The Practice Of Nurse-led Clinics: A Case Study

Background Rapid development of advanced education of nursing and medical sciences brings a group of experienced nursing experts with expertise and clinical skills,which makes the professional nursing service provided by nurse possible.The nurse-led clinics come into being,which is even beyond the original meaning of nursing.The appearance of nurse-led clinics quenches the desire of the society to the convenient and timely access to medical and health services.Opening of nurse-led clinics gives great social benefit has already been showed by some study abroad.It also reduces the burden of resident physicians and primary care physicians and it have obvious advantages on meeting the timely treatment demands of patients,improving patients' satisfaction and reducing medical costs.Nurse-led clinic in Mainland China is still in embryo.The related research still remains in the stage of reporting single case or simple evaluation.The details,characteristics and roles of the Advanced Nursing Practice are still in the absence of a comprehensive study.Objective To explore and describe the practice of nurse-led clinics in hospital setting in Shanghai,including the models,content,and methods of the practice.To describe the role competencies of the nurses in nurse-led clinics.To evaluate the outcomes of nurse-led clinics.To discuss the influential factors in the environment of nurse-led clinic.Methods A case study was adopted as the research approach.13 nurse-led clinics from the specialties of diabetes and stoma/wound care were selected by snowball sampling process.The data were collected from different sources,including individual in-depth interviews,group interviews,observation and questionnaire.The data were analyzed by using within case and cross-case comparison.The quantitative data were treated using descriptive analysis and inferential analysis and the qualitative data were analyzed by statistical analysis.Results The core of the practice of nurse-led clinics is that nurses provide clinical health care services by using her expertise and skills;The content of the practice of nurse-led clinics is to provide direct care,health education,behavior guidance, advisory services and reasonable referral;The method of the practice of nurse-led clinics is based on a holistic perspective,the establishment of trust between patients, the clinical use of professional discretion and the application of effective and variable means and research results;The characteristics of the practice of nurse-led clinics is the development of service,the specialty of service,the autonomy of service and the strong sense of responsibility of nurses;The ability of practitioners includes knowledge,clinical experience,core competencies for decision-making, communication and education skills for diabetes nurses and stoma nurses in the superb practice skills.The practice of nurse-led clinics gives a great impact on the individual patients,health care system,the nursing profession and the nurses themselves.The practice of nurse-led clinics is affected by socio-cultural,economic development,health security system,policy environment and the hospital internal support.The present practice of nurse-led clinics is lack of uniform norms of practice.The practitioners are lack of unified qualification requirements,licensing and registration.Conclusion Nurse-led clinic is one of the modes of advanced nursing practice and it's a valuable and effective mode of health service.The practice of nurse-led clinics needs norms and reunification,and nurses in nurse-led clinics need to have the qualification and certification of statutory registration system.