Feasibility and acceptability of nurse-led youth clinics in Australian general practice
Kelsey Hegarty A C , Rhian Parker A B , Danielle Newton A , Laura Forrest B , Janelle Seymour A and Lena Sanci A
+ Author Affiliations
- Author Affiliations
A General Practice and Primary Health Care Academic Centre, The University of Melbourne, 200 Berkeley Street, Carlton, Vic. 3053, Australia.
B Australian Primary Health Care Research Institute, The Australian National University, Corner of Gordon and Marcus Clarke Streets, Acton, ACT 2601, Australia.
C Corresponding author. Email: k.hegarty@unimelb.edu.au
Australian Journal of Primary Health 19(2) 159-165 https://doi.org/10.1071/PY12025
Submitted: 17 August 2011 Accepted: 9 March 2012 Published: 4 May 2012
Abstract
Internationally, youth access to primary health care is problematic due to documented barriers such as cost, concerns about confidentiality, and knowledge about when to attend and available services. The treatment of health problems earlier in life together with engagement in prevention and health education can optimise youth health and maximise the potential of future wellbeing. This study investigated the feasibility, acceptability and cost of establishing nurse-led youth clinics in Victoria, Australia. Three general practices in rural and regional areas of Victoria implemented the nurse-led youth health clinics. The clinics were poorly attended by young people. Practice nurses identified several barriers to the clinic attendance including the short timeframe of the study, set times of the clinics and a lack of support for the clinics by some GPs and external youth health clinics, resulting in few referrals. The clinics cost from $5912 to $8557 to establish, which included training the practice nurses. Benefits of the clinics included increased staff knowledge about youth health issues and improved relationships within the general practice staff teams. The implementation of youth health clinics is not feasible in a short timeframe and to maximise use of the clinics, all members of the general practice team need to find the clinics acceptable.
Additional keywords: cost, GPs, nurses, primary health care.
References
Australian Bureau of Statistics (2007a) ‘Average weekly earnings, Australia, May 2007.’ (Australian Government: Canberra)Australian Bureau of Statistics (2007b) ‘Labour price index, Australia, June 2007.’ (Australian Government: Canberra)
Australian Institute of Health and Welfare (2007) ‘Young Australians: their health and wellbeing.’ (AIHW: Canberra).
Booth ML, Bernard D, Quine S, Kang MS, Usherwood T, Alperstein G, Bennett DL (2004) Access to health care among Australian adolescents young people. The Journal of Adolescent Health 34, 97–103.
Britt H, Miller GC, Charles J, Henderson J, Bayram C, Harrison C, Valenti L, Fahridin S, Pan Y, O’Halloran J (2008) ‘General practice activity in Australia 1998–99 to 2007–08: 10 years data tables.’ (Australian Institute of Health and Welfare: Canberra)
Brooks K, Davidson PM, Daly J, Halcomb EJ (2007) Role theory: a framework to investigate the community nurse role in contemporary health care systems. Contemporary Nurse 25, 146–155.
Bush M, Moss L, Wallis S (2006) Hustling to health – a nurse led outreach service. Australian Nursing Journal 14, 35–41.
Department for Transport (1993) ‘COBA 9 manual.’ (Highways Economics and Traffic Appraisal Division: London)
Drummond MF, Sculpher MJ, Torrance GW, O’Brien BJ, Stoddart GL (2005) ‘Methods for the economic evaluation of health care programme.’ (Oxford University Press: New York)
Eley DS, Del Mar CB, Patterson E, Synnott RL, Baker PG, Hegney D (2008) A nurse led model of chronic disease care − an interim report. Australian Family Physician 37, 1030–1032.
Halcomb EJ, Davidson PM, Yallop J, Griffiths R, Daly J (2007) Strategic directions for developing the Australian General Practice nurse role in cardiovascular disease management. Contemporary Nurse 26, 125–135.
| Strategic directions for developing the Australian General Practice nurse role in cardiovascular disease management.Crossref | GoogleScholarGoogle Scholar |
Halcomb EJ, Davidson PM, Griffiths R, Daly J (2008a) Cardiovascular disease management: time to advance the practice nurse role? Australian Health Review 32, 44–55.
| Cardiovascular disease management: time to advance the practice nurse role?Crossref | GoogleScholarGoogle Scholar |
Halcomb EJ, Davidson PM, Salamonson Y, Ollerton R (2008b) Nurses in Australian general practice: implications for chronic disease management. Journal of Clinical Nursing 17, 6–15.
| Nurses in Australian general practice: implications for chronic disease management.Crossref | GoogleScholarGoogle Scholar |
Haller DM, Sanci LA, Patton GC, Sawyer SM (2007) Toward youth friendly services: a survey of young people in primary care. Journal of General Internal Medicine 22, 775–781.
| Toward youth friendly services: a survey of young people in primary care.Crossref | GoogleScholarGoogle Scholar |
Hawkins JW (1980) A nursing model for delivery of primary health care for women. American Nurses Association Publications G-147, 22–28.
Hayter M (2009) The structure of contraceptive education and instruction within nurse led family planning clinics: a grounded theory study. Journal of Clinical Nursing 18, 2656–2667.
| The structure of contraceptive education and instruction within nurse led family planning clinics: a grounded theory study.Crossref | GoogleScholarGoogle Scholar |
Jones KE, Beeching BA, Roberts P, Devine M, Davies J, Bates CM, Jones C (2006) Success of a nurse led community based genitourinary medicine clinic for young people in Liverpool: review of the first year. Sexually Transmitted Infections 82, 318–320.
| Success of a nurse led community based genitourinary medicine clinic for young people in Liverpool: review of the first year.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD28vlsVejsg%3D%3D&md5=0c930b8214a5f66ed5be294d81b7cc21CAS |
Keleher H, Parker R, Abdulwadud O, Francis K (2009) Systematic review of the effectiveness of primary care nursing. International Journal of Nursing Practice 15, 16–24.
| Systematic review of the effectiveness of primary care nursing.Crossref | GoogleScholarGoogle Scholar |
Kleinert S (2007) Adolescent health: an opportunity not to be missed. Lancet 369, 1057–1058.
| Adolescent health: an opportunity not to be missed.Crossref | GoogleScholarGoogle Scholar |
May C, Finch T (2009) Implementation, embedding, and integration: an outline of Normalization Process Theory. Sociology 43, 535–554.
| Implementation, embedding, and integration: an outline of Normalization Process Theory.Crossref | GoogleScholarGoogle Scholar |
May C, Finch T, Mair F, Ballini L, Dowrick C, Eccles M, Gask L, MacFarlane A, Murray E, Rapley T, Rogers A, Treweek S, Wallace P, Anderson G, Burns J, Heaven B (2007) Understanding the implementation of complex interventions in health care: the normalization process model. BMC Health Services Research 7, 148
| Understanding the implementation of complex interventions in health care: the normalization process model.Crossref | GoogleScholarGoogle Scholar |
McIntyre P (2002) ‘Adolescent friendly health services: an agenda for change.’ (World Health Organization: Geneva)
Mills J, Fitzgerald M (2007) The changing role of practice nurses in Australia: an action research study. The Australian Journal of Advanced Nursing 26, 16–20.
Patton MQ (1990) ‘Qualitative evaluation and research methods.’ 2nd edn. (Sage: Newbury Park, CA)
Patton GC, Viner R (2007) Pubertal transitions in health. Lancet 369, 1130–1139.
| Pubertal transitions in health.Crossref | GoogleScholarGoogle Scholar |
Patton GC, Sanci LA, Sawyer SM (2002) Adolescent medicine. The Medical Journal of Australia 176, 3
Pilotto LS, Smith BJ, Heard AR, McElroy HJ, Weekley J, Bennett P (2004) Trial of nurse run asthma clinics based in general practice versus usual medical care. Respirology 9, 356–362.
| Trial of nurse run asthma clinics based in general practice versus usual medical care.Crossref | GoogleScholarGoogle Scholar |
Potts Y, Gillies ML, Wood SF (2001) Lack of mental well-being in 15 year-olds: an undisclosed iceberg? Family Practice 18, 95–100.
| Lack of mental well-being in 15 year-olds: an undisclosed iceberg?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MvlvFCrtg%3D%3D&md5=f5fdf5fab37ddf013e8eaa048521e59fCAS |
Price K, Patterson E, Hegney D (2006) Being strategic: utilising consumer views to better promote an expanded role for nurses in Australian general practice. Collegian (Royal College of Nursing, Australia) 13, 16–21.
| Being strategic: utilising consumer views to better promote an expanded role for nurses in Australian general practice.Crossref | GoogleScholarGoogle Scholar |
Royal College of Paediatrics and Child Health (2003) ‘Bridging the gaps: health care for adolescents.’ (Royal College of Paediatrics and Child Health: UK)
Sanci LA, Coffey CMM, Veit FCM, Carr-Gregg M, Patton GC, Day N, Bowes G (2000) Evaluation of an educational intervention for general practitioners in adolescent health care: randomised controlled study. British Medical Journal 320, 224–230.
| Evaluation of an educational intervention for general practitioners in adolescent health care: randomised controlled study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c7gvVKrtg%3D%3D&md5=b97bf39e150c34323aa786a729c51e5eCAS |
Sanci LA, Kang MSL, Ferguson BJ (2005) Improving adolescent’s access to primary health care. The Medical Journal of Australia 183, 416–417.
Thomas DR (2006) A general inductive approach for analyzing qualitative evaluation data. The American Journal of Evaluation 27, 237–246.
| A general inductive approach for analyzing qualitative evaluation data.Crossref | GoogleScholarGoogle Scholar |
Tylee A, Haller DM, Graham T, Churchill R, Sanci LA (2007) Youth-friendly primary-care services: how are we doing and what more needs to be done? Lancet 369, 1565–1573.
| Youth-friendly primary-care services: how are we doing and what more needs to be done?Crossref | GoogleScholarGoogle Scholar |
Yallop J, Clark R, Chan B, Croucher J, Wilson A, Sellar B, Piterman L, Tonkin A, Krum H (2006) CHAT – a study of a nurse-led system of care. Australian Nursing Journal 14, 19
Zwarenstein M, Bryant W (2000) Interventions to promote collaboration between nurses and doctors. Cochrane Database of Systematic Reviews CD000072
