Abstract
We have developed our original outpatient nursing consultation system, outpatient primary nursing in our hospital in the background of new establishment of “Home health care guidance charge” in remuneration in 1992. We stated the outline of this system, and studied the activities during the past five years and the change in attitude of nurses.
The consultation is carried out in accordance with the standard of “Home health care guidance charge”. The necessity of consultation to each patient is assessed by nurse, asking a doctor the order of starting of consultation. Nursing service is controlled so as to be attended continuously by the same nurse. The number of patients to whom consultation was carried out was 615 persons, composed of patients in internal medicine, surgery and pediatrics in the orders of their numbers. The ratio of the number of patients with remuneration to the total numbers of consultation has a tendency to increase. Nineteen nurses had experience in this activity among 31 nurses who were assigned in the outpatient department. In their answers to questionnaire, comparing with the case before they participate in this activity, both answers of “I became a good listener to their talk as much as possible when patients and their families talked to me” and “I became to call to patients to get some information about their condition at home” increased “greatly”. Further, their teamwork became better and many of them answered that their self-studying promotion and satisfaction with and independence for their work increased “considerably” or “to a certain extent”.
As for the burden of their work, both answers of “increase” and “no change” were found. In free comments, they expressed such as “I am busy, but I am satisfied with my work”, “my attitude toward patients were changed”. The answers of 12 nurses who had no experience in this activity had a tendency as follows “it seems to be hard work for me”, but “I would like to try”. On the other hand, “it seems to be unable for me to do during working hours”. From these results, this activity seems to be useful for making good use of nurses and developing the ability of them, and we aim at increasing of this activity.
