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Role of Nurse Practitioner in General Practice within Chronic Disease Management

Role of Nurse Practitioner in General Practice within Chronic Disease Management. Colleen McGoldrick NP, PSP, IPN, Asthma Educator. Introduction. Why do we need NP How we integrate What will the benefit be Conceptual Framework. Why?. Improve identification Proactive management

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Role of Nurse Practitioner in General Practice within Chronic Disease Management

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  1. Role of Nurse Practitioner in General Practice within Chronic Disease Management Colleen McGoldrick NP, PSP, IPN, Asthma Educator

  2. Introduction • Why do we need NP • How we integrate • What will the benefit be • Conceptual Framework

  3. Why? • Improve identification • Proactive management • Health promotion • Increase health system capacity • Greater collaboration

  4. Challenges • Fee for service • Lack of MD teams within GP setting • Lack of engagement – due to barriers-self management • Under developed information and support systems- not ready for the role • Under developed infrastructure- no workforce diversification

  5. COLLABORATIVE NOT COMPETITIVE

  6. Integration • Organise caseload • Organise maintenance/follow-up pathology • Protocol based CDM clinics • Assessment of client goals • Repeat maintenance scripts • Ref. to allied health professionals-GPMP/TCA/PIP • Unstable clients ref. to GP

  7. NOT 'MINI' DOCTORS ADVANCED PRACTITIONERS TEAM/AUTONOMOUS

  8. Clinical Protocols Asthma management COPD management Diabetes management Cardiovascular risk management

  9. Guidelines Asthma Management Handbook 2006 National Heart Foundation 2008 COPDX 2006 Lipid Management 2005 RACGP

  10. Outcomes • Home BP control improved 15% in our cardiovascular clients (NHF Criteria) • HbA1c <7 improved from 43% to 70% over a 3 yr period • 71% of our diabetics have a BP <130/85 mmHg • Asthma attendance increased from 30%-57% • Diabetes attendance is up to 90% • Cardiovascular attendance 79% • Significant saving of GP time (nurse does ¾ of work)

  11. QUESTIONS?

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