This article address the problem found to relate with the management of chronic disease in primary care settings. This relates to increase in demand for better management and improved health care. The purpose of this research is to determine the effectiveness of those specialized nurses in managing the patient with chronic diseases in the area of primary care settings. This simply wants to find out if their services are at optimal settings or not.
This research was done by performing some literature searches on different databases. The result of research was based on randomized controlled trials and systematic reviews. The two models are (model 1 involving nurse alone versus physician alone) and (model 2 involving nurse and physician versus physician alone). In terms of results, six studies included in model 1 showed no significant differences in terms of the health outcome, quality of life, patient satisfaction and health resources used.
Effectiveness was found in model 2 which relates to reduction in hospitalization and improved management of blood pressure and lipid control. Other noticeable changes that are prominent in the model 2 are those relating to the trend towards improved process that were measured such as medications prescribing and clinical assessments although that which relates to the aspect of quality of life evaluation was found to be insignificant or inconsistent. Patient satisfaction with the nurse-physician combo was found to be improved. Although there were certain changes notices in terms of workload, nurse had longer visit but physician had no change.
The study had it limitation in terms of the heterogeneity found across the patient populations and in the scope of practice of specialized nurses. This study had an important nursing implication in the sense that it shows that the specialized nurses if found alone in the primary settings, such can manage patient with chronic diseases effectively. This is simply because of the fact that model 1 of the study reveal an efficient management of chronic patient when specialized nurse is found alone in the service.
The result was also comparable to that of the physician alone. Another implication of the study is that a specialized nurse working with the nurse-physician team can help reduce the hospitalization for patients especially those with coronary diseases. This study clearly states that the specific role of nurse substituting or supplementing physician care is yet unclear especially when it turns to efficiency aspect. This somewhat counteract the part of the article in terms of the result of the model 1.
Specialized nurses have a lot of roles to play in helping primary care patients with chronic ailments. This can be linked with their additional skills, training and scope of practice. More of such nurses are needed in primary care settings to help complement those cases where there are shortages in the numbers of available primary care physicians. According to the conclusion of the research paper, this does not mean that those specialized nurses are there to substitute the role of the primary care physicians. The essences of having this are to achieve the treatment goals which will also help the patient achieve high level of satisfaction.
Bibliography
Health Quality Ontario. Specialized nursing practice for chronic disease management in the primary care setting: an evidence-based analysis. PubMed. 2013. Web. 11, November, 2013 <http://www.ncbi.nlm.nih.gov/pubmed/24194798>
