PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of brjgenpracRCGP homepageJ R Coll Gen Pract at PubMed CentralBJGP at RCGPBJGP at RCGP
 
Br J Gen Pract. 1997 November; 47(424): 699–703.
PMCID: PMC1409960

An evaluation of a nurse-led ear care service in primary care: benefits and costs.

Abstract

BACKGROUND: Nurses trained in ear care provide a new model for the provision of services in general practice, with the aim of cost-effective treatment of minor ear and hearing problems that affect well-being and quality of life. AIM: To compare a prospective observational cohort study measuring health outcomes and resource use for patients with ear or hearing problems treated by nurses trained in ear care with similar patients treated by standard practice. METHOD: A total of 438 Rotherham and 196 Barnsley patients aged 16 years or over received two self-completion questionnaires: questionnaire 1 (Q1) on the day of consultation and questionnaire 2 (Q2) after three weeks. Primary measured outcomes were changes in discomfort and pain; secondary outcomes included the effect on normal life, health status, patient satisfaction, and resources used. RESULTS: After adjusting for differences at Q1, by Q2 there was no statistical evidence of a difference in discomfort and pain reduction, or differential change in health status between areas. Satisfaction with treatment was significantly higher (P = 0.0001) in Rotherham (91%) than in Barnsley (82%). Average total general practitioner (GP) consultations were lower in Rotherham at 0.4 per patient with an average cost of 6.28 Pounds compared with Barnsley at 1.4 per patient and an average cost of 22.53 Pounds (P = 0.04). Barnsley GPs prescribed more drugs per case (6% of total costs compared with 1.5%) and used more systemic antibiotics (P = 0.001). CONCLUSIONS: Nurses trained in ear care reduce costs, GP workload, and the use of systemic antibiotics, while increasing patient satisfaction with care. With understanding and support from GPs, such nurses are an example of how expanded nursing roles bring benefits to general practice. Nurses trained in ear care reduce treatment costs, reduce the use of antibiotics, educate patients in ear care, increase patient satisfaction, and raise ear awareness.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (905K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Davis AC. The prevalence of hearing impairment and reported hearing disability among adults in Great Britain. Int J Epidemiol. 1989 Dec;18(4):911–917. [PubMed]
  • Robertson DG, Bennett JD. The general practice 'management of otitis externa'. J R Army Med Corps. 1992 Feb;138(1):27–32. [PubMed]
  • Sharp JF, Wilson JA, Ross L, Barr-Hamilton RM. Ear wax removal: a survey of current practice. BMJ. 1990 Dec 1;301(6763):1251–1253. [PMC free article] [PubMed]
  • Newton VE, Hillier VF, Stephens SD. Prescription of hearing aids for the elderly: the views of general practitioners. J Laryngol Otol. 1992 Nov;106(11):963–966. [PubMed]
  • Bickerton RC, Roberts C, Little JT. Survey of general practitioners' treatment of the discharging ear. Br Med J (Clin Res Ed) 1988 Jun 11;296(6637):1649–1650. [PMC free article] [PubMed]
  • Fisher EW, Pfleiderer AG. Assessment of the otoscopic skills of general practitioners and medical students: is there room for improvement? Br J Gen Pract. 1992 Feb;42(355):65–67. [PMC free article] [PubMed]
  • Feldmeier JJ, Court WS, Davolt DA, Stegmann B, Heimbach RD, Sheffield PT. Hyperbaric oxygen therapy. Otolaryngol Head Neck Surg. 1997 Jun;116(6 Pt 1):703–704. [PubMed]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners