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Optimizing the use of telephone nursing advice for upper respiratory infection symptoms
Rosalind Harper, Tanya Temkin, Reena Bhargava1
1710 Lawrence Expressway, Santa Clara, CA 95051-5173.
Objectives:
To describe efforts to optimize telephone self-care advice for upper respiratory infection (URI) symptoms by registered nurses in Kaiser Permanente Northern California's Appointment and Advice Call Center, and to assess the sufficiency of this advice.
Study Design:
Retrospective observational study.
Methods:
The study sample included 279,625 calls from adults 18 years and older that resulted in self-care advice for URI symptoms in 2009. Utilizing electronic medical records of these calls and follow-ups, we determined the rate of return calls within 7 days and the clinical outcomes associated with these. Advice for self-care at home was considered sufficient if no return calls received within 7 days of the original call were associated with the need for a "higher" level of care, such as an appointment.
Results:
Self-care advice was sufficient for 88% of index advice calls, with either no follow-up calls within 7 days associated with a higher level of care, or follow-up calls only for additional advice or nonmedical information.
Conclusions:
Telephone advice for self-care by registered nurses can effectively manage URI symptoms for most otherwise healthy adults.
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