An analysis of primary nurse consultation in the Community of Madrid

Abstract

Objective: to analyse the characteristics of primary care nurse consultation and to identify the factors associated with different types of activity.

Method: A cross-sectional multicentre observational study in 23 health centres (Community of Madrid), on 164 different nurses. The consultation was classified according to a consensus proposal in: "preventive activities" (PA), "self-care deficit" (SD), "coping and adaptation" (CA) and "diagnostic and therapeutic procedures" (DTP). Sociodemographic characteristics, health needs, and consultation characteristics were collected. A bivariate inferential analysis was made, and explanatory multivariate models were constructed.

Results: Of the total consultations 63.6% (95% CI: 59.9-67.3%) were classified as DTP. The consultation was directly requested by the patient in 24.3% (95% CI: 21.0- 27.7%) of the cases. There were no differences in the type of consultations by gender (P=.858), or for immigrants (P=.428). Subjects from higher social classes more frequently attended PA consultations (P=.007). There were no other differences in accessibility. The DTP consultations related to previous hospitalizations (OR: 1.191, 95% CI: 1.088-1.304), or the previous use of services (nurse consultation OR: 1.002, 95% CI: 1.000-1.003, medical consultation OR: 1.003, 95% CI: 1.000-1.006).

Conclusions: The nurse consultation is mainly aimed at carrying out procedures and previously arranged consultation prevails over patient demanded consultation. No inequities in accessibility were detected, but the type of care for different social groups was not homogeneous.

Keywords: Atención Primaria; Atención de Enfermería; Consulta de Enfermería; Nurse's role; Nursing Care; Nursing Office; Primary Care; Rol de la enfermera.