The diffusion of nursing clinics represents a strategic node of the primary care system because, operating in close functional connection with the GPs and the service network, they allow the monitoring of risk factors in the population and the management of subjects with chronic degenerative diseases, beyond to provide adequate care responses to acute events. Moreover, this care setting is one of the privileged places for the development of a proactive approach, aimed at overcoming the current model based on expectations.
Nursing Outpatients foresee the "taking charge" of the person through the evaluation of the need for assistance, the use of methodologies and planning tools for objectives and adequate information tools (nursing record). They perform the function of nursing in the community, in a multidisciplinary perspective; they are integrated into the district processes and, if the needs of the patient require a strong social-health integration, they envisage the use of Multi Dimensional Assessment (VMD) methodologies, contributing to the drafting of the Individual Assistance Plan (PAI).
Features and address lines
Nursing surgery means the physical structure or place, located in the territory and / or hospital, responsible for the provision of nursing care organized and managed directly by nursing staff, who is responsible under the DMS 739/94 and the law 251/00, article 1, paragraphs 1 and 3., for those patients who do not require admission even during the diurnal cycle.
The model of the Nursing Surgery (AA.II.), responds to the need to:
improve accessibility and usability of citizens for health services and primary health care services (primary care level), even in close functional collaboration with the Single Point of Social-Health Access (PUA).
establish a link between the hospital services, territorial (home care, mental health, geriatrics, maternal-child, disability of adults and children, outpatient specialist and General Practitioners) in order to ensure continuity of care;
ensure appropriate responses to the needs of nursing care of the population through the use of planning methodologies and tools for objectives and the definition of integrated care pathways.
to promote self-care processes in people, also in order to realize an active and conscious participation in the choices of a welfare nature (Empowerment of the Citizen).
promote health prevention and education activities.
Recognize the full assumption of responsibility and the autonomy of the nurse in the organization and management of the assistance in accordance with the regulations governing professional practice (DMS 739/94, Patto Infermerie-Cittadino 1996, L.42 / 99 , Deontological Code 1999, Law n ° 251/00, Law n. 1/2002, Didactic Classifications of the Degree Classes / 02).
As part of their functions, nursing clinics promote self-care processes in people, also in order to achieve active and conscious participation in care choices, thus contributing to the citizen's empowerment processes, which are one of the key elements of present Health Plan.
As part of the welfare processes, additional services can be included, which can be traced back to those envisaged in the professional profile (DMS 739/94). In this case, the Companies will have to act with their own actions to include these services in the nomenclatori-tariffari aziendali and specify to be fully charged to the users.
The information flow
The activity of Nursing Outpatients is systematically detected and transmitted to the Company Information System. The nursing services whose code is present in the tariff nomenclator of the Lazio Region, are transmitted to the Public Health Agency for registration in the SIAS stream.
The SIAS provides a field, "CODAMB", column 127-130 of the health file, which identifies the outpatient office that performs the service. For the nursing clinic the code "04" must be used followed by a progressive number for a total of 4 characters. Therefore, if the main facility has two nursing surgeries it will register the first with "0401" and the second with "0402".
Therefore, the SIAS structure will record the information with: ASL Code; SIAS Code, Performance (code, quantity, amount, specialty, etc) and the coded Surgery field as described above.
Nursing services not included in the tariff nomenclature must be sent to the Health Department and to the ASP for the periodic evaluation of the implemented activities.