[The team-based care models in primary care: General Practitioners' perspectives on nurses' role.]

Area of Science:

• Primary Care
• Nursing Roles
• Team-Based Care

Background:

• Recent Italian primary care reforms have introduced team-based models integrating General Practitioners (GPs) with nurses.
• Understanding GP perspectives on nurse roles is crucial for effective collaboration in these evolving models.

Purpose of the Study:

• To explore General Practitioners' (GPs) attitudes towards the roles and autonomy of nurses within primary care settings.
• To identify specific areas where GPs perceive nurses can operate independently or require supervision.

Main Methods:

• A two-phase study involving a focus group with 12 GPs to define potential nurse responsibilities.
• A subsequent questionnaire administered to 45 GPs, assessing their views on nurse autonomy for various patient groups and tasks.
• Interviews were conducted with participating GPs to further clarify their responses.

Main Results:

• GPs granted nurses autonomy in health promotion, lifestyle education, fall prevention, malnutrition screening, and treatment adherence.
• Nurses were seen to require GP supervision for managing chronic conditions, particularly monitoring deterioration and specific health education aspects.
• GPs retained primary responsibility for complex, unstable patients (e.g., heart failure) due to unpredictable clinical trajectories.

Conclusions:

• General Practitioners generally hold a positive view of nurses' contributions in primary care.
• Perceived nurse autonomy is contingent upon patient clinical stability and the complexity of their health conditions.