Nurse management of 'same day' consultation for patients with minor illnesses: results of an extended programme in primary care in Catalonia

Aims. This paper is a report of a study to assess the feasibility and efficacy of a programme of nurse management for patients requesting same day consultation for minor illnesses in primary care. Background. The efficacy of such programmes has been demonstrated in randomized studies but there is little information on these programmes in highly populated areas. Methods. Patients seeking same day consultation for one of 23 preselected minor illnesses (16 for adults, 7 for paediatric patients) from March 2009 to April 2010 were seen by trained nurses who followed predefined algorithms. If signs of alarm were detected, patients were referred to a general practitioner. Findings. A total of 629,568 consultations were performed, 575,189 in adults and 54,379 in paediatric patients. Case resolution was achieved in 61.8% of adult and 75.6% of paediatric patients. In adults, the highest resolution rates (> 90%) were obtained for burns, skin injury and emergency contraception, and the lowest for lower urinary symptoms (46.7%), sore throat (45.7%), pink eye (45.5%) and upper respiratory symptoms (41.4%). In paediatric patients, the highest resolution rates (> 90%) were obtained for stomach cramps and burns and the lowest for cough (36.2%). A return to consultation during a 7-day period for the same reason as the first consultation was low, 4% for adults and 2.4% for paediatric patients. Conclusion. An extended programme of nurse management for same day consultation of patients with minor illnesses showed an acceptably high rate of resolution and low rate of return to consultation. The application of such programmes in extensive areas is feasible and effective.