizing nursing practice (RNs and NPs) and establishing team based primary care and AA. This supports findings from other studies [ 16 , 26 , 28 , 30 ]. Training and support were seen as essential, as was networking with early adopter clinics, given the complexity of operationalizing AA to enable access management.…”

“…Their key activities in primary care include managing chronic diseases, supporting physicians in clinical activities, providing patient education, counselling and self-care management support, applying collective orders to perform clinical activities (e.g., administering or adjusting medication, etc. ), assuring systematic and joint follow-up of patients, and participating in decision making [ 26 ].…”

Dynamic evaluation of the comparative effectiveness of an integrated program for heart failure care

“…The prevalence of HF continues to grow due to population ageing and the same trend can be expected in the resources required for HF care 38 . The systematic monitoring of patients with HF by PC team nurses 40 helps reduce hospitalizations, by keeping patients at home. Therefore, it is an efficient option to improve the sustainability of HF care in patients with high comorbidity, half of our patients having a Charlson index higher than five.…”

L’étendue effective de la pratique des infirmières dans les services de proximité en région éloignée

“…Des études ont souligné qu'une meilleure utilisation des ressources infirmières par la pleine étendue de leur pratique contribuerait aussi à un accroissement de leur satisfaction professionnelle et de leur satisfaction au travail (Déry, 2013;Halcomb et Ashley, 2016). Celle-ci contribuerait à un accroissement de l'efficience et de la performance des organisations en permettant une économie des coûts de fonctionnement (Parkinson et Parker, 2013;Smolowitz et al, 2015), une plus grande accessibilité aux soins et services de santé (Jacobson, 2012 ;Borgès Da Silva, 2018) ainsi qu'une qualité et sécurité des soins accrue (Houweling et al, 2011;Jacobson, 2012 ;Parkinson et Parker, 2013 ;Aroke, 2014;Halcomb, Peters et Davies, 2013). Des études ont également démontré qu'une meilleure utilisation des ressources infirmières contribuerait à un accroissement de la satisfaction de la clientèle (Parkinson et Parker, 2013;Houweling et al, 2011;Jacobson, 2012;Borgès Da Silva et al, 2018) ainsi qu'à une plus grande satisfaction professionnelle (Déry, 2013;Halcomb et Ashley, 2016).…”