Time use of advanced practice nurses in hospitals: A cross‐sectional study

Abstract

Aims To examine the use of time by advanced practice nurses and time use differences according to type of healthcare organization, work experience, and supervisor. Design A cross‐sectional, observational study. Methods Non‐participant observations were executed in Belgium (October 2015–January 2016). Time use was categorized in domains (patient/family, team, healthcare organization) and roles (clinical expert, educator/coach, change agent/innovator, researcher, leader, collaborator, and ethical decision‐making facilitator). Proportional working time in domains and roles was calculated. Chi‐squared tests identified differences in time use according to type of healthcare organization, number of years of work experience, and type of hierarchical/functional supervisor. Results Participants mainly devoted time to the patient/family domain (30.78%) and the clinical expert role (34.19%). The role of leader and ethical decision‐making facilitator covered, respectively, 4.84% and 0.07% of participants’ time. Time distribution in domains and roles differed between participants in university and peripheral hospitals. Conclusion Activities were executed in all domains and roles, except for the ethical decision‐making facilitator role. Further research could uncover barriers and facilitators for role execution, especially about leadership and ethical decision‐making. Impact Advanced practice nurses, supervisors and policymakers could act to optimize advanced practice nurses’ scope of practice.

Delphi survey on the application of advanced practice nursing competencies: Strong points and unfinished business in cancer care

“…In the domains of research and evidence-based practice as well as professional leadership, a lower proportion of nurses met the standard established. Goemaes et al (2019) reported that nurses carried out activities mainly in the domain of the patient and family and also of the team and the health care organization. Regarding their role, APNs dedicated the most time to acting as expert clinicians and the least to exercising leadership, while they did not carry out any specific activities in the area of ethical decision-making.…”

“…Jean et al ( 2019 ) highlighted the lack of a legal framework or vision of the APN role in Spain as a barrier to the development and implementation of advanced nursing practice, so regulations establishing education and certification standards would favour the full development of advanced practice and improved health outcomes for patients (Heale & Rieck Buckley, 2015 ). On the other hand, the strategic, complete implementation of the APN role requires the involvement and support of the organization's managers and administrators, as well as the availability of curricula to educate and empower APNs (Dowling et al, 2013 ; Goemaes et al, 2019 ; Van Hecke et al, 2019 ).…”

“…Apart from education, constraints on time, space and resources were described as hampering the development of research competencies. In addition, nurses reported the need for more time for direct clinical practice, health promotion, education and teaching, and evidence‐based practice, suggesting that heavy workloads prevented them from developing practice‐specific competencies (Goemaes et al, 2019 ). This information is relevant and may be useful to managers working towards the implementation of these advanced practice roles.…”

Nurse Leaders’ Reflections and Difficulties Fighting the NCP Epidemic： A Qualitative Study

“…During the period of NCP prevalence, communication was hindered by increasing pressure, information overload, environment disorder, service interruption, personnel infection and death. Influential leaders must successfully control the environment [9,10], and ensure teamwork throughout the organization by building trust relationships and developing processes that allow teamwork [11].…”

What, when, and how long? Doula time use in a community doula program in San Francisco, California

“… 33 In healthcare settings, time-use studies are commonly used in the context of quality improvement and cost effectiveness. 34 Time-use studies with healthcare providers, 35 – 38 including community health workers, 39 – 41 exist, but we are not aware of any similar systematic efforts to track doulas’ time use.…”