Involvement of Advanced Practice Nurse in the Management of Geriatric Conditions: Examples from Different Countries

Fougère, Bertrand; Lagourdette, Christine; Abele, Patricia; Rantz, Marilyn; Lai, Cky; Chen, Q.; Moyle, Wendy; Vellas, Bruno; Morley, John E.

doi:10.1007/s12603-018-1008-6

Cited by 12 publications

(20 citation statements)

References 88 publications

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“…to the management of patients' health and well-being needs regardless of diagnosis. For example, older adults can be seen as a vulnerable group, and research has found that NPs caring for older adults focus on maintaining their health through health-promoting treatments, chronic disease management and the diagnosis and treatment of minor acute illnesses (85,89).…”

Section: Role and Scope Of Practice Of Nurse Practitioners Working In Primary Carementioning

confidence: 99%

The integration of new nurse practitioners into care of older adults: A survey study

Henni

Kirkevold

Antypas

et al. 2019

Journal of Clinical Nursing

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Background: Older adults constitute an important population group receiving primary care services. Registered nurses (RNs) need comprehensive knowledge and skills to adequately address the complex needs of frail older adults. Despite the need for RNs with advanced qualifications, integrating the new advanced roles for RNs into interdisciplinary teams has proved to be challenging. Previous research on the integration of new advanced roles for RNs indicates that the degree to which they are integrated into their workplaces affects how they use their knowledge and skills. Integration is therefore seen as important in this study, which focuses on the introduction of advanced geriatric nurses (AGNs) into the Norwegian healthcare system. Aims:The overall aim of this study was to investigate the role of AGNs, what AGNs and their collaborators see as an appropriate scope of practice for these nurses and how AGNs are being integrated into the Norwegian healthcare system. The aim was investigated through three sub-studies that: I) describe AGNs' experiences in their new role, II) investigate the level of agreement among AGNs, their colleagues and their leaders regarding which activities related to different functions are seen as appropriate for AGNs and III) investigate the degree to which AGNs are integrated into their workplaces. Methods:The study employed an exploratory sequential mixed methods design. In 2016, each AGN in the total sample of AGNs in Norway (N = 21) was interviewed about her/his role. In 2017, 23 AGNs and 195 of their colleagues (including leaders) answered a questionnaire focusing on the integration of AGNs and their scope of practice. The interview data were analysed by content analysis (Sub-study I). A series of cross-tabulations were conducted to identify the respondents' reporting of the appropriateness of different activities (Sub-study II). The survey data pertaining to the integration of the AGNs were analysed through cross-tabulations, Pearson's chi-squared test, Fisher's exact test and the Kruskal-Wallis test (Sub-study III). Results:The AGNs explained that they had developed a complex and extensive role and that they had developed a new 'gaze' based on a combination of their new knowledge and skills with their experience and interests. This new gaze provided them with the ability to see a wider range of medical, social and environmental problems in the older adults' situations compared to before they started the educational programme. The AGNs related that How to cite this article:

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Section: Role and Scope Of Practice Of Nurse Practitioners Working In Primary Carementioning

confidence: 99%

The integration of new nurse practitioners into care of older adults: A survey study

Henni

Kirkevold

Antypas

et al. 2019

Journal of Clinical Nursing

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show abstract

“…Several US studies adopted the quality improvement (QI) and safety approach by: a) testing programme results (Fortinsky et al 2014;Ganz et al 2010;Ouslander et al 2011;Rantz et al 2010;Reuben et al 2013) , b) comparing care by provider type -NPs vs. primary care physicians (Jennings et al 2016) and c) implementing an evidence-based quality improvement program (Donald et al 2013;Unroe et al 2015).…”

Section: Striving For Quality Improvement and Safetymentioning

confidence: 99%

“…In regard to independent functions, US APNs provided a critical link to evidence-based practice and focused on QI and patient safety (Donald et al 2013;Jennings et al 2016;Ouslander et al 2011;Reuben et al 2013;Unroe et al 2015). This finding reflected US health policy focus on improving quality, while reducing Medicare costs and enhancing primary care (Fortinsky et al 2014). Therefore, as physician substitutes, APNs in the US enhanced mutual accountability (strategy #2) and strove for an enabling environment (strategy #5) in order to provide elderly centred care.…”

Section: Apn Contributions By Role Ipchs Strategies and Approachesmentioning

confidence: 99%

Integrated older people care and advanced practice nursing: an evidence‐based review

Prajankett

Markaki

2020

International Nursing Review

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Aim: To critically appraise and synthesize evidence of integrated care stemming from advanced practice nursing in elderly primary care settings throughout the United States and Thailand. Background: Advanced practice nurses are key to accelerating integrated elderly care in the community. Yet, their scope and capacity vary greatly across countries, making impact measurement highly challenging. Methods: A systematic search of PubMed, CINAHL, Scopus and ThaiJo databases was performed. Full-text articles in English or Thai language were reviewed using an inductive thematic approach from the integrated people-centred Health Services framework, adopted by the World Health Organization. Results: A total of 42 articles were appraised according to framework strategies: (1) people and community empowerment/engagement;(2) governance and accountability strengthening; (3) model of care reorientation; (4) service coordination; and (5) enabling environment creation. Collaborative roles and empowerment of older people were associated with higher quality of care. Thai nurses empowered individuals through community networks and resources, incorporating care models (strategy 1). In contrast, US nurses adopted a quality improvement and safety approach, incorporating technology into nursing interventions (strategy 5). Conclusion: Advanced practice nurses employ an array of strategies and approaches in caring for older people. Although their role varies from mostly substitute (US) to supplemental (Thailand), nurses in both countries contribute towards integrated person-centred care. Implication for nursing practice and nursing policy: Preparing advanced practice nurses to work in the community is a prerequisite for meeting ageing population health needs in a sustainable manner. Education, professional development and leadership training opportunities should focus on capacity building in: a) strengthening mutual accountability, b) reorienting the work environment through innovative care models and c) coordinating services through partnerships to achieve universal health and ensure healthy ageing.

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“…The nurse practitioner (NP) role is being expanded globally as an innovative solution to managing the increasing healthcare demands of older adults with chronic diseases [1][2][3], a group that often has complex healthcare needs requiring provider continuity. NPs' unique advanced nursing and extended medical skills are important in caring for this group.…”

Section: Introductionmentioning

confidence: 99%

Swedish stakeholders' views of the preparatory work needed before introducing the nurse practitioner role in municipal healthcare–A focus group study

Ljungbeck,

Carlson,

Forss

2023

Scandinavian Caring Sciences

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BackgroundThe nurse practitioner role has become important globally in handling the growing healthcare needs of older adults with chronic diseases. Nevertheless, research shows that introducing the role is a complex process, and more studies are needed to prepare for its introduction into different healthcare contexts, such as municipal healthcare.AimThe aim is to investigate what Swedish stakeholders identify as the preparatory work needed before introducing the nurse practitioner role into municipal healthcare.MethodsData were collected through four focus group interviews conducted virtually on the TEAMS digital platform, with three to six participants in each group and 18 participants total. The transcribed interviews were analysed using a six‐step thematic approach: familiarisation with the data, coding the data, generating initial themes, reviewing themes, defining and naming the themes and producing the report.FindingsThe findings are divided into two main themes, each with two sub‐themes. In the first, clarifying why the nurse practitioner role is needed, participants stressed the importance of having a clear intention for introducing the role. The second, ensure a national framework to bolster the introduction at the local level, demonstrates the need for collaboration among national actors to clarify the role's mandate and authority before its introduction.ConclusionsAdding the nurse practitioner role to municipal healthcare can help increase the supply of nursing competence and the quality of patient care, but preparation for introducing the role requires extensive work. The development of the nurse practitioner role requires decision‐makers and leaders to take primary responsibility for its introduction. This study can support countries in the early phase of developing the nurse practitioner role by identifying both best practices and pitfalls.

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Involvement of Advanced Practice Nurse in the Management of Geriatric Conditions: Examples from Different Countries

Cited by 12 publications

References 88 publications

The integration of new nurse practitioners into care of older adults: A survey study

The integration of new nurse practitioners into care of older adults: A survey study

Integrated older people care and advanced practice nursing: an evidence‐based review

Swedish stakeholders' views of the preparatory work needed before introducing the nurse practitioner role in municipal healthcare–A focus group study

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