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A randomized controlled trial of nurses vs. doctors in the resolution of acute disease of low complexity in primary care
Author(s) -
Iglesias Begoña,
Ramos Francisca,
Serrano Beatriz,
Fàbregas Mireia,
Sánchez Carmen,
García María José,
Cebrian Hèlia Marta,
Aragonés Rosa,
Casajuana Josep,
Esgueva Neus
Publication year - 2013
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.12120
Subject(s) - medicine , randomized controlled trial , patient satisfaction , family medicine , intervention (counseling) , population , physical therapy , primary care , nursing , environmental health
Aims To compare the effectiveness of care delivered by nurses to the usual care delivered by general practitioners, in adult patients requesting same day appointments in primary care practices in C atalonia ( S pain). Background Same day appointments conducted by nurses are characterized by high patient satisfaction and a high resolution index. The profile of nursing and the organization of primary care services in our country differ from other countries. Design Multicentre, randomized, unblinded clinical trial with two parallel groups. Methods Patients were randomized to an intervention group (seen by nurses trained to respond to low complexity problems) or a control group (seen by the general practitioner) using an automatic probabilistic function. Setting: 38 primary care practices in C atalonia, 142 general practitioners and 155 nurses participated. Population study: ≥ 18‐year‐old patients who requested a same day consultation. Recruitment period: J anuary– M ay, 2009. Of the 1,461 randomized patients, 92·5% completed the study. Main outcome measures: resolution of symptoms and patient satisfaction 2 weeks after the visit. Results Seven hundred and fifty‐three patients were assigned to the intervention group and 708 to the control group. Nurses successfully solved 86·3% of the cases. We did not observe any differences in resolution of symptoms or patient satisfaction between the groups. Conclusions Nurses trained specifically to resolve acute health problems of low complexity give comparable quality of care to that provided by general practitioners in terms of resolution of the problem 15 days after the visit and in patient satisfaction with the visit.