A case study of nurse management of upper respiratory tract infections in general practice

Background. Nurses increasingly manage acute illness in United Kingdom (UK) general practice. Few data exist about patients routinely consulting with these nurses. There are concerns that providing this additional service wil l lower thresholds for consulting with an overall increase in workload. Upp er respiratory tract infection (URTI) is the commonest reason for consultin g. Inappropriate antibiotics promote resistant bacteria. Nurse management o f URTI is an ideal opportunity to promote self-care and nonantibiotic manag ement. Aims. To describe the effects of a specially trained practice nurse managin g URTI in a general practice in Cardiff, UK. Methods. Descriptive study. Results. Data were collected on 132 patients consulting with the nurse. We also collected data on 234 patients consulting general practitioners (GPs) in the same practice. Patients seen by the nurse were younger and less like ly to be given antibiotics at the time of their index illness than those wh o saw GPs (7% vs. 93%; P < 0.001). During the year following the consultati on with the nurse, patients consulted slightly less often and received anti biotics for URTI less often compared with the year preceding this consultat ion (P=0.02). Their consultation rate for all conditions did not change. Th e consultation rates for URTI of the patients managed by the GPs remained c onstant and consultations for all conditions increased (P < 0.01). Conclusions. Nurse management of URTI did not lower patients' threshold for future consulting, and patients who saw her were prescribed antibiotics le ss often.