How nurse-led models of care are reshaping healthcare – ACT’s Walk in Centres

Advanced Practice Nurse Kirsten Madsen Photographer: Rohan Thomson

Nurses working in nurse-led models of care undertake comprehensive assessment, provide timely person-centred care, opportunistic education and support, continuity of care and link patients to other health professionals and services.

Underpinned by advanced practice nursing care, innovative and cost-effective nurse-led models of care aim to improve access to healthcare and give people choice while also enhancing the patient’s experience.

Over four weeks ANMJ is delving into what nurse led-models of care are while featuring different models across Australia in a four part series.

This week we look at nurse-led walk in centres.

In 2010, the ACT Government unveiled its first Walk-In-Centre in Canberra offering free healthcare for minor injuries and illnesses.

Open daily from 7.30am to 10pm, the centres, which now exist across five locations, are led by highly-skilled nurse practitioners and advanced practice nurses who provide treatment for a range of health issues, including but not limited to, cold and flu, cuts and burns, sinus infections and minor infections and wounds.

Nurses can remove sutures, apply wound dressings, offer emergency contraception, carry out blood glucose tests, treat minor fractures and provide X-ray referrals for suspected uncomplicated fractures.

Opportunistic health promotion, education and intervention is a core objective.

Kristen Madsen  –  Photographer: Rohan Thomson

Based at the Tuggeranong Walk-In-Centre, Advanced Practice Nurse Kirsten Madsen joined the service four years ago after two decades working in intensive care.

“It was the opportunity to work autonomously in an innovative, quite unique healthcare service alongside other nurses,” Kirsten says of the appeal.

The nurse-led model of care was established to relieve pressure from the Canberra Hospital’s Emergency Department by providing an alternative healthcare option.

Nurses work collaboratively with GPs and link patients with other health services, such as the Canberra Sexual Health Centre or dental and allied health professionals.

“It’s having that knowledge and helping people in their moment of need but then being able to refer them onto the next step for their healthcare.”

Before COVID-19, three of the centres were seeing a total of 250-300 patients each day – respiratory tract infections remain the most common reason people present.

The Weston Creek clinic rapidly transitioned into a COVID-19 testing/respiratory assessment centre in early March at the height of the pandemic.

Kirsten says the Walk-In-Centres encounter a wide-range of clinical scenarios.

On a recent shift, she treated people aged from 11 to 60.

There was an ankle sprain, a person with a stye, someone with infected toenails, and an acute wound dressing that needed applying.

Nurses hail from diverse clinical backgrounds such as sexual health, ED, ICU, mental health and general practice.

Kristen Madsen  –  Photographer: Rohan Thomson

“There’s a lot of incredibly skilled and intelligent nurses working across all areas of healthcare and I believe this nurse-led model of care gives us the opportunity to utilise our skills and work to our full scope. We work autonomously and we’re cost-effective,” Kirsten says.

The Walk-In-Centres provide greater access to healthcare, particularly for marginalised groups.

“There are a lot of people who are disengaged from the health system and they don’t have the financial means to access GPs on a regular basis for their healthcare needs so I think we provide an important part of the answer for these people.”

Kirsten says success is measured by how many people present, wait and consultation times, a breakdown of the most common presentations and critically, consumer feedback.

“I think the service provides people with timely access to high-quality healthcare and we are supported by management to take as long as we need to deliver the best care. I think we make a difference.”

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