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MODEL PRACTICE IN COMMUNITY
HEALTH CENTER LJUBLJANA; WORKING
TOGETHER AS ONE, DOES IT WORK?
Metka Žitnik
E-mail: [email protected]
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Today, more than ever, medicine is
a group activity rather than an individual one.
Due to this change in how we view medicine individual professions now demand
acknowledgement and recognition of skills and competencies.
To be esteemed, respected,
and acknowledged for one's contribution!
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674
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WHY HAVE WE CHANGED THE WORK
METHOD?
• Due to the aging population there are more andmore patients with chronic diseases in Slovenia,
• the transfer of work from secondary to primary levelis increasing,
• the number of chronic patients is rising,
• the education and demands of patients areincreasing,
• the number of patients managed by a single doctoris rising.
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FROM THEORY TO PRACTICE- MODEL
PRACTICE
• A nurse practitioner is in charge of performing
routine/prevention check-ups and managing
chronic patients with chronic diseases.
WHAT DOES THE LITERATURE SAY?
• Research studies of patients with several chronic
diseases show that such patients have a positive
attitude towards the new work method (Fortin et
al, 2010).
• Patients receive more practical advice on how to
maintain or improve their medical condition and
take their medicine (Haidar, 2007).
• With the help of a nurse practitioner the quality of
the treatment increases significantly and
consequently the health and well-being of the
patient improve (Redsell et al., 2007).
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HOW TO IMPLEMENT SUCH WORK
METHOD?
• Vision,
• good plan,
• professionals of all involved disciplines (gp, nurses, ect..),
• quality indicators,
• numbers are important,
• evidence,
• courage!
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IT WASN'T THAT EASY
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ADITIONAL EDUCATION
• Module - management of asthma and COPD in a model practice,
• Module - hypertension and management of a patient with chronic hypertension,
• Module - diabetes,
• Module - prevention,
• Module – osteoporosis,
• Course in mediation
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TRANSFER OF COMPETENCE FROM
DOCTOR TO NURSE
• Management of chronic patients with diabetes,
hypertensia, asthma, copd, depression,
osteoprosis, benign prostatic hyperplasia,
• Independent decision-making (lab test, ekg,..),
• Doing cardiovascular prevention,
• Professional license.
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WHAT DO WE DO?
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PREVENTION
KEEPING
A REGISTER
AND
REPORTING
ABOUT ONE'S
WORK
MANAGEMENT
OF WELL
MANAGED
CHRONICAL
PATIENT
‘’MY’’ POPULATION
• 3775 PATIENTS
• 334 DIABETES
• 1193 HYPERTENSION
• 97 COPD
• 171 ASTHMA
• ... AND SO ON...
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MY WORK DAY
• PREVENTIVE CHECK-UP;
• All patients over 30 years,
• Systematic checking/screening,
• Use of standardized questionnaires.
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MY WORK DAY
• MANAGEMENT OF CHRONIC DISEASE AND
PREVENTION HAN IN HAND
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INTERPROFESSIONAL
COLLABORATION
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NURSE PRACTITIONER
Simulation center
Community nurse
Health care promotion center
GP
Patient
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MY WORK DAY
• KEEPING REGISTERS AND REPORTING
ABOUT ONE’S WORK
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BENEFIT?
• Extended team aproach,
• In-depth and systematic implementation of
prevention,
• Better medical surveillance of the population,
• Registers of chronica diseases,
• Better management of patient with chronic non-
communicable diseases.
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NEWLY DIAGNOSED PATIENTS
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ASTHMA COPD DIABETES HYPERTENSIA DEPRESSION
2012 720 798 2442 3578 278
2013 690 833 2481 5581 754
2014 848 931 3366 6551 1669
2015 982 943 3723 8015 2631
GOOD RELATIONS, GOOD WORK!
• During their work, nurse practitioners establish a
wide range of relations with patients and with
their colleagues.
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• It has been proved that good collegial relations
among nurse practitioners and doctors improve
the outcome of the treatment; however, it is too
often the case that relations between these two
working groups function on the principle of
hierarchy or competitiveness, which harms
patients (Klemenc, 2007).
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OUR TEAM BUILDING
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• An American study from 2010 revealed that a
group of several women has a higher collective
intelligence and makes better, more successful
decisions, regardless of how smart and
experienced the individuals in it are (Williams
Woolley, 2010).
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People keep saying that
something can't be done,
until someone comes along
...and does it!
Florence Nightingale
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THANK YOU