[An approach to acute diseases using a nursing practice guide].

OBJECTIVE To evaluate the health results of patients who make spontaneous visits when attended by nurses in a primary health care team and by applying a nursing practice guide. DESIGN Cross-sectional, descriptive study. SETTING Primary health care team from the Barcelona metropolitan area, Spain. PARTICIPANTS Patients who request a spontaneous visit for the same day in the primary health care centre (PHC). INTERVENTION A nursing practice guide was prepared in which health problems were classified into 3 groups according to seriousness and possibility of being resolved by the nursing staff: a) group 1, problems where the protocols allowed that the nurse could finalise the process; b) group 2, problems that might require emergency action; and c) group 3, problems that required an assessment of the level of seriousness. When the patient arrived at the PHC requesting an urgent visit, and the problem fell into group 1 it was dealt with by a nurse. RESULTS There were 202 patients with health problems included in group 1.The mean age was 36.3 years (SD, 18.6 years).The most consulted health problems were musculo-skeletal (32.7%), followed by skin (22.3%), and the digestive system (22.3%). Of those, 63.9% of the problems were completely resolved and only 5.9% required visits by the out of hours doctor. DISCUSSION The nursing practice guide meant that the nurse became the entrance door to the primary care system, with a high possibility of resolving health problems.