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The impact of general practice nursing care on patient satisfaction and enablement in Australia: A mixed methods study
journal contributionposted on 03.03.2021, 02:18 by J Desborough, N Bagheri, M Banfield, Jane MillsJane Mills, C Phillips, R Korda
© 2016 Elsevier Ltd Background The numbers of nurses in general practice in Australia tripled between 2004 and 2012. However, evidence on whether nursing care in general practice improves patient outcomes is scarce. Although patient satisfaction and enablement have been examined extensively as outcomes of general practitioner care, there is little research into these outcomes from nursing care in general practice. The aim of this study was to examine the relationships between specific general practice characteristics and nurse consultation characteristics, and patient satisfaction and enablement Methods A mixed methods study examined a cross-section of patients from 21 general practices in the Australian Capital Territory. The Patient Enablement and Satisfaction Survey was distributed to 1665 patients who received nursing care between September 2013 and March 2014. Grounded theory methods were used to analyse interviews with staff and patients from these same practices. An integrated analysis of data from both components was conducted using multilevel mixed effect models. Results Data from 678 completed patient surveys (response rate = 42%) and 48 interviews with 16 nurses, 23 patients and 9 practice managers were analysed. Patients who had longer nurse consultations were more satisfied (OR = 2.50, 95% CI: 1.43–4.35) and more enabled (OR = 2.55, 95% CI: 1.45–4.50) than those who had shorter consultations. Patients who had continuity of care with the same general practice nurse were more satisfied (OR = 2.31, 95% CI: 1.33–4.00) than those who consulted with a nurse they had never met before. Patients who attended practices where nurses worked with broad scopes of practice and high levels of autonomy were more satisfied (OR = 1.76, 95% CI: 1.09–2.82) and more enabled (OR = 2.56, 95% CI: 1.40–4.68) than patients who attended practices where nurses worked with narrow scopes of practice and low levels of autonomy. Patients who received nursing care for the management of chronic conditions (OR = 2.64, 95% CI: 1.32–5.30) were more enabled than those receiving preventive health care. Conclusions This study provides the first evidence of the importance of continuity of general practice nurse care, adequate time in general practice nurse consultations, and broad scopes of nursing practice and autonomy for patient satisfaction and enablement. The findings of this study provide evidence of the true value of enhanced nursing roles in general practice. They demonstrate that when the vision for improved coordination and multidisciplinary primary health care, including expanded roles of nurses, is implemented, high quality patient outcomes can be achieved.
Australian Postgraduate Award and Australian Primary Health Care Research Institute PhD scholarship - no role in conduct of research. Australian Capital Territory (ACT) Medicare Local - assisted in promoting the study to the general practices in the ACT.
JournalInternational Journal of Nursing Studies
PublisherPERGAMON-ELSEVIER SCIENCE LTD
Rights StatementThe Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.
Science & TechnologyLife Sciences & BiomedicineNursingGeneral practice nursingGeneral practiceMixed methodsNursing scope of practicePatient satisfactionPatient enablementPrimary health careQuality of careHIGH SOCIOECONOMIC DEPRIVATIONCHRONIC DISEASE MANAGEMENTHIGH-QUALITY CAREPRACTICE CONSULTATIONSPRACTICE NURSESPATIENTS WANTLED MODELTIMEPRACTITIONERPHYSICIANHumansNursing CareAdultAgedMiddle AgedProfessional AutonomyPatient SatisfactionQuality of Health CareAustraliaFemaleMaleGeneral Practice