Effects on quality of care for patients with NIDDM or COPD when the specialised nurse has a central role: a literature review

Chronic care has to be organised in a way that care from any one caregiver is linked up to that provided by others so that disturbing gaps, contradict ions and overlaps are avoided. In the search for the most effective and eff icient combination of health professionals to deliver care to chronic patie nts, the role of the specialised nurse has become important. This article r eviews a Medline search for publications about the effects of models of car e for patients with NIDDM or COPD in which the specialised nurse has a cent ral role. Main features of the models are identified and related to expecte d and statistically significant effects. In this young domain of effect eva luation ten publications met our criteria. Depending on the division of tas ks between care providers, improvements are seen in self-care, quality of l ife and patient satisfaction, as well as increased medical consumption. Mor e methodologically suitable evaluations with the use of only valid measures are needed. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.