Implementation of Nursing Demand Management as a Factor for Improvement in a Primary Care Emergency Center.

NCT06298240 | Active Not Recruiting

• 1 other identifier: 4R22/074
• Study Type: interventional
• Target: 312
• Locations: 1 country
• Sites: 1

Brief Summary

Background: Nurse Demand Management was born in 2009 out of the need to address the growth of spontaneous acute demand in primary care. But it is not until 2013 that guidelines for the exercise of nursing actions in demand management were established in Catalonia, Spain. Nurses trained specifically to solve acute and low complexity health problems generate a quality of care comparable to that provided by family medicine doctors. On the other hand, it is worth highlighting the need to rationalise medical resources in primary care centres, primary care emergency centres or points of continuous care (different emergency facilities in the territory in terms of size and services) in order to give priority to doctors being able to dedicate more time to medium or high complexity pathology. Although nurse demand management has been implemented in primary care teams for years, it is being carried out in different intensities according to the needs or priorities of each health territory. The promotion of the autonomous role of nursing through the implementation of nurse demand management in the urgent spontaneous demand of low complexity can be transcendent, both in the optimisation of health resources in primary care and in the management of the demand for care. Hypothesis: The implementation of nurse demand management is a factor of improvement in the efficiency and quality of care in the Primary Care Emergency Centre of the city of Mataró (Barcelona, Spain). Objectives: The main objective of this study was to determine whether the implementation of nurse demand management is a factor in improving efficiency and quality of care in the CUAP of Mataró. Methodology: Non-randomised controlled experimental intervention study. Application of a consensual guide with 5 reasons for health consultations where demand management nursing can be applied.

Conditions

Nurse's Role; Disease, Acute

Keywords

primary care nursing; primary health care; nurses; acute disease/nursing; advanced rractice nursing; minor health problems; practice guideline

Outcome Measures

Primary Outcomes (3)

• Waiting time and resolution of the visit

  Different time points are collected to analyze the duration of care at the center: time of entry into the triage consultation, time of entry into the medical or nursing consultation, and time of departure from the consultation. Time that the administrator receives the user and includes him/her in the work agenda of the emergency center. Time the user makes the triage. Time that the user is attended in the agenda of the demand management center (experimental group days). Time that the user is seen in the medical office (control group days).

  During the entire process of assistance to the participant, an average of 4 hours.

• Number of reconsultations

  Number of return visits for the same health problem made by the participant in the subsequent 30 days.

  30 days

• patient experience

  Participant satisfaction survey, on the same day, of the care received by the doctor or nurse From 15 days after the hearing, a quality telephone survey will be conducted with all recruited subjects.

  On a scale from 0 to 10, where 0 is not very satisfied and 10 is very satisfied.

Other Outcomes (3)

• Prescribed drugs

  0 to 10

• Processed labour disabilities

  0 to 1

• Diagnoses change

  0 to 1

Study Arms (2)

Consensuated nurse intervencion group

EXPERIMENTAL

Application of a consensual nursing guide with 5 reasons for health consultation where an autonomous role can be applied. Users who come to the emergency center during the first fifteen days of each month are assigned to the experimental group until the necessary sample of 156 subjects is reached.

Other: nursing procedure for acute health problems of low complexity

Usual medical visit group

NO INTERVENTION

Users who come to the emergency center in the second fortnight of each month are assigned to the non-intervention (control) group where the usual medical visit is applied until the required sample of 156 subjects is reached.

Interventions

nursing procedure for acute health problems of low complexity OTHER

An agreed nursing procedure is applied for users of a primary care emergency center who spontaneously consult for 5 acute health problems of low complexity: gastroenteritis, cystitis in women, dental pain, upper respiratory tract affections and acute wounds

Consensuated nurse intervencion group

Eligibility Criteria

• Age: 16 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• All users who come to the emergency centre between Monday and Friday (excluding public holidays) from 8 a.m. to 8 p.m. and who consult for the 5 possible health problems that are part of the study protocol.

You may not qualify if:

• Any spontaneous user or user referred by another health centre who comes for a re-consultation for the same health problem in less than 30 days will be excluded.

Sponsors & Collaborators

• Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina: lead

Study Sites (1)

Mataró primary care emergency center

Mataró, Barcelona, 08301, Spain

Location

Related Publications (1)

• Estarlich-Corominas J, Soler-Abril N, Casanellas-Chuecos A, Becerra-Corzo S, Bianco AS, Toran-Monserrat P, Garcia-Sierra R. Nurse management of minor problems in primary care emergencies: a non-randomized controlled trial. BMC Nurs. 2025 Jan 24;24(1):87. doi: 10.1186/s12912-025-02729-2.

  PMID: 39856650 DERIVED

MeSH Terms

Conditions

Acute Disease

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Jordi Estarlich Corominas, IP

  Active nurse in the emergency center where the study is carried out

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 6, 2024
• First Posted: March 7, 2024
• Study Start: October 1, 2022
• Primary Completion: January 5, 2024
• Study Completion: September 1, 2024
• Last Updated: April 15, 2024

Record last verified: 2024-02

Data Sharing

• IPD Sharing: Will not share

Locations

ES (1)