Development of a nurse-led primary healthcare service for injecting drug users in inner-city Sydney
Carolyn A. Day A F , M. Mofizul Islam B C , Ann White C , Sharon E. Reid C D E , Stephen Hayes C and Paul S. Haber A E
+ Author Affiliations
- Author Affiliations
A Discipline of Addiction Medicine, Central Clinical School (C39), Sydney Medical School, University of Sydney, NSW 2006, Australia.
B School of Public Health and Community Medicine, University of NSW, Sydney, NSW 2052, Australia.
C Harm Minimisation Services, Drug Health Services, Sydney South West Area Health Service, 103–105 Redfern Street, Redfern, NSW 2016, Australia.
D Drug Health Services, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia.
E School of Public Health (A27), Sydney Medical School, University of Sydney, NSW 2006, Australia.
F Corresponding author. Email: carolyn.day@sydney.edu.au
Australian Journal of Primary Health 17(1) 10-15 https://doi.org/10.1071/PY10064
Submitted: 6 September 2010 Accepted: 11 January 2011 Published: 16 March 2011
Abstract
Injecting drug users (IDUs) experience numerous health problems, but report barriers to utilising general practitioners (GPs). A nurse-led Harm Minimisation-based Primary Healthcare (HMPH) service for IDUs was established within a needle and syringe program in inner-city Sydney with Area Health Service medical support and clinical governance. This paper aimed to describe the HMPH service, review service utilisation and assess nurses’ perceptions of their work with IDUs. A review of the most recent 200 clinic files was undertaken. Service utilisation, GP and other health service use and access were extracted and analysed using SPSS. A semi-structured qualitative interview with clinic nurses regarding their experience working with IDUs and local GPs was conducted and analysed. Since its inception in mid-2006, the service has been utilised by 417 clients. Of the most recent 200 files, blood-borne virus and sexually transmitted infection screening were the primary reason for presentation (64.5%). At least one follow-up visit was attended by 90% of clients. A total of 62% of clients reported consulting a GP in the last 12 months. The service provided 102 referrals. Nurses believed that IDUs tend to utilise GPs ineffectively and that self-care is a low priority, but that they can support IDUs to overcome some barriers to GPs and facilitate access. Targeted primary health care services led by nurses with focussed medical support and co-located with needle and syringe programs can fill an important gap in delivering and facilitating health care to IDUs.
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