RESUMO
El aumento de las enfermedades crónicas y el envejecimiento progresivo de la población es una fuente de preocupación y de ocupación para los diferentes organismos que tienen bajo su responsabilidad el cuidado de la salud. Ello ha motivado que se generen multitud de documentos enfocados al análisis de la situación y de la atención de las enfermedades crónicas, así como recomendaciones de la OMS para que los países y los servicios de salud diseñen e implementen estrategias que permitan abordar la demanda existente, controlar y prevenir las enfermedades crónicas. Paralelamente a esta amenaza, surge la necesidad de dar respuesta a la demanda que genera la cronicidad en toda su dimensión, y desde los diferentes sistemas se va, cada vez con más fuerza, manifestando la necesidad de contar para ello con equipos multidisciplinares, en los que la enfermera cobra cada vez más valor. A la vez que la cronicidad supone una amenaza por los costes que genera, es también una oportunidad para la Enfermería estar allí donde se precisa de cuidados avanzados, realizados por profesionales con competencias clínicas avanzadas y reconocidas, para llevar a cabo la gestión de casos y el seguimiento y control de pacientes crónicos complejos. Los diferentes servicios del Sistema Nacional de Salud, están incorporando, aunque no con el desarrollo que sería deseable, enfermeras que desempeñan diversos roles (gestoras de casos, enfermeras de enlace, enfermeras de práctica avanzada, etc, etc). Es, pues, el momento de que las autoridades sanitarias determinen en la relación de puestos funcionales la figura de la Enfermera de Práctica Avanzada, y con ello se podrá avanzar en el desarrollo de unas competencias unificadas en todo el Sistema Nacional de Salud. De las experiencias realizadas, hemos aprendido que las Enfermeras de Práctica Avanzada son un recurso que facilita la sostenibilidad de los servicios, por la eficiencia demostrada en los resultados obtenidos en la atención a pacientes crónicos y crónicos complejos
The increase in chronic diseases and the progressive ageing of the population is asource of concern for the different agencies with responsibility for health care. This has led to the creation of many documents focused on the analysis of the current situation and care of chronic diseases, including the WHO recommendations intended to assist countries and health services design and implement strategies that will address the existing demand, control and prevention of chronic diseases. In addition, there is a need to respond to the demand generated by chronic diseases in every sense, and from the different systems it is becoming more difficult to get enough support from multidisciplinary teams where the nurse has a central importance. While chronic diseases are becoming a threat due to the costs they generate, it is also an opportunity for nursing to beat the forefront for advanced care requirements, performed by professionals with recognized advanced clinical skills and ability for case management while monitoring and controlling complex chronic patients. The different services of the National Health System have introduced nurses that play different roles (cases managers, liaison nurses, advanced practice nurses andso on). However, it could be argued that they are not being trained to a desirable developmentlevel. It is therefore time for health care authorities to determine the role of the advanced practice nurse in relation to functional positions, and allow them to make an advance in the development of unified skills for the whole National Health System. From our experience we have learned that the advanced practice nurse is a resource that helps in the sustainability of services, thanks to the efficiency shown in the results obtained from the care given to both chronic and complex chronic patients
Assuntos
Humanos , Doença Crônica/enfermagem , Cuidados de Enfermagem/tendências , Prática Avançada de Enfermagem/métodos , Administração de Caso/organização & administração , Administração dos Cuidados ao Paciente/métodos , Índice de Gravidade de Doença , Melhoria de Qualidade/tendênciasRESUMO
The increase in chronic diseases and the progressive ageing of the population is a source of concern for the different agencies with responsibility for health care. This has led to the creation of many documents focused on the analysis of the current situation and care of chronic diseases, including the WHO recommendations intended to assist countries and health services design and implement strategies that will address the existing demand, control and prevention of chronic diseases. In addition, there is a need to respond to the demand generated by chronic diseases in every sense, and from the different systems it is becoming more difficult to get enough support from multidisciplinary teams where the nurse has a central importance. While chronic diseases are becoming a threat due to the costs they generate, it is also an opportunity for nursing to be at the forefront for advanced care requirements, performed by professionals with recognized advanced clinical skills and ability for case management while monitoring and controlling complex chronic patients. The different services of the National Health System have introduced nurses that play different roles (cases managers, liaison nurses, advanced practice nurses and so on). However, it could be argued that they are not being trained to a desirable development level. It is therefore time for health care authorities to determine the role of the advanced practice nurse in relation to functional positions, and allow them to make an advance in the development of unified skills for the whole National Health System. From our experience we have learned that the advanced practice nurse is a resource that helps in the sustainability of services, thanks to the efficiency shown in the results obtained from the care given to both chronic and complex chronic patients.
