Telephone Management of Acute Pediatric Illnesses
110
Citation
13
Reference
10
Related Paper
Citation Trend
Abstract:
Abstract To evaluate the telephone management of five common acute pediatric problems, a "programmed mother" made unidentified calls to five pediatric nurse practitioners, 28 pediatric house officers and 23 pediatricians in practice. Calls were tape recorded and scored for history taking, disposition and interviewing skill. Nurse practitioners averaged 79.6 per cent of the total possible theoretical score for history taking, house officers 69.1 per cent, and practicing pediatricians 52.6 per cent (P<0.001). For disposition, nurse practitioners averaged 71.1 per cent of the maximum score, in contrast to 60.1 per cent for house officers and 58.9 per cent for practicing pediatricians. Similarly, nurse practitioners had significantly higher (P<0.001) scores for interviewing skills. No significant differences were found among house officers in the first, second and third years in history taking, disposition or interviewing skills. We conclude that pediatric nurse practitioners manage common pediatric problems by telephone better than house officers or practicing pediatricians and that better training for this aspect of practice is needed. (N Engl J Med 298:130–135, 1978)Keywords:
Interview
Pediatric Nurse Practitioner
Disposition
Practice nurse
Telephone interview
Pediatric nursing
History-taking, disposition, and telephone communication skills of pediatric nurse practitioners, pediatric house officers, and practicing pediatricians were assessed and compared. To evaluate the management of five common acute pediatric problems, a "programmed mother" made 148 unidentified calls to these health professionals during evening hours. The calls were tape recorded, and scored for history-taking, disposition, and interviewing skills. The scoring system, developed by a panel of 11 experts, assessed the relevance and completeness of each history obtained. Nurse practitioners averaged 79.6 percent of the total possible score, as compared to 52.6 percent for pediatricians (p<.001). When disposition was similarly analyzed, the nurse practitioners scored significantly higher than pediatricians. Analyzing only those items of history-taking and disposition deemed most critical by the panel, nurse practitioners included 91 percent and pediatricians only 55 percent (p<.001). Parameters of interviewing skill were scored by the interviewer and each author with agreement of 80 percent or above; nurse practitioners obtained significantly higher scores than pediatricians (p<.001). Calls handled by nurses averaged 7.4 minutes, those by pediatricians 3.2 minutes (p<.001). Nurse Practitioners, it was concluded, can safely and effectively share responsibility with physicians for night and weekend telephone call coverage for a pediatric practice with adequate physician back up.
Interview
Disposition
Pediatric Nurse Practitioner
Cite
Citations (0)
Pediatric Nurse Practitioner
Pediatric nursing
Cite
Citations (11)
Pediatric nursing
Pediatric Nurse Practitioner
Practice nurse
Cite
Citations (0)
History-taking, disposition, and telephone communication skills of pediatric nurse practitioners, pediatric house officers, and practicing pediatricians were assessed and compared. To evaluate the management of five common acute pediatric problems, a "programmed mother" made 148 unidentified calls to these health professionals during evening hours. The calls were tape recorded, and scored for history-taking, disposition, and interviewing skills. The scoring system, developed by a panel of 11 experts, assessed the relevance and completeness of each history obtained. Nurse practitioners averaged 79.6 percent of the total possible score, as compared to 52.6 percent for pediatricians (p less than .001). When disposition was similarly analyzed, the nurse practitioners scored significantly higher than pediatricians. Analyzing only those items of history-taking and disposition deemed most critical by the panel, nurse practitioners included 91 percent and pediatricians only 55 percent (p less than .001). Parameters of interviewing skill were scored by the interviewer and each author with agreement of 80 percent or above; nurse practitioners obtained significantly higher scores than pediatricians (p less than .001). Calls handled by nurses averaged 7.4 minutes, those by pediatricians 3.2 minutes (p less than .001). Nurse practitioners, it was concluded, can safely and effectively share responsibility with physicians for night and weekend telephone call coverage for a pediatric practice with adequate physician back up.
Cite
Citations (14)
A controlled two-year study of the effectiveness of well-child care by pediatric nurse practitioners (PNPs) of 1,152 children, newborns through age 22 months, was made at the Kaiser-Peranente Medical Centers in San Francisco and Oakland, Calif. In this setting of a large, prepaid, group practice health care plan, the PNPs were found to be entirely competent in maintaining the health of their patients, and were generally accepted by the parents. Effects on utilization of medical care facilities were minimal. Costs of well-child care were reduced.
Pediatric Nurse Practitioner
Practice nurse
Pediatric nursing
Child Care
Medical care
Medical practice
Cite
Citations (18)
Pediatric nursing
Pediatric Nurse Practitioner
Cite
Citations (10)
. Nurses with pediatricians in pediatric outpatient clinics: a survey on family pediatricians' opinions.Pediatric nurses next to family pediatricians could contribute to several activities, included limiting inappropriate access to the emergency room.To describe the perceived benefit of the activities that could be performed by pediatric nurses in the pediatrician's clinic according to the opinion of family pediatricians.Pilot on-line survey with family pediatricians, using list of activities grouped in four areas: "Care of pediatric patients with illnesses and disabilities", "Health education", "Prevention of diseases" and "Coordination and organizational activities". For each activity a judgement of benefit (1= not useful at all; 6= very useful) was reported.Overall, 178 family pediatricians participated in the survey; 55% of them were female, mean age was 55 years. They rated as very useful both the presence of a pediatric nurse in their clinic (mean 5.37+1.06) and would recommend it to a colleague (5.36+1.05). Health education was perceived as the most important area of activity (4.88+0.97). The more they considered useful the pediatric nurse in their clinic, the higher they rated relevant the activities of the pediatric nurse (r=0.60-0.70). Older and more experienced pediatricians found less useful educational (r=-0.19 p<0.05; r=-0.23 p<0.01) and prevention (r=-0.18 p<0.05; r=-0.24 p<0.01) activities compared to younger and less experienced pediatricians.Pediatricians consider very helpful a pediatric nurse in their clinic, for clinical, educational and organizational activities.
Pediatric Nurse Practitioner
Outpatient clinic
Limiting
Judgement
Pediatric nursing
Cite
Citations (1)
The experience of a two-man pediatric practice with a pediatric nurse practitioner indicates that this is an economically sound means of partially relieving the immediate manpower shortage and of improving medical care to children. The pediatric nurse practitioner provides skill and competent services to patients and their parents which is well accepted by them. Having the pediatric nurse practitioner in the office is an economic asset. She is a valuable associate in managing a variety of day-to-day problems. Her presence has resulted in an increase in the number of patients seen and an overall improvement of services provided.
Pediatric Nurse Practitioner
Economic shortage
Private practice
Practice nurse
Pediatric nursing
Cite
Citations (60)
Abstract To evaluate the telephone management of five common acute pediatric problems, a "programmed mother" made unidentified calls to five pediatric nurse practitioners, 28 pediatric house officers and 23 pediatricians in practice. Calls were tape recorded and scored for history taking, disposition and interviewing skill. Nurse practitioners averaged 79.6 per cent of the total possible theoretical score for history taking, house officers 69.1 per cent, and practicing pediatricians 52.6 per cent (P<0.001). For disposition, nurse practitioners averaged 71.1 per cent of the maximum score, in contrast to 60.1 per cent for house officers and 58.9 per cent for practicing pediatricians. Similarly, nurse practitioners had significantly higher (P<0.001) scores for interviewing skills. No significant differences were found among house officers in the first, second and third years in history taking, disposition or interviewing skills. We conclude that pediatric nurse practitioners manage common pediatric problems by telephone better than house officers or practicing pediatricians and that better training for this aspect of practice is needed. (N Engl J Med 298:130–135, 1978)
Interview
Pediatric Nurse Practitioner
Disposition
Practice nurse
Telephone interview
Pediatric nursing
Cite
Citations (110)
Pediatric Nurse Practitioner
Specialty
Pediatric nursing
Cite
Citations (2)