Nurse-led protocols are effective for managing outpatient care of chronic illnesses, according to an article being published in Annals of Internal Medicine.
Chronic diseases cause a substantial burden to the U.S. health care system and account for about 75 percent of every health care dollar spent. There are well-established clinical practice guidelines for the outpatient management of chronic illnesses, but access to quality and appropriate care can be an issue, especially considering the nation's shortage of primary care physicians. Some groups have suggested that quality care be delivered through a team-based approach, which the American College of Physicians calls the "patient-centered medical home".
One new model of the medical home may involve nurse-managed protocols for routine outpatient care of chronic diseases. Researchers conducted a systematic review of published evidence to determine whether nurse-managed protocols are effective for outpatient management of adults with diabetes, hypertension, and hyperlipidemia, common chronic illnesses that require ongoing outpatient management. They found that a patient-centered medical home model using nurse-managed protocols helps to improve health outcomes for patients with moderately severe diabetes, hypertension, and hyperlipidemia, and that RNs can successfully titrate medications according to protocols for these conditions.