Telephone counselling by nurses in Norwegian primary care out-of-hours services: a cross-sectional study

BMC Family Practice

Research Article

Vivian Midtbø¹  Steinar Hunskaar²  Guttorm Raknes³ 

[1] National Centre for Emergency Primary Health Care, Uni Research Health, Box 7810, NO 5020, Bergen, Norway;National Centre for Emergency Primary Health Care, Uni Research Health, Box 7810, NO 5020, Bergen, Norway;Department of Global Public Health and Primary Care, University of Bergen, Box 7804, NO 5018, Bergen, Norway;National Centre for Emergency Primary Health Care, Uni Research Health, Box 7810, NO 5020, Bergen, Norway;Regional Medicines Information & Pharmacovigilance Centre (RELIS), University Hospital of North Norway, Box 79, NO 9038, Tromsø, Norway;Raknes Research, Myrdalskogen 243, NO 5117, Ulset, Norway;

关键词: Telephone counselling;    Primary health care;    After-hours care;    Nurse;    Reason for encounter;    International classification of primary care;    Norway;   

DOI  :  10.1186/s12875-017-0651-z

 received in 2016-11-03, accepted in 2017-08-09,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe primary care out-of-hours (OOH) services in Norway are characterized by high contact rates by telephone. The telephone contacts are handled by local emergency medical communication centres (LEMCs), mainly staffed by registered nurses. When assessment by a medical doctor is not required, the nurse often handles the contact solely by nurse telephone counselling. Little is known about this group of contacts. Thus, the aim of this study was to investigate characteristics of encounters with the OOH services that are handled solely by nurse telephone counselling.MethodsNurses recorded ICPC-2 reason for encounter (RFE) codes and patient characteristics of all patients who contacted six primary care OOH services in Norway during 2014. Descriptive statistics and frequency analyses were applied.ResultsOf all telephone contacts (n = 61,441), 23% were handled solely by nurse counselling. Fever was the RFE most frequently handled (7.3% of all nurse advice), followed by abdominal pain, cough, ear pain and general symptoms. Among the youngest patients, 32% of the total telephone contacts were resolved by nurse advice compared with 17% in the oldest age group. At night, 31% of the total telephone contacts were resolved solely by nurse advice compared with 21% during the day shift and 23% in the evening. The share of nurse advice was higher on weekdays compared to weekends (mean share 25% versus 20% respectively).ConclusionThis study shows that nurses make a significant contribution to patient management in the Norwegian OOH services. The findings indicate which conditions nurses should be able to handle by telephone, which has implications for training and routines in the LEMCs. There is the potential for more nurse involvement in several of the RFEs with a currently low share of nurse counselling.

【 授权许可】

CC BY   
© The Author(s). 2017