IMPROVING THE EFFICIENCY OF NURSING SERVICES IN ORGANIZING PATIENT CARE AT THE PRIMARY HEALTH CARE LEVEL
DOI:
https://doi.org/10.55640/Keywords:
primary health care, nursing services, patient-centered care, healthcare management, efficiency model, quality improvement.Abstract
Primary health care (PHC) plays a central role in ensuring accessibility, continuity, and quality of medical services [11,12]. Nurses constitute the largest workforce in PHC and significantly influence patient outcomes [2,3]. However, organizational inefficiencies, workload imbalance, limited autonomy, and insufficient digital integration reduce the effectiveness of nursing services [15,29,30]. This study aims to identify modern organizational models and evidence-based strategies to improve the efficiency of nursing services in organizing patient care at the primary health care level. A mixed-method analytical study was conducted, including structural analysis, workload assessment, and evaluation of patient satisfaction indicators. The findings demonstrate that implementing patient-centered care models [10,28], digital documentation systems [6], standardized nursing protocols [1], and expanded nurse autonomy [7,16] significantly improve care quality, reduce hospitalization rates, and increase patient satisfaction [14,24]. The study concludes that systematic modernization of nursing service organization is essential for strengthening PHC performance.
Downloads
References
1.McCullough K., Andrew L., Genoni A., et al. An examination of primary health care nursing service evaluation using the Donabedian model: a systematic review. Res Nurs Health. 2023;46(1):159–176.
2.Keleher H., Parker R., Abdulwadud O., Francis K. Systematic review of the effectiveness of primary care nursing. Int J Nurs Pract. 2009;15(1):16–24.
3.Effectiveness of registered nurses on patient outcomes in primary care: a systematic review. BMC Health Serv Res. 2022.
4.Abdikadirova I., Yermukhanova L., Blaževičiene A., et al. Patient satisfaction with the expanded nurses service in primary health care: evidence from Kazakhstan. Healthcare (Basel). 2025;13(24):3314.
5.Nursing practice in primary care and patients’ experience of care. PubMed. 2018.
6.Vaughan C., Lukewich J., Mathews M., et al. Nursing contributions to virtual models of care in primary care: a scoping review protocol. BMJ Open. 2022;12(9):e065779.
7.Côté N., Freeman A., Jean E., et al. New understanding of primary health care nurse practitioner role optimisation. BMC Health Serv Res. 2019;19:882.
8.Horton M., Dixon J., Turi E., et al. Advanced practice nurses in primary care and their impact on health services utilisation, costs and access globally: a scoping review. J Clin Nurs. 2025;34(5):1592–1601.
9.Pullen C., Edwards J.B., Lenz C.L., Alley N. A comprehensive primary health care delivery model. J Prof Nurs. 1994;10(4):201–208.
10.Abukari K., Petrucka P.M. A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC Nurs. 2021;20:158.
11.Muldoon L.K., Hogg W.E., Levitt M. Primary care (PC) and primary health care (PHC): what’s the difference? Can J Public Health. 2006;87(5):409–411.
12.National Academies of Sciences, Engineering, and Medicine. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care. Washington, D.C.: National Academies Press; 2021.
13.Sav A., Kendall E., McMillan S.S., et al. Reforming primary health care: research informing nurse practitioner policy. J Clin Nurs. 2016.
14.Swan M., Ferguson S., Chang A., Larson E., Smaldone A. Quality and safety outcomes of nurse-managed care: a systematic review. Int J Nurs Stud. 2015.
15.Poghosyan L., Lucero R.J., Rauch D.A., Berkowitz B. Nurse practitioner organizational climate in primary care settings: implications for professional practice. J Prof Nurs. 2017.
16.Laurant M., van der Biezen M., Wijers N., et al. Nurses as substitutes for doctors in primary care. Cochrane Database Syst Rev. 2018.
17.Horrocks S., Anderson E., Salisbury C. Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. BMJ. 2002.
18.Xue Y., Ye Z., Brewer C., Spetz J. Impact of nurse practitioners on health outcomes of Medicare and Medicaid patients. Med Care Res Rev. 2016.
19.Poghosyan L., Ghaffari-Rafi A., et al. Relationship of nurse practitioners’ collaboration with physicians to patient outcomes. Med Care Res Rev. 2019.
20.Canadian Nurse Practitioner Initiative. Primary Health Care Performance Measurement Framework for NPs. 2019.
21.Carter N., et al. Policy implications of the role and practice of advanced nurse practitioners. J Health Serv Res Policy. 2009.
22.Horvat L., Horey D., Romios P., Kis-Rigo J. Cultural competence education for health professionals. Cochrane Database Syst Rev. 2014.
23.Poghosyan L., Nichols E., Martin-Misener R., et al. Primary care providers’ perspectives on nurse practitioner role. Int J Nurs Stud. 2018.
24.Williams A.M., Irurita V.F., et al. Patient outcomes and nurse practitioner care: a systematic review. J Am Acad Nurse Pract. 2011.
25.Shaw T., Isham L., Colquhoun M., et al. Evaluating the impact of nursing in community care. J Adv Nurs. 2018.
26.Lovink M., Raine R., De Brún A., et al. Collaborative care and case management in primary care for adults with chronic conditions. Health Serv Res. 2017.
27.Sibbald B., Laurant M., Scott A. Role of nurses in primary care. Policy Reviews; 2016.
28.Kim M.N., Lee A., Lee S. Patient-centered care interventions on patient outcomes. BMC Health Serv Res. 2020.
29.Drennan V.M., Griffiths P. Workforce skill mix and task shifting in primary care. Int J Nurs Stud. 2015.
30.Buerhaus P.I., Skinner L.E., Auerbach D.I., Staiger D.O. Four challenges facing the nursing workforce in the United States. J Nurs Regul. 2017.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain the copyright of their manuscripts, and all Open Access articles are disseminated under the terms of the Creative Commons Attribution License 4.0 (CC-BY), which licenses unrestricted use, distribution, and reproduction in any medium, provided that the original work is appropriately cited. The use of general descriptive names, trade names, trademarks, and so forth in this publication, even if not specifically identified, does not imply that these names are not protected by the relevant laws and regulations.
Germany
United States of America
Italy
United Kingdom
France
Canada
Uzbekistan
Japan
Republic of Korea
Australia
Spain
Switzerland
Sweden
Netherlands
China
India
