Mental health and addiction credential in primary care

This report is an evaluation of a demonstration coordinated by Health Workforce New Zealand. The credential aims to recognise and boost the skills and knowledge of registered nurses who work with patients with mental health and addiction needs. This evaluation report finds credentialing: improves the competence and confidence of primary care nurses working with patients with mental health and addiction issues aids understanding of the integration of physical and mental health encourages closer collaboration with secondary care and community practitioners. Barriers for wider implementation include: limited understanding of the value credentialing can add to staff competency difficulty obtaining release time for nurses to attend education and training lack of available education resources

Developing a workbook for primary care nursing students

There is a continuing need to prepare a nursing workforce that is adaptable within a range of care settings. The faculty of health at Staffordshire University seconded a lecturer practitioner for a 12-month period to conduct an audit on primary care placements. Mentors were involved in the audit in order to include their views and opinions alongside those of students

International Implementation Research Network in Primary Health Care

This paper outlines the importance of Implementation Research in primary health care and the context in which it operates. The first section gives background to the vital role of implementation research in developing and supporting health care delivery, systems and services, and the importance of closely linking implementation research to primary health care to achieve this. The second section outlines the background, purpose and role of the IIRNPC and to discuss network activities in 2014

A review of certain recent advances in primary health care

A strong primary health care system is the keystone of health care and helps patients manage their health conditions in the community, whilst also providing disease prevention services. Primary care is a continuously evolving specialty, with recent exciting innovations, aiming to improve all aspects of care and to meet people’s needs and expectations. A search for articles focusing on the specific aspects of recent advances in primary health care was done using internet search engines. Articles were selected from primary and secondary literature sources, which included original research articles, review articles and other epidemiological studies. Recent advances in information technology, services and access, dealing with multimorbidity, academic family medicine, equity and outcome measures have all made an impact on the primary health care system and on meeting the ever-increasing challenges of modern society. Primary health care is of extreme importance in having an efficient and effective health care system. As primary health care improves with recent advances, a positive effect is seen on the population’s health, cost savings and health care disparities.peer-reviewe

The breadth of primary care: a systematic literature review of its core dimensions

Background: Even though there is general agreement that primary care is the linchpin of effective health care delivery, to date no efforts have been made to systematically review the scientific evidence supporting this supposition. The aim of this study was to examine the breadth of primary care by identifying its core dimensions and to assess the evidence for their interrelations and their relevance to outcomes at (primary) health system level. Methods: A systematic review of the primary care literature was carried out, restricted to English language journals reporting original research or systematic reviews. Studies published between 2003 and July 2008 were searched in MEDLINE, Embase, Cochrane Library, CINAHL, King's Fund Database, IDEAS Database, and EconLit. Results: Eighty-five studies were identified. This review was able to provide insight in the complexity of primary care as a multidimensional system, by identifying ten core dimensions that constitute a primary care system. The structure of a primary care system consists of three dimensions: 1. governance; 2. economic conditions; and 3. workforce development. The primary care process is determined by four dimensions: 4. access; 5. continuity of care; 6. coordination of care; and 7. comprehensiveness of care. The outcome of a primary care system includes three dimensions: 8. quality of care; 9. efficiency care; and 10. equity in health. There is a considerable evidence base showing that primary care contributes through its dimensions to overall health system performance and health. Conclusions: A primary care system can be defined and approached as a multidimensional system contributing to overall health system performance and health

Increasing the Capacity of Primary Care Through Enabling Technology.

Primary care is the foundation of effective and high-quality health care. The role of primary care clinicians has expanded to encompass coordination of care across multiple providers and management of more patients with complex conditions. Enabling technology has the potential to expand the capacity for primary care clinicians to provide integrated, accessible care that channels expertise to the patient and brings specialty consultations into the primary care clinic. Furthermore, technology offers opportunities to engage patients in advancing their health through improved communication and enhanced self-management of chronic conditions. This paper describes enabling technologies in four domains (the body, the home, the community, and the primary care clinic) that can support the critical role primary care clinicians play in the health care system. It also identifies challenges to incorporating these technologies into primary care clinics, care processes, and workflow

Unique health care utilization patterns in a homeless population in Ghent

Background: Existing studies concerning the health care use of homeless people describe higher utilisation rates for hospital-based care and emergency care, and lower rates for primary care by homeless people compared to the general population. Homeless people are importantly hindered and/or steered in their health care use by barriers directly related to the organisation of care. Our goal is to describe the accessibility of primary health care services, secondary care and emergency care for homeless people living in an area with a universal primary health care system and active guidance towards this unique system. Methods: Observational, cross-sectional study design. Data from the Belgian National health survey were merged with comparable data collected by means of a face-to-face interview from homeless people in Ghent. 122 homeless people who made use of homeless centres and shelters in Ghent were interviewed using a reduced version of the Belgian National Health survey over a period of 5 months. 2-dimensional crosstabs were built in order to study the bivariate relationship between health care use (primary health care, secondary and emergency care) and being homeless. To determine the independent association, a logistic model was constructed adjusting for age and sex. Results and Discussion: Homeless people have a higher likelihood to consult a GP than the non-homeless people in Ghent, even after adjusting for age and sex. The same trend is demonstrated for secondary and emergency care. Conclusions: Homeless people in Ghent do find the way to primary health care and make use of it. It seems that the universal primary health care system in Ghent with an active guidance by social workers contributes to easier GP access

Improving postpartum care among low parity mothers in Palestine

In an effort to improve the health status of Palestinian women and their children in the West Bank and Gaza, USAID, in collaboration with the Palestinian Ministry of Health and a number of NGOs, designed and funded a 28-month pilot activity, the Pilot Health Project (PHP), that was expected to have a positive impact on the health of women and children. This report describes the results of the intervention designed to measure the effectiveness of a second home visit on low-parity women in 1) improving their knowledge and practices regarding their own health as well as the health of their newborn child; 2) increasing utilization of healthcare services postpartum, particularly the day 40 clinic visit; 3) increasing husband support; 4) increasing contraceptive use at six months postpartum; and 5) improving awareness and practice of breast and cervical cancer prevention techniques. Based on its findings, the report recommends: at least one home visit to low-parity women during the postpartum period, improving the performance of community health workers during home visits, involving husbands, encouraging mothers to seek postpartum care, catering to the needs of the mother as well as the newborn during the day 40 visit, and investigating use of mass media as a way of disseminating health information to low parity mothers

Patients' and health professionals' views on primary care for people with serious mental illness : focus group study

Objective To explore the experience of providing and receiving primary care from the perspectives of primary care health professionals and patients with serious mental illness respectively. Design Qualitative study consisting of six patient groups, six health professional groups, and six combined focus groups. Setting Six primary care trusts in the West Midlands. Participants Forty five patients with serious mental illness, 39 general practitioners (GPs), and eight practice nurses. Results Most health professionals felt that the care of people with serious mental illness was too specialised for primary care. However, most patients viewed primary care as the cornerstone of their health care and prefer-red to consult their own GP, who listened and was willing to learn, rather than be referred to a different,GP with specific mental health knowledge. Swift access was important to patients, with barriers created by the effects of the illness and the noisy or crowded waiting area. Some patients described how they exaggerated symptoms ("acted up") to negotiate an urgent appointment, a strategy that was also employed by some GPs to facilitate admission to secondary care. Most participants felt that structured reviews of care had value. However, whereas health professionals perceived serious mental illness as a lifelong condition, patients emphasised the importance of optimism in treatment and hope for recovery. Conclusions Primary care is of central importance to people with serious mental illness. The challenge for health professionals and patients is to create a system in which patients can see a health professional when they want to without needing to exaggerate their symptoms. The importance that patients attach to optimism in treatment, continuity of care, and listening skills compared with specific mental health knowledge should encourage health professionals in primary care to play a greater role in the care of patients with serious mental illness