Daily practices of advanced practice nurses within a multi-professional primary care practice in Switzerland: a qualitative analysis.
Advanced practice nursing
Primary care
Qualitative research
Journal
BMC primary care
ISSN: 2731-4553
Titre abrégé: BMC Prim Care
Pays: England
ID NLM: 9918300889006676
Informations de publication
Date de publication:
21 01 2023
21 01 2023
Historique:
received:
21
10
2022
accepted:
09
01
2023
entrez:
21
1
2023
pubmed:
22
1
2023
medline:
25
1
2023
Statut:
epublish
Résumé
The rising global population of older persons with chronic conditions demands new primary care models. Advanced practice nurses (APNs) can help meet that need. In Switzerland, APNs have only recently been introduced in primary care and little is known about their daily practice. This study aims to describe APNs' activities and general roles at four sites with multi-professional primary care practices in the Swiss cantons of Bern and Solothurn. To study the practices of APNs at the study sites, we adopted a social constructivist perspective, lending methods from ethnographic field research. We interviewed, observed and accompanied participants over five months, generating rich data on their daily practices. The analysis followed Braun and Clarke's six-step thematic analysis process. The APNs' daily practices cover three main themes. Their core activities are working with expanded clinical skills and being on-site specialists for patients and their relatives. These practices are surrounded by net activities, i.e., taking care of patients in tandem with the physicians and regular visits in residential long-term care facilities. The outer activity layer consists of cohesive activities, with which APNs anchor and facilitate their role and catalyze further development of the care model. APNs tailor their expanded medical knowledge and nursing practice to maximize the value they provide in patient care. This study extends our knowledge of APNs' daily practice within a Swiss multi-professional primary care practice. Our results indicate competencies that need to be integrated in APN education and point out the high potential of APN integration in such primary care practices.
Sections du résumé
BACKGROUND
The rising global population of older persons with chronic conditions demands new primary care models. Advanced practice nurses (APNs) can help meet that need. In Switzerland, APNs have only recently been introduced in primary care and little is known about their daily practice. This study aims to describe APNs' activities and general roles at four sites with multi-professional primary care practices in the Swiss cantons of Bern and Solothurn.
METHODS
To study the practices of APNs at the study sites, we adopted a social constructivist perspective, lending methods from ethnographic field research. We interviewed, observed and accompanied participants over five months, generating rich data on their daily practices. The analysis followed Braun and Clarke's six-step thematic analysis process.
RESULTS
The APNs' daily practices cover three main themes. Their core activities are working with expanded clinical skills and being on-site specialists for patients and their relatives. These practices are surrounded by net activities, i.e., taking care of patients in tandem with the physicians and regular visits in residential long-term care facilities. The outer activity layer consists of cohesive activities, with which APNs anchor and facilitate their role and catalyze further development of the care model. APNs tailor their expanded medical knowledge and nursing practice to maximize the value they provide in patient care.
CONCLUSIONS
This study extends our knowledge of APNs' daily practice within a Swiss multi-professional primary care practice. Our results indicate competencies that need to be integrated in APN education and point out the high potential of APN integration in such primary care practices.
Identifiants
pubmed: 36681797
doi: 10.1186/s12875-023-01977-y
pii: 10.1186/s12875-023-01977-y
pmc: PMC9862513
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
26Informations de copyright
© 2023. The Author(s).
Références
J Am Assoc Nurse Pract. 2019 Dec;31(12):705-711
pubmed: 30951009
BMC Fam Pract. 2019 Nov 27;20(1):163
pubmed: 31775651
J Gen Intern Med. 2017 Mar;32(3):284-290
pubmed: 27798780
Swiss Med Wkly. 2022 Jul 01;152:w30199
pubmed: 35816630
J Am Acad Nurse Pract. 2006 Jul;18(7):325-34
pubmed: 16827838
Int J Nurs Stud. 2017 Sep;74:1-7
pubmed: 28577459
BMC Fam Pract. 2020 Aug 13;21(1):164
pubmed: 32791993
Health Aff (Millwood). 2014 Dec;33(12):2247-55
pubmed: 25410260
Praxis (Bern 1994). 2017 Apr;106(9):459-464
pubmed: 28443716
BMC Nurs. 2020 Jan 02;19:1
pubmed: 31908597
Int J Qual Stud Health Well-being. 2014 Oct 16;9:26152
pubmed: 25326092
Nurs Res Pract. 2014;2014:170514
pubmed: 25692039
Med J Aust. 2006 Jul 3;185(1):10-2
pubmed: 16813539
J Interprof Care. 2019 Nov-Dec;33(6):661-669
pubmed: 30681392
Can J Nurs Res. 2020 Dec;52(4):317-327
pubmed: 31530000
Ann Fam Med. 2018 May;16(3):250-256
pubmed: 29760030
Cien Saude Colet. 2020 Jan;25(1):303-314
pubmed: 31859878