Abstract
ntroduction: Primary care (PC) faces increasing demand due to the aging population and the rise in chronic conditions. To address this demand, the Conselleria de Sanidad of the Valencian Community introduced the Nursing Intervention Guide in Acute Processes (NIGAP) in 2023.
Objectives: To evaluate the level of knowledge and acceptance of the NIGAP among primary care professionals.
Materials and Methods: A cross-sectional study was conducted with the participation of professionals from primary care centers. An anonymous and self-administered questionnaire, distributed electronically, was used, consisting of 20 questions about demographic data, knowledge of the NIGAP (Likert scale), and perception of its utility.
Results: Of the 337 professionals surveyed, 79.5% were women and 33.2% were nurses. A higher proportion of specialist nurses believed that "Some or few" patients were informed about the NIGAP (p=0.004) and that "some or few" nurses were adequately trained (p=0.001). While nurses felt they managed "the majority" of NIGAP cases (p=0.001), primary care physicians (PCPs) believed that nurses resolved "Some or few" cases (p=0.001). Additionally, 64.4% considered that the IEPA promotes health education, and 56.4% believed it improves accessibility to health centers, with pediatricians being the most likely to recognize its benefits (p<0.001).
Conclusions: Although there is significant support for the NIGAP, improvements are needed in nursing staff training and interprofessional collaboration. It is essential to implement educational strategies that increase visibility and optimize the implementation of the NIGAP in PC.
References
Barómetro Sanitario 2023. Madrid: Ministerio de Sanidad. Disponible en: https://www.sanidad.gob.es/estadEstudios/estadisticas/BarometroSanitario/Barom_Sanit_2023/Barom_Sanit_2023_totales/Resumen_grafico_BS2023.pdf
Vidal Milla A, Fabrellas i Padrés N. Proceso patológico agudo: nivel de resolución de las enfermeras mediante una guía de actuación. Nursing (Ed. española). 2012; 30 (2):64-66. https://doi.org/10.1016/S0212-5382(12)70034-1
Plan de Acción de Atención Primaria y Comunitaria Proyecto Regional Integral (PRI) 2022/2023 Guía en procesos agudos: Intervención enfermería. Valencia: Conselleria de Sanitat Universal i Salud Pública. Disponible en: https://www.san.gva.es/documents/d/assistencia-sanitaria/4_guia-en-procesos-agudos-intervencion-enfermera-algoritmos-pdf.
Vara-Ortiz MÁ, Fabrellas Padrés N. Impacto de la formación y aspectos legales en la aplicación de la gestión enfermera de la demanda por parte de las enfermeras de atención primaria de Cataluña [Impact of training and legal aspects on the application of nurse demand management by primary care nurses in Catalonia]. Atención Primaria. 2022;54(11):102491. https://doi.org/10.1016/j.aprim.2022.102491
Román-Baquero J, Redondo-Collado D.Resolución enfermera de los procesos leves autolimitados en atención primaria: estudio descriptivo [Nurse resolution of self-limiting mild processes in health care. Descriptive study]. Atencion primaria. 2022; 54(4), 102219. https://doi.org/10.1016/j.aprim.2021.102219
Brugués Brugués A, Peris Grao A, Pavón Rodríguez F, Mateo Viladomat E, Gascón Ferret J, Flores Mateo G. Evaluación de la gestión enfermera de la demanda en atención primaria [Evaluation of Nurse Demand Management in Primary Care]. Atención Primaria. 2016;48(3):159-65 https://doi.org/10.1016/j.aprim.2015.02.014
Iglesias B, Ramos F, Serrano B, Fàbregas M, Sánchez C, García M J, Cebrian HM, Aragonés R, Casajuana J, Esgueva N, PIPA Group. A randomized controlled trial of nurses vs. doctors in the resolution of acute disease of low complexity in primary care. Journal of advanced nursing. 2013; 69(11), 2446–2457. https://doi.org/10.1111/jan.12120
Barnett M, Balkissoon C, Sandhu J. The level of quality care nurse practitioners provide compared with their physician colleagues in the primary care setting: A systematic review. J Am Assoc Nurse Pract. 2022;34(3):457-464. doi: 10.1097/JXX.0000000000000660. Erratum in: J Am Assoc Nurse Pract. 2022 Apr 01;34(4):696. doi: 10.1097/JXX.0000000000000718. PMID: 34678807.
Shannon G, Minckas N, Tan D, Haghparast-Bidgoli H, Batura N, Mannell J. Feminisation of the health workforce and wage conditions of health professions: an exploratory analysis. Hum Resour Health. 2019;17(1):72. doi: 10.1186/s12960-019-0406-0. Erratum in: Hum Resour Health. 2019;17(1):84. doi: 10.1186/s12960-019-0425-x.
Dall'Ora C, Saville C, Rubbo B, Turner L, Jones J, Griffiths P. Nurse staffing levels and patient outcomes: A systematic review of longitudinal studies. Int J Nurs Stud. 2022;134:104311. doi: https://10.1016/j.ijnurstu.2022.104311.
Butler M, Schultz TJ, Halligan P, Sheridan A, Kinsman L, Rotter T, Beaumier J, Kelly RG, Drennan J. Hospital nurse-staffing models and patient- and staff-related outcomes. Cochrane Database Syst Rev. 2019;4(4):CD007019. doi: https://10.1002/14651858.CD007019.pub3.
Abdelhadi N, Drach-Zahavy A, Srulovici E. The nurse's experience of decision-making processes in missed nursing care: A qualitative study. J Adv Nurs. 2020;76(8):2161-2170.doi: https://10.1016/j.ijnurstu.2022.104311.10.1111/jan.14387.
Málaga G, Cuba-Fuentes M, Rojas-Mezarina L, Romero-Albino Z, Hamb A, Paz-Soldán V. Estrategias para promover la alfabetización en salud desde la atención primaria: una perspectiva que considera las realidades de los países de ingresos medios y bajos. An Fac med. 2019;80(3):372-8. doi: https://10.15381/anales.803.16864
Catalán-Matamoros, D., Muñoz-Cruzado y Barba, M., & Fuentes Hervías, M. Técnicas de comunicación para la prevención y el control de enfermedades . Revista Española De Comunicación En Salud. 2016; 1(1): 50-65. Recuperado a partir de https://e-revistas.uc3m.es/index.php/RECS/article/view/3426
Pastor Redondo C, Pérez Monteagudo M, Rodríguez Sáwez M, Giner Pastor A, Martínez Seguí A, Estébanez Bautista ML, Viñas Asensio I, Puchades Company MJ, Navarro Martínez R, Borja Herrero, C. La intervención enfermera en procesos agudos leves clave en la gestión de la demanda: un estudio piloto. Enfermería integral: Revista científica del Colegio Oficial de Enfermería de Valencia. 2024; 138, 73-80.
Audet LA, Bourgault P, Rochefort CM. Associations between nurse education and experience and the risk of mortality and adverse events in acute care hospitals: A systematic review of observational studies. Int J Nurs Stud. 2018;80:128-146. doi: https://10.1016/j.ijnurstu.2018.01.007.
Brugués Brugués A, Cubells Asensio I, Flores Mateo G. Implantación de la gestión enfermera de la demanda en las entidades proveedoras de servicios de Atención Primaria de Salud de Cataluña [Implementation of nurse demand managment in primary health care service providers in Catalonia]. Atencion Primaria. 2017;49(9):518-524. doi: https://10.1016/j.aprim.2016.11.012.
Paterick TE, Patel N, Tajik AJ, Chandrasekaran K. Improving health outcomes through patient education and partnerships with patients. Proc (Bayl Univ Med Cent). 2017;30(1):112-113. doi: https://10.1080/08998280.2017.11929552.
Millas Ros J, Otegui Recio A, Pérez Gil S, Arzuaga Arambarri MJ, Martínez Eizaguirre JM, Insausti Carretero MJ. Consulta de atención primaria: ¿todo es del médico? Atención Primaria. 2011; 43 (10): 516-522.
World Health Organization. (2010). "Framework for Action on Interprofessional Education & Collaborative Practice." Geneva: WHO.
Reeves S, Pelone F, Harrison R, Goldman J, Zwarenstein M. Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2017;6(6):CD000072. doi: https://10.1002/14651858.CD000072.pub3.
National Academies of Science, Engineering, & Medicine. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. National Academies Press. https://doi.org.10.17226/25982.

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2025 RqR Quantitative and Qualitative Community Nursing Research
