Task redistribution from general practitioners to nurses in acute infection care: A prospective cohort study

J Adv Nurs. 2024 Jan 31. doi: 10.1111/jan.16075. Online ahead of print.

Abstract

Aim: To examine the impact of implementing nurse-led consultations compared to physician-led consultations on the frequency of follow-up contacts within 14 days following an acute infectious consultation.

Design: Monocentric, prospective cohort study.

Methods: The study was conducted in a multidisciplinary, capitation-based general practice in Belgium. Through analysis of patient files, the number of follow-up contacts within 14 days after an infection consultation was investigated to determine any difference between physician-led or nurse-led consultations. Secondary outcomes included pharmacological interventions and the prescribing behaviour of medical leave certificates.

Results: A total of 352 consultations were analysed, of which 174 conducted by physicians and 178 by nurses. No significant difference was found in the number of follow-up contacts. However, the probability of a pharmacological intervention by a physician was revealed to be significantly higher. The presence or absence of such pharmacological intervention did not significantly influence the number of follow-up contacts.

Conclusion: This study demonstrates that nurses can be safely and efficiently utilized in acute infection care within a general practice setting. Although these results are promising, more extensive research is needed which incorporates the experiences of patients and healthcare providers. Furthermore, it is advisable to consider the experience and education of the nurses and incorporate them into the analyses.

Impact: This study addressed the high workload on general practitioners by researching a task shift in the acute infectious, primary health care. The results demonstrate the feasibility of this task shift, which may have an impact on primary health care professionals (whose workload may be reorganized), as well as on patients for whom primary care may become more accessible.

Patient or public contribution: This study includes direct patient data from people who presented themselves with acute infectious complaints in a primary healthcare practice.

Keywords: acute care; infectious diseases; nurse role; primary care; task redistribution.