Health Care Provision in a Swiss Urban Walk-In-Clinic. Is Advanced Nursing Practice a Solution for a New Model in Primary Care? / Gesundheitsversorgung in einer städtischen Walk-In-Praxis in der Schweiz. Ist Advanced Nursing Practice ein neues Modell in der Grundversorgung?

Abstract

Abstract Background: Changing demographic and economic factors are producing serious challenges to Switzerland’s primary care providers: meeting the population’s growing needs will require redevelopment and reorganization. Large-scale community-based care can be expanded via alternative care models, including walk-in-clinics (WIC) stuffed by interdisciplinary teams, with Advanced Practice Nurses (APNs) playing key roles in the treatment of minor complaints. Aims: To reveal the proportion of adult patients within five exemplary diagnostic groups (respiratory tract infections, earaches, hearing impairments, urinary tract infections and wounds) who could be treated by APNs in a Swiss urban WIC in order to develop a future model of multidisciplinary collaboration between APN and physicians. Methods: A retrospective data analysis was performed on WIC’s medical records. Reflecting seasonal variations, a one-month patient data sample was collected for each of four consecutive seasons (July and October 2010, January and April 2011). Data analyses included calculations of frequencies of individual diagnoses and of diagnostic groups. Results: Of a combined sample of 5,130 patient consultations, 53% (n=2,733) fit within the scope of APN competencies. The most common diagnoses concerned minor wounds (24%; n=1,240) and upper respiratory tract infections (18%; n=926). Conclusion: Based on this study’s results, we conclude that assigning APNs to primary care clinics would contribute a meaningful new professional role to Switzerlands healthcare system. Further research will be necessary to evaluate the effects of such implementation on inter-professional collaboration and patient outcomes.