Nurse's RoleNCT06298240
Implementation of Nursing Demand Management as a Factor for Improvement in a Primary Care Emergency Center.
A study testing nursing procedure for acute health problems of low complexity in people with Nurse's Role and Disease, Acute, run by Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina at 1 site in Spain.
Trial summary
Background: Nurse Demand Management was born in 2009 out of the need to address the growth of spontaneous acute demand in primary care. But it is not until 2013 that guidelines for the exercise of nursing actions in demand management were established in Catalonia, Spain. Read more about this study
- Who is it for?
- Ages 16 to 65 yearsHealthy volunteers can take part
- Conditions the study is for
- Nurse's Role, Disease, Acute
- What is being tested?
- nursing procedure for acute health problems of low complexity
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 312 participants
- Where
- 1 siteSpain
- Study dates
- 1 Oct 2022to 1 Sep 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 16 to 65 years
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
- All users who come to the emergency centre between Monday and Friday (excluding public holidays) from 8 a.m. to 8 p.m. and who consult for the 5 possible health problems that are part of the study protocol.
Who cannot join
- Any spontaneous user or user referred by another health centre who comes for a re-consultation for the same health problem in less than 30 days will be excluded.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: The Implementation of Nurse Demand Management as a Factor in Improving the Quality of Care in a Primary Care Emergency Center.
Background: Nurse Demand Management was born in 2009 out of the need to address the growth of spontaneous acute demand in primary care. But it is not until 2013 that guidelines for the exercise of nursing actions in demand management were established in Catalonia, Spain. Nurses trained specifically to solve acute and low complexity health problems generate a quality of care comparable to that provided by family medicine doctors. On the other hand, it is worth highlighting the need to rationalise medical resources in primary care centres, primary care emergency centres or points of continuous care (different emergency facilities in the territory in terms of size and services) in order to give priority to doctors being able to dedicate more time to medium or high complexity pathology. Although nurse demand management has been implemented in primary care teams for years, it is being carried out in different intensities according to the needs or priorities of each health territory.
The promotion of the autonomous role of nursing through the implementation of nurse demand management in the urgent spontaneous demand of low complexity can be transcendent, both in the optimisation of health resources in primary care and in the management of the demand for care.
Hypothesis: The implementation of nurse demand management is a factor of improvement in the efficiency and quality of care in the Primary Care Emergency Centre of the city of Mataró (Barcelona, Spain). Objectives: The main objective of this study was to determine whether the implementation of nurse demand management is a factor in improving efficiency and quality of care in the CUAP of Mataró. Methodology: Non-randomised controlled experimental intervention study. Application of a consensual guide with 5 reasons for health consultations where demand management nursing can be applied.
Read the detailed description
Background: Demand Nurse Management was born in 2009 due to the need to address the growth of spontaneous acute demand in primary care. But it was not until 2013 that guidelines for the practice of demand management nursing were established in Catalonia, Spain. Nurses trained specifically to solve acute and low complexity health problems generate a quality of care comparable to that provided by family medicine physicians. On the other hand, it is worth highlighting the need to rationalize medical resources in primary care centers, primary care emergency centers or points of continuous care (different emergency devices in the territory in terms of size and services) in order to prioritize physicians' time for medium or high complexity pathology. Although nurse demand management has been implemented in primary care teams for years, it is being carried out in different intensities according to the needs or priorities of each health territory. The most complete research work, to date, regarding demand management nursing, was carried out between 2011 and 2012 at the Can Bou primary care center in Castelldefels, Barcelona. A retrospective, observational, descriptive and cross-sectional study was conducted, which concluded that the application of demand management nursing showed a high resolution of diseases attended and a high percentage of health advice and health education in visits attended autonomously by nurses. Primary care emergency points and centers form a powerful network in the spontaneous urgent demand of low and medium complexity and help to stop the collapse of hospital care and make it easier for hospital care to focus on highly complex or vital emergencies. The promotion of the autonomous role of nursing through the implementation of nurse demand management in urgent spontaneous demand of low complexity can be transcendent, both in the optimization of health resources in primary care throughout the territory, as well as in the improvement in terms of the quality and efficiency of these services and the quality of care for their users. Hypothesis: The implementation of nurse demand management is a factor of improvement in the efficiency and quality of care in the Primary Care Emergency Center of the city of Mataró (Barcelona, Spain). Objectives: The main objective was to determine whether the implementation of demand management nursing is a factor for improving efficiency and quality of care in the CUAP of Mataró, and specifically, to evaluate whether it frees time for physicians to attend medium and high complexity health problems, reduces consultations for health problems attended within 15 days, the level of user satisfaction, and whether it facilitates efficiency and quality with respect to waiting time and resolution of the health problem. Methodology: Non-randomized controlled experimental intervention study. Application of a consensual guide with 5 health consultation reasons where the nursing management of the demand can be applied the first fifteen days of each month in the emergency center of Mataró (experimental group) and until reaching the necessary sample of 156 subjects. Control group of application in the second fortnight of each more where the usual operation is applied and until reaching a necessary sample of 156 subjects. Determinations: Sociodemographic, clinical data, characteristics of the visits and patient experience will be collected. Statistical analysis: Descriptive, correlational and multivariate analysis will be performed. Expected results: Improvement in waiting time, resolution, number of consultations and user satisfaction with respect to low intensity health consultations under the application of nurse demand management. Improved efficiency of the emergency center and quality of care of the service. Applicability and Relevance: This is a first prospective experimental study that may help public health authorities to determine the general interest in the widespread implementation of demand management nursing in emergency and non-emergency primary care.
- Conditions
- Nurse's Role, Disease, Acute
- Being tested
- nursing procedure for acute health problems of low complexity
- Keywords
- primary care nursing, primary health care, nurses, acute disease/nursing, advanced rractice nursing, minor health problems, practice guideline
- Medical subject headings
- Acute Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
nursing procedure for acute health problems of low complexityOther
An agreed nursing procedure is applied for users of a primary care emergency center who spontaneously consult for 5 acute health problems of low complexity: gastroenteritis, cystitis in women, dental pain, upper respiratory tract affections and acute wounds
| Study group | Role | What they receive |
|---|---|---|
| Consensuated nurse intervencion group | Experimental | Application of a consensual nursing guide with 5 reasons for health consultation where an autonomous role can be applied. Users who come to the emergency center during the first fifteen days of each month are assigned to the experimental group until the necessary sample of 156 subjects is reached. Receives: Other: nursing procedure for acute health problems of low complexity |
| Usual medical visit group | No intervention | Users who come to the emergency center in the second fortnight of each month are assigned to the non-intervention (control) group where the usual medical visit is applied until the required sample of 156 subjects is reached. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Waiting time and resolution of the visit
Different time points are collected to analyze the duration of care at the center: time of entry into the triage consultation, time of entry into the medical or nursing consultation, and time of departure from the consultation.
Time that the administrator receives the user and includes him/her in the work agenda of the emergency center.
Time the user makes the triage. Time that the user is attended in the agenda of the demand management center (experimental group days).
Time that the user is seen in the medical office (control group days).
Measured: During the entire process of assistance to the participant, an average of 4 hours.
Number of reconsultations
Number of return visits for the same health problem made by the participant in the subsequent 30 days.
Measured: 30 days
patient experience
Participant satisfaction survey, on the same day, of the care received by the doctor or nurse From 15 days after the hearing, a quality telephone survey will be conducted with all recruited subjects.
Measured: On a scale from 0 to 10, where 0 is not very satisfied and 10 is very satisfied.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 Mar 2024
- Study start1 Oct 2022
- Primary completion5 Jan 2024
- Study completion1 Sep 2024 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Nurse's RoleStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 312 participants (actual)
Sponsor and investigators
- Lead sponsor
- Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Jordi Estarlich Corominas, IP, Principal investigator, Active nurse in the emergency center where the study is carried out
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06298240
- Sponsor's protocol ID
- 4R22/074
- Status last verified
- Feb 2024
- First submitted
- 6 Feb 2024
- Last updated
- 15 Apr 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Estarlich-Corominas J, Soler-Abril N, Casanellas-Chuecos A, Becerra-Corzo S, Bianco AS, Toran-Monserrat P, Garcia-Sierra R. Nurse management of minor problems in primary care emergencies: a non-randomized controlled trial. BMC Nurs. 2025 Jan 24;24(1):87. doi: 10.1186/s12912-025-02729-2.
PubMed 39856650
Study at a glance
From the registry record, last updated by the sponsor on 15 Apr 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Implementation of Nurse Demand Management as a Factor in Improving the Quality of Care in a Primary Care Emergency Center.
- ClinicalTrials.gov ID
- NCT06298240
- Acronym / sponsor ID
- 4R22/074
- Conditions
- Nurse's Role, Disease, Acute
- Keywords
- primary care nursing, primary health care, nurses, acute disease/nursing, advanced rractice nursing, minor health problems, practice guideline
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 312 participants (actual)
- Lead sponsor
- Fundacio d'Investigacio en Atencio Primaria Jordi Gol i GurinaUniversity, hospital or other
- Study start
- 1 Oct 2022 (actual)
- Primary completion
- 5 Jan 2024 (actual)
- Study completion
- 1 Sep 2024 (estimated)
- First posted
- 7 Mar 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Background: Nurse Demand Management was born in 2009 out of the need to address the growth of spontaneous acute demand in primary care. But it is not until 2013 that guidelines for the exercise of nursing actions in demand management were established in Catalonia, Spain. Nurses trained specifically to solve acute and low complexity health problems generate a quality of care comparable to that provided by family medicine doctors. On the other hand, it is worth highlighting the need to rationalise medical resources in primary care centres, primary care emergency centres or points of continuous care (different emergency facilities in the territory in terms of size and services) in order to give priority to doctors being able to dedicate more time to medium or high complexity pathology. Although nurse demand management has been implemented in primary care teams for years, it is being carried out in different intensities according to the needs or priorities of each health territory.
The promotion of the autonomous role of nursing through the implementation of nurse demand management in the urgent spontaneous demand of low complexity can be transcendent, both in the optimisation of health resources in primary care and in the management of the demand for care.
Hypothesis: The implementation of nurse demand management is a factor of improvement in the efficiency and quality of care in the Primary Care Emergency Centre of the city of Mataró (Barcelona, Spain). Objectives: The main objective of this study was to determine whether the implementation of nurse demand management is a factor in improving efficiency and quality of care in the CUAP of Mataró. Methodology: Non-randomised controlled experimental intervention study. Application of a consensual guide with 5 reasons for health consultations where demand management nursing can be applied.
Detailed description
Background: Demand Nurse Management was born in 2009 due to the need to address the growth of spontaneous acute demand in primary care. But it was not until 2013 that guidelines for the practice of demand management nursing were established in Catalonia, Spain. Nurses trained specifically to solve acute and low complexity health problems generate a quality of care comparable to that provided by family medicine physicians. On the other hand, it is worth highlighting the need to rationalize medical resources in primary care centers, primary care emergency centers or points of continuous care (different emergency devices in the territory in terms of size and services) in order to prioritize physicians' time for medium or high complexity pathology. Although nurse demand management has been implemented in primary care teams for years, it is being carried out in different intensities according to the needs or priorities of each health territory. The most complete research work, to date, regarding demand management nursing, was carried out between 2011 and 2012 at the Can Bou primary care center in Castelldefels, Barcelona. A retrospective, observational, descriptive and cross-sectional study was conducted, which concluded that the application of demand management nursing showed a high resolution of diseases attended and a high percentage of health advice and health education in visits attended autonomously by nurses. Primary care emergency points and centers form a powerful network in the spontaneous urgent demand of low and medium complexity and help to stop the collapse of hospital care and make it easier for hospital care to focus on highly complex or vital emergencies. The promotion of the autonomous role of nursing through the implementation of nurse demand management in urgent spontaneous demand of low complexity can be transcendent, both in the optimization of health resources in primary care throughout the territory, as well as in the improvement in terms of the quality and efficiency of these services and the quality of care for their users. Hypothesis: The implementation of nurse demand management is a factor of improvement in the efficiency and quality of care in the Primary Care Emergency Center of the city of Mataró (Barcelona, Spain). Objectives: The main objective was to determine whether the implementation of demand management nursing is a factor for improving efficiency and quality of care in the CUAP of Mataró, and specifically, to evaluate whether it frees time for physicians to attend medium and high complexity health problems, reduces consultations for health problems attended within 15 days, the level of user satisfaction, and whether it facilitates efficiency and quality with respect to waiting time and resolution of the health problem. Methodology: Non-randomized controlled experimental intervention study. Application of a consensual guide with 5 health consultation reasons where the nursing management of the demand can be applied the first fifteen days of each month in the emergency center of Mataró (experimental group) and until reaching the necessary sample of 156 subjects. Control group of application in the second fortnight of each more where the usual operation is applied and until reaching a necessary sample of 156 subjects. Determinations: Sociodemographic, clinical data, characteristics of the visits and patient experience will be collected. Statistical analysis: Descriptive, correlational and multivariate analysis will be performed. Expected results: Improvement in waiting time, resolution, number of consultations and user satisfaction with respect to low intensity health consultations under the application of nurse demand management. Improved efficiency of the emergency center and quality of care of the service. Applicability and Relevance: This is a first prospective experimental study that may help public health authorities to determine the general interest in the widespread implementation of demand management nursing in emergency and non-emergency primary care.
Study design
- Primary purpose
- Health services research
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Consensuated nurse intervencion group | Experimental | Other: nursing procedure for acute health problems of low complexityApplication of a consensual nursing guide with 5 reasons for health consultation where an autonomous role can be applied. Users who come to the emergency center during the first fifteen days of each month are assigned to the experimental group until the necessary sample of 156 subjects is reached. |
| Usual medical visit group | No intervention | –Users who come to the emergency center in the second fortnight of each month are assigned to the non-intervention (control) group where the usual medical visit is applied until the required sample of 156 subjects is reached. |
Who may qualify
- Ages
- 16 to 65 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (1 listed)
- All users who come to the emergency centre between Monday and Friday (excluding public holidays) from 8 a.m. to 8 p.m. and who consult for the 5 possible health problems that are part of the study protocol.
Key exclusion criteria (1 listed)
- Any spontaneous user or user referred by another health centre who comes for a re-consultation for the same health problem in less than 30 days will be excluded.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| nursing procedure for acute health problems of low complexityAn agreed nursing procedure is applied for users of a primary care emergency center who spontaneously consult for 5 acute health problems of low complexity: gastroenteritis, cystitis in women, dental pain, upper respiratory tract affections and acute wounds | Other | Consensuated nurse intervencion group |
Primary outcome
Waiting time and resolution of the visit
Time frame: During the entire process of assistance to the participant, an average of 4 hours.
Different time points are collected to analyze the duration of care at the center: time of entry into the triage consultation, time of entry into the medical or nursing consultation, and time of departure from the consultation. Time that the administrator receives the user and includes him/her in the work agenda of the emergency center. Time the user makes the triage. Time that the user is attended in the agenda of the demand management center (experimental group days). Time that the user is seen in the medical office (control group days).
Number of reconsultations
Time frame: 30 days
Number of return visits for the same health problem made by the participant in the subsequent 30 days.
patient experience
Time frame: On a scale from 0 to 10, where 0 is not very satisfied and 10 is very satisfied.
Participant satisfaction survey, on the same day, of the care received by the doctor or nurse From 15 days after the hearing, a quality telephone survey will be conducted with all recruited subjects.
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Apr 2024.
- Derived from this study: PubMed 39856650Estarlich-Corominas J, Soler-Abril N, Casanellas-Chuecos A, Becerra-Corzo S, Bianco AS, Toran-Monserrat P, Garcia-Sierra R. Nurse management of minor problems in primary care emergencies: a non-randomized controlled trial. BMC Nurs. 2025 Jan 24;24(1):87. doi: 10.1186/s12912-025-02729-2.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jordi Estarlich Corominas, IP principal investigator
Active nurse in the emergency center where the study is carried out
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing nursing procedure for acute health problems of low complexity in people with Nurse's Role and Disease, Acute, run by Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina at 1 site in Spain.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 15 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Waiting time and resolution of the visit (time frame: During the entire process of assistance to the participant, an average of 4 hours.). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06298240, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Apr 2024.