Zusammenfassung

OBJECTIVE: To evaluate the health results of patients who make spontaneous visits when attended by nurses in a primary health care team and by applying a nursing practice guide. DESIGN: Cross-sectional, descriptive study. SETTING: Primary health care team from the Barcelona metropolitan area, Spain. PARTICIPANTS: Patients who request a spontaneous visit for the same day in the primary health care centre (PHC). INTERVENTION: A nursing practice guide was prepared in which health problems were classified into 3 groups according to seriousness and possibility of being resolved by the nursing staff: a) group 1, problems where the protocols allowed that the nurse could finalise the process; b) group 2, problems that might require emergency action; and c) group 3, problems that required an assessment of the level of seriousness.When the patient arrived at the PHC requesting an urgent visit, and the problem fell into group 1 it was dealt with by a nurse. RESULTS: There were 202 patients with health problems included in group 1.The mean age was 36.3 years (SD, 18.6 years).The most consulted health problems were musculoskeletal (32.7%), followed by skin (22.3%), and the digestive system (22.3%). Of those, 63.9% of the problems were completely resolved and only 5.9% required visits by the out of hours doctor. DISCUSSION: The nursing practice guide meant that the nurse became the entrance door to the primary care system,with a high possibility of resolving health problems.