RESUMO
AIM: To evaluate the impact of an interdisciplinary intervention designed to improve the capacity of nurses to manage walk-in patient demand for primary health care. BACKGROUND: Implementation of a programme to expand nursing practice is a complex process that requires the application of context-appropriate measures and adaptation when results do not meet expectations. METHODS: A longitudinal, uncontrolled intervention study with a 3-year follow-up, from 2009 to 2012, was carried out in Catalonia (northeast Spain). The intervention included three training periods focused on clinical and instrumentation topics. The capacity of nurses to manage walk-in patient demand was assessed by determining the number of cases resolved and of return visits for the same complaint within 72 hours. RESULTS: In total, 2751 patient care demands were evaluated. Resolved cases increased (χ(2) = 54.624, df = 1, P < 0.001) and the number of return visits decreased (χ(2) = 54.585, df = 1, P < 0.001) significantly from baseline to the end of the study period. CONCLUSIONS: Nurses' capacity to manage walk-in patient demand improved after an interdisciplinary intervention using a mutually agreed upon, locally adapted approach. IMPLICATIONS FOR NURSING MANAGEMENT: To improve outcomes, nurses in management positions should systematically consider the need for skills training, specific academic courses, leadership development and, as appropriate, legislative initiatives.
