Nursing Staff and Nurse Article Review

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Nurse-headed telephone triage has increasingly been employed for managing physician consultation demands in British general practice. Prior research works are vague when it comes to delineating the association between nurse triage call results and practical clinical experience. A majority of studies are restricted to scrutinizing out-of-hours nurse phone triage. This particular study has been performed within the framework of current knowledge, thereby contributing a solution angle highly relevant to the nursing profession. This study's key purpose was investigating whether or not primary care nursing staff's (who undertake digital decision-backed software phone triage) professional traits are associated with call disposition (Varley, et al., 2016).

Literature Review

Telephone Triage

Telephone triage application is an approach utilized for tackling increasing nurse workloads. Nursing staff offer an effective and safe triage service within various settings such as primary care, in which they may prove efficient in terms of managing doctors' workload in out-of-hours and day-of-contact primary healthcare facilities.

1. Nursing Characteristics

Qualification levels, duration of experience in the field and other nursing traits can impact triage results as well. An analysis of as many as 60,794 calls that were handled by a total of 296 National Health Service Direct nurses revealed a positive link with call disposal trends and duration of experience. Relatively new nursing staff (not even ten years in the field) depicted lesser likelihood to dispose self-care calls as compared to nursing staff practicing for two decades or more. This finding is in line with other studies that note that more experienced nursing staff exhibit greater correctness/accuracy of selected triage results, decreased data acquisition levels in triage evaluations, and more inference/judgment-making on the basis of past experience.

This research on nursing elements represents a continuous endeavor being carried out for the last many years. It appears that numerous researches published several years back continue to apply in the present scenario. The researchers have referenced journal articles published between 1995 and 2016.

Theoretical Framework

1. This research hasn't directly applied theoretic concepts. It has only directly applied some general nursing-related research hypotheses and problems. Questionnaires of nursing staff delivering ESTEEM's nurse intervention branch effectively captured kind of role (i.e., NP (nurse practitioner) or practice nurse), duration of experience, status of prescriber, educational qualification, perceived triage readiness and past triage experience. The key result sought was: share of triaged nursing care patients who received follow-up recommendation in the practice (i.e., call disposition). This included all forms of contact (direct, house visits and telephonic), by nurses or doctors.

1. The study has employed nursing theory elements having relevance with regard to the research problem.

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Every nurse participated in a customized training initiative for facilitating their application of CDSS (clinical decision support software) offered by software company, Plain Healthcare in phone triage consultations. Every study subject potentially engaged in a triage role was expected to be provided with the standardized aforementioned training package relating to phone consultation skills and CDSS application. One point to bear in mind is that this support software aims at supporting nursing professional inpatient care-related decision-making. While nurses need to login to this software for all consultations, they need not abide by the software-generated recommendation, for the trial. Hence, the software usage intent was to facilitate nurse decision-making as well as offer them flexibility for applying their expertise and experience in deciding triage phone call outcomes.

1. Approach Framework

Yes, the step-wise strategy employed in this study is described below.

1. Extraction of patient information from clinician forms (primary result modeling),

1. Gleaning of likely explanatory factors from clinician forms,

1. Survey of nursing staff and

1. Data acquisition at practice level.

Variables/Hypotheses/Questions/Assumptions

1. What are the independent and dependent variables in this study?

Covariates at the patient level were:

1. Participant Sex (Reference-female);

1. Age categorized as: 0 to 4 years; 5 to 11 years; 16 to 24 years; 25 to 59 years (reference category); 60 to 74 years; 75+ years;

1. Duration of experience

1. Deprivation at patient level segregated into rank-based quintiles

1. Ethnicity

Covariates at the practice level were:

1. Location;

1. Deprivation at practice level; non-deprived: deprived; below average or average deprivation in case of England (reference group); and above average England-based deprivation; and

1. Size of practice list: small (8000 registered patients; this is the reference category); and medium (between 3500 and 8000 registered patients).

Every variable above is independent. The study purpose establishes call disposition as its dependent variable. Research content to support it is as follows.

Suggested call disposition was the chief outcome, dichotomized in binary variable form and suggesting whether practice follow-up was needed or not. Every statistical analysis was composed of logistical hierarchical models. Distinct patient examinations were nested in nurses and vice versa, hence, both practice and nurse are random effects in the study (Varley, et al., 2016)

1. Are the operational definitions of the variables given? If so, are they concrete and measurable?

Variable understanding, levels and context haven't been clearly delineated. However, researchers have mentioned a general survey parameter application.

1. Is the research question or the hypothesis stated?.....

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