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Primary child health care by family nurse practitioners.

Greenberg RA

Proceedings of the VII International Congress of Rural Medicine, September 17-21, Salt Lake City, Utah. International Association of Agricultural Medicine, 1978 Sep; :53-57

00185391

A program for providing primary health care in an isolated rural area was described. Four family nurse practitioners (FNPs) provided primary health care to families at a federally sponsored clinic at Prospect Hill, a rural crossroad in North Carolina. They made diagnoses on the basis of a medical history and physical examination, counseled patients and prescribed treatment, or made referrals using standing orders. The FNPs were registered nurses who had undergone special training in family practice. A pediatrician and an internist were at the clinic 1.5 days a week and an obstetrician 0.5 days a week to see patients referred by the FNPs and to review and certify medical records. The clinic served approximately 3000 patients representing over 900 families and 1300 children during the period October 1971 to October 1972. The highest utilization rates were for infants under 1 year of age who made an average of 4.7 visits per year and patients over 65 years old who averaged 3.6 visits per year. Analyzing the data for the child care services for the period September 18, 1972 to December 11, 1972 revealed that 270 children were examined, of which only 15.6 were well. The most frequently diagnosed health problem was respiratory infections, followed by well child care, psychogenic problems, allergic problems, and injuries and accidents in that order. Over 67 percent of the consultations involved therapy. Approximately 25 percent of the consultations involved establishing a diagnosis and evaluating a clinical finding. The FNPs managed 70.3 percent of the cases without consulting a physician. In 10.4 percent of the cases the FNP requested a physician consultation and the physician confirmed the FNP's diagnosis and referred the case back to the FNP for the treatment originally set out by the FNP. Ninety three percent of the cases were considered to have been managed properly by the FNPs. Of the remaining 7 percent only minor errors were committed. Sixty eight percent of the clinic patients were black, in comparison with 50 percent in the community. The author concludes that FNPs can provide comprehensive child health care in an isolated rural clinic.

NIOSH-Grant; Grants-other; Medical-examinations; Agriculture; Health-care-personnel; Health-care-facilities; Medical-treatment; Clinical-diagnosis; Health-protection; Age-factors

Prev Med & Environmental Hlth University of Iowa Inst/agric Med & Environ Hlth Iowa Oakdale, Iowa 52319

19780917

Conference/Symposia Proceedings

24225

Grant

1978

Grant-Number-R13-OH-00694

Other Occupational Concerns; Grants-other

Proceedings of the VII International Congress of Rural Medicine, September 17-21, Salt Lake City, Utah

NC; UT; IA

University of Iowa, Iowa City, Iowa