Advanced practice nurses in primary care in Switzerland: an analysis of interprofessional collaboration

Abstract

BackgroundThe increase in the number of chronically ill patients due to ageing is calling existing models of primary care (PC) into question. New care models have recently been implemented in Swiss PC and involve interprofessional teams. This paper aimed to investigate the practice of interprofessional collaboration between advanced practice nurses, registered nurses, and medical practice assistants within new models of PC in Switzerland using the National Interprofessional Competency Framework.MethodsAn ethnographic design comprising semi-structured interviews and non-participant observations was conducted. Sixteen interviews were conducted with care providers at their PC practice. Interviewees included four advanced practice nurses, two registered nurses, six medical practice assistants, and four general practitioners. Nine other health professionals were subsequently observed in their practice. Interviews and observations were conducted by the first author from February to April 2019.ResultsOur analysis of interview and observational data confirmed that role clarification, team functioning, collaborative leadership, interprofessional conflict resolution, patient-centered care, and interprofessional communication have a significant influence on the interprofessional collaboration among health professionals in Swiss PC. Among these domains, role clarification and team functioning were the most frequently raised issues. Both were found to have the potential to negatively influence and, therefore, hinder efficient interprofessional collaboration within PC.ConclusionFrom the analysis, it emerged that role clarification is crucial for effective interprofessional collaboration within new care delivery models in the Swiss PC context. Our study results may inform international health policymakers and practitioners about six important domains of interprofessional care when implementing new care models. Practical experience with new models of care involving advanced practice nurses and medical practice assistants may also influence the regulation of the scope of practice of these health professionals in Switzerland.

The effect of ethical leadership on subjective wellbeing, given the moderator job satisfaction (a case study of private hospitals in Mashhad)

“…In this regard, the authors also conducted interviews with the nurses under study, which they also confirmed and stated that the ethical leadership style in the hospital can greatly affect their mental happiness and feeling of happiness. The second conclusion indicates that ethical leadership affects nurses’ job satisfaction, which is in line with the study of Ngabonzima et al, [ 35 ], Ganji et al, [ 36 ] and Tu et al, [ 15 ]. Moreover, the results also are in line with Freire and Bettencourt [ 12 ] study, shown the positive effect of ethical leadership on nurses’ job satisfaction.…”

General Practitioners' Experiences During the First Phase of the COVID-19 Pandemic in Italy: A Critical Incident Technique Study

“…In line with our findings, in the case of influenza outbreaks, teamwork and interprofessional collaboration were described as factors that can lead to a more adequate response ( 48 ). Healthy teams showed to be effective in preventing burnout among GPs ( 49 ), in improving professional motivation ( 50 , 51 ), and patient and family-centered care ( 52 ). That said, interprofessional collaboration and teamwork is not well-established among Italian GPs ( 53 ), and further research is needed to address the impact of the working environment on mental health, safety, and care delivery of Italian GPs during the COVID-19 pandemic.…”

Association between self-efficacy and general health: a cross-sectional study of the nursing population

“…The type of job is a key social determiner of health, which can affect individuals’ physical and psychological health statuses [ 1 ]. Nursing, as a stressful profession, is associated with a high level of skeletal/muscular stress, and psychologically speaking, it requires a high level of consciousness to respond to patients’ and their families’ medical needs as well as their key questions[ 2 , 3 ]. Moreover, the limited sources in nursing work environment, fatigue induced by long working shifts [ 4 ], less support by nurses with senior ranks, and organizational changes can add to the above-mentioned problems [ 2 , 5 ].…”