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 will lower thresholds for consulting with an overall increase in workload. Upper respiratory tract infection (URTI) is the commonest reason for consulting. Inappropriate antibiotics promote resistant bacteria. Nurse management of URTI is an ideal opportunity to promote self-care and nonantibiotic management.


OBJECTIVE
To describe the effects of a specially trained practice nurse managing 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 likely to be given antibiotics at the time of their index illness than those who saw GPs (7% vs. 93%; P < 0.001). During the year following the consultation with the nurse, patients consulted slightly less often and received antibiotics for URTI less often compared with the year preceding this consultation (P=0.02). Their consultation rate for all conditions did not change. The consultation rates for URTI of the patients managed by the GPs remained constant 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 less often.
Department of General Practice, University of Wales College of Medicine, Llanedeyrn Health Centre, Cardiff, UK. butlercc@cf.ac.uk
C C
CC
Butler
M
M
Rees
P
P
Kinnersley
S
S
Rollnick
K
K
Hood
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D004363:Drug Utilization; D005194:Family Practice / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000592:standards* / Q000706:statistics & numerical data; D015403:Nursing Evaluation Research; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000379:methods* / Q000706:statistics & numerical data; D017009:Professional Autonomy; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012141:Respiratory Tract Infections / Q000628:therapy*; D012648:Self Care; D016896:Treatment Outcome; D014852:Wales; D016526:Workload
D000900:Anti-Bacterial Agents