Implantación de la gestión enfermera de la demanda en las entidades proveedoras de servicios de Atención Primaria de Salud de Cataluña

OBJECTIVE: To describe and analyse the implementaction of nurse demand managment (NDM) among health care providers in Catalonia from 2005 to 2014. DESIGN: Cross sectional survey. Participants All service providers in Catalonia (n = 37). Main measurements Interviews with nurse manager of each health care provides about ht barriers and facilitators concerning NDM. Facilitators and barriers were classified into 3 types: (i) health professional (competence, attitudes, motivation for change and individual characteristics); (ii) social context (patients and companions), and (iii) system related factors (organization and structure, economic incentives). RESULTS: Of the 37 providers, 26 (70.3%) have implemented the Demand Management Nurse (NDM). The main barriers identified are the nurse prescriptin regulation, lack of knowledge and skills of nurses, and the lack of protocols at the start of implantation. Among the facilitators are the specific training of professionals, a higher ratio of nurses to doctors, consensus circuits with all professionals and linking the implementation of NDM to economic incentives. DISCUSSION: NDM is consolidated in Catalonia. However, the NDM should be included in the curricula of nursing degree and continuing education programs in primary care teams.