Impact of nurse practitioners on workload of general practitioners: randomised controlled trial

摘要

Objective To examine the impact on general practitioners' workload of adding nurse practitionersto the general practice team.Design Randomised controlled trial with measurements before and after the introduction ofnurse practitioners.Setting 34 general practices in a southern region of the Netherlands.Participants 48 general practitioners.Intervention Five nurses were randomly allocated to general practitioners to undertake specific elementsof care according to agreed guidelines. The controlgroup received no nurse.Main outcome measures Objective workload, derived from 28 day diaries, included the number of contacts per day for each of three conditions (chronicobstructive pulmonary disease or asthma, dementia,cancer), by type of consultation (in practice,telephone, home visit), and by time of day (surgeryhours, out of hours). Subjective workload wasmeasured by using a validated questionnaire.Outcomes were measured six months before and18 months after the intervention.