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Abstract
This paper focuses on parents’ use and experiences of general practitioner (GP) out-of-hours (OOHs) services in Ireland. The progress in the establishment of GP OOHs services is considered by the Health Service Executive (HSE) to be a highly significant quality initiative for patient care, and the health service as a whole. Outside of normal GP surgery hours, parents of children can call a dedicated telephone number, to have their urgent health concerns assessed and to be advised about the appropriate level of care. Experienced nurses, who are often based in a GP OOHs centre, assess the call over the telephone and provide advice to the callers. The spur for conducting this study arose from my personal and professional experience which, I believe, underscores the need for exploring and understanding parents’ views of GP OOHs services, in order to bring about change in nurses’ practice of delivering advice over the telephone. The overall aim of the study is to explore and understand the views of parents of children, aged two years and under, following telephone advice received from nurses in the context of a GP out-of-hours service. A qualitative, exploratory, and descriptive design was used to examine the views and experiences of parents of children aged two years and under, who used a GP out-of-hours service provider in Ireland. Nine parents who had received phone advice from a nurse were purposively sampled to take part in the study. Data were collected using semi-structured interviews by telephone. Data were transcribed and analysed thematically. Themes included parents’ perceptions of illness in children with the need to be heard, parents’ views about accessibility to GP OOHs, parents’ expectations that the service would offer guidance and reassurance, parents’ satisfaction with the nurse’s advice, and parents’ experiences of hospital emergency departments (EDs). Suggestions for improving the GP OOHs service were made across these themes. The suggestions include: higher staffing levels, wanting a quicker call back, preference for face-to-face assessment over telephone advice and a preference for a children’s area in the GP OOHs. The study revealed that parents are satisfied with the GP OOHs service and the parental decision-making model has the potential to provide an opportunity to continue the progress of the establishment of GP OOHs services in Ireland.
Highlights
The term telephone advice nursing will be used throughout this paper to refer to the use of telecommunication technology, by nurses working in general practitioner (GP) OOHs health services, and to deliver remote health information and advice
The nine parents who agreed to take part were all mothers of children aged two years and under, registered with the GP OOHs service and met the criteria identified in the purposive sampling strategy
This study suggests that parents of children aged two years and under are generally aware of the existence and availability of the GP OOHs service, and that this service is being actively promoted to these groups of users in accordance with GP OOHs services’ national health policy in Ireland
Summary
The literature shows that parents tend to employ reasonable strategies and have a strong sense of responsibility for managing their children’s illness at home before seeking help from a health care provider [13] [14] [19] [20] [21]. These strategies usually involve taking the child’s temperature, checking for rash, and giving over the counter medication. In a qualitative interview study of 20 parents presenting to a GP OOHs service in the Netherlands with a febrile children less than 12 years, De Bont et al [22] found that parents consulted other parents as well as the internet as source of information before consulting the GP OOHs
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