Off-site expert support for nurses undertaking ECGs in primary care.

Area of Science:

• Healthcare innovation
• Primary care services
• Nursing practice expansion

Background:

• The Department of Health aims to enhance patient care through innovative service delivery in primary care.
• Increased nursing staff activities, including diagnostic tests previously done by GPs or at hospitals, are being explored.
• General practices are evaluating the adoption of cardiac telemetry and independent provider services.

Purpose of the Study:

• To aid decision-making regarding the implementation of in-practice electrocardiograms (ECGs) by nurses.
• To present audit results from general practices and walk-in centres performing nurse-led ECGs.
• To assess the practical application and outcomes of nurse-performed ECGs in primary care.

Main Methods:

• An audit was conducted across eight general practices and two walk-in centres.
• Electrocardiograms (ECGs) were performed by nursing staff in these primary care settings.
• Data collected included frequency of ECG use and subsequent patient management changes.

Main Results:

• The frequency of nurse-performed ECGs varied from 1 to 27 per month per centre.
• Out of 373 patients, 76 had their management decisions altered following an in-practice ECG.
• 14 hospital referrals were avoided, 18 patients were admitted to acute hospitals, and 24 were referred for further hospital investigation.

Conclusions:

• Nurse-led ECGs in primary care settings can significantly impact patient management decisions.
• The findings suggest a potential for reducing unnecessary hospital referrals and admissions through expanded nursing roles.
• Implementing in-practice ECGs requires careful consideration of practice-specific utilization rates and outcomes.