Abstract
BackgroundThe number of frail elderly people with complex nursing and medical care needs is increasing, and consequently, the healthcare burden. The implementation of Advanced Nurse Practitioners globally has been shown to make healthcare more effective and increase patient safety, continuity of care and access to care. In Sweden, research about Advanced Nurse Practitioners is limited. Thus, this study aimed to investigate the opinions of managers, doctors and nurses in primary care and municipal healthcare about the role of ANPs in municipal healthcare as a way to meet the increasing healthcare needs of the frail elderly.MethodsManagers, doctors and specialist nurses in primary care and municipal healthcare adopted a qualitative, descriptive design through 12 semi-structured interviews. The data were analysed using content analysis.ResultsThe participants expressed both opportunities as well as challenges with Advanced Nurse Practitioners in municipal healthcare. This role considered to satisfy frail elderly people’s healthcare needs and making the healthcare more effective as the doctors would have more time for other patients. The challenges mainly consist of doubts from the managers whether the nurses would be motivated to pursue further education to become an Advanced Nurse Practitioner if the role becomes a reality. The doctors were unsure if the nurses would consider taking the responsibility the role would imply.ConclusionsAdvanced Nurse Practitioner is considered to be a valuable resource not only for the frail elderly but also for the nurses in the municipal healthcare and for the doctors in primary care as they probably would make healthcare more effective. They might be a way to meet the increasing healthcare needs of frail elderly, however there are also challenges to overcome before they can become a reality in a Swedish healthcare context. Consequently, this role deserves further investigation.
Highlights
The number of frail elderly people with complex nursing and medical care needs is increasing, and the healthcare burden
International Council of Nurses (ICN) defines Advanced Nurse Practitioners (ANPs) as “A registered nurse that has the expert knowledge required, the ability to make complex decisions and clinical competence for an expanded work description, whose character is formed by the context and/or the country where he/she has the right to work” [6]
The unclear role ANPs have in the healthcare system [11,12,13] as well as doctors feeling their authority is being threatened has contributed to difficulties in implementing the role globally [14,15,16]
Summary
The number of frail elderly people with complex nursing and medical care needs is increasing, and the healthcare burden. The implementation of Advanced Nurse Practitioners globally has been shown to make healthcare more effective and increase patient safety, continuity of care and access to care. The shortage of doctors in primary care affects the continuity of care as well as the availability of healthcare for this vulnerable group It affects the nurses who work in municipal healthcare, as they find it difficult to make consultations with the doctors’ due this shortage [1, 2]. This is a risk to the patient safety and may lead to unnecessary hospitalizations of the frail elderly [2]. The unclear role ANPs have in the healthcare system [11,12,13] as well as doctors feeling their authority is being threatened has contributed to difficulties in implementing the role globally [14,15,16]
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