Nurse-led consultations and nurse-led care models in primary care: from evidence to real-world best-practices

Ann Van Hecke, Leen Roobaert, Kristel De Vliegher, Sahar Kharaghanipour

Keywords: Nurse-led care - Nurse-led consultation - best-pratice - Advanced Practice Nursing - Primary care

Introduction:

Background: In many countries, healthcare systems are under pressure as evidenced by the scarcity of healthcare professionals, general practitioners, nurses and other primary care actors, and by prolonged waiting times and decreased healthcare access. A key explanation for these challenges are societal evolutions, such as an ageing population and an increased prevalence of chronic conditions and comorbidity. As a result, patients not only need more care, but also need more complex and comprehensive care. The debate on future-proof healthcare systems has long been suggesting that nurses can take on more advanced roles and set-up nurse-led consultations/care models. Based on their core competencies, nurses can contribute to qualitative and efficient primary care. Their skills and competencies deserve more recognition, a legal, organizational and financial framework and a clear visible place as a crucial partner in the primary healthcare of today and tomorrow.

Aim(s):

Learning objectives: (1) To describe the nursing profiles (in primary care) in Belgium and state of the art on nurse-led consultations/nurse-led care models in primary care; (2) To describe international and national good practices in primary care; (3) To provide insights in perspectives of stakeholders involved in the development and implementation of nurse-led consultations / nurse-led care models in primary care; and (4) to discuss with the audience the facilitating and inhibiting factors, and future domains for nurse-led consultations and nurse-led care models in innovative practice organizations in primary care.

Programme:

Contributions
Introduction + Contribution 1: Nursing profiles in Belgium and state of the art on nurse-led consultations/nurse-led care models in primary care Presenter: Prof. dr. Ann Van Hecke (14 minutes)

In 2018, the federal council of nurses outlined a model for future proof nursing profiles. In 2023, the cabinet of the minister of health initiated the reform of the nursing profession, outlined the different authorities of these nursing profiles, and took several initiatives to support primary care. In this presentation, an overview of these nursing profiles in primary care will be presented. The role descriptions and educational backgrounds of these nursing profiles within the context of primary care will be outlined.
Nursing profiles like nurses in GP practices and advanced practice nurses in primary care are well placed to provide nurse consultations and coordinate nurse-led care models. Therefore, the state of the art of nurse consultations and nurse-led care models within an interprofessional team approach in primary care will also be given, with a focus on patient, organizational and team based outcomes.

Contribution 2: What can we learn from (inter)national best-practices on nurse-led consultations and nurse-led care models? Presenter: Leen Roobaert (12 minutes)
In this presentation, we want to strengthen the knowledge base on nursing in primary care by exchanging experiences from national and international best-practices. First, results of an international exploration (field visits in Canada, the Netherlands and Belgium) on the role of nurses in primary care will be presented. Also, lessons learned based on the KCE 2023 report will be integrated. Contextual factors will be reported that have perceived as facilitators or barriers in implementation of nurse-led consultations and nurse-led care models in these good practices. Stakeholders perspectives in a community healthcare centre who were involved in the development and implementation of nurse-led consultations/care models will be outlined.

Contribution 3: Street Nursing: Exploring its intrinsic value in promoting community health and social inclusion Presenters: Sahar Kharaghanipour and Kristel De Vliegher (12 minutes)

Street nursing has emerged as an innovative approach to healthcare delivery, particularly in urban settings. In this session, we delve into a best practice of the White and Yellow Cross on street nursing in two provinces in Flanders. One of the advantages of these initiatives is its capacity to provide timely and tailored care, to address immediate health concerns while also establishing rapport with individuals who may be reluctant to seek conventional medical assistance. This connection serves as a catalyst for ongoing healthcare engagement. Through the provision of basic healthcare services, education, and resource linkage, street nurses empower individuals to take control of their health. This empowerment extends beyond medical interventions to encompass aspects of social integration, breaking down barriers to accessing housing, employment, and community support services. By meeting people where they are, street nursing actively contributes to reducing health disparities.

Discussion on implications and future perspectives, chaired by Prof. dr. Ann Van Hecke (25 minutes)
Interactive discussions with the audience will be held (1) to facilitate the translation of the evidence-based knowledge on nurse-led consultations and nurse-led care models into recommendations applicable for their personal working context and related to the Belgian primary care context, (2) to discuss on future domains in primary care in which nurse-led consultations and nurse-led care models could be promising, and (3) to reflect on barriers and facilitators in future implementation of nurse-led consultations and nurse-led care models in primary care in Belgium.

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