A NURSE PRACTITIONER AS THE FIRST POINT OF CONTACT FOR URGENT MEDICALPROBLEMS IN A GENERAL-PRACTICE SETTING

Objectives. The aim of this study was to examine the suitability of nu rse practitioners for assessing and managing urgent clinical problems presenting in primary care. Methods. Patients registered at a suburban group practice presenting with acute medical problems were offered th e choice of seeing a GP or a nurse practitioner. The outcomes of 1000 consultations were analysed by recording the repeat consultation rate, the prescription-issue rate and the rate of referral to secondary car e, as well as investigating patient satisfaction and the number of dys functional consultations and misdiagnoses. Results. Patients reported a high level of satisfaction with nurse practitioner consultations, an d there were no recorded instances of medical sequelae due to poor dia gnosis or mismanagement. Nurse and doctors saw patients with similar a ge and sex distributions, but the results suggested that there was a s ignificant difference between the morbidity of problems seen. There wa s also a difference in the outcomes of repeat consultation rate and th e prescription issue rate, although there was little difference in the rate of referral for secondary care. Conclusion. As patients expresse d a high level of satisfaction with the nurse practitioner, this sugge sts that given the choice, patients in primary care can safely and eff ectively 'self triage' themselves between GPs and nurse practitioners.