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Nurse practitioner in Swedish municipal elderly care: A Delphi study of challenges and opportunities
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Municipal Healthcare in Hässleholm, Management of Care and Welfare, Malmö, Sweden.ORCID iD: 0000-0002-4714-4752
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Municipal Healthcare in Hässleholm, Management of Care and Welfare, Malmö, Sweden.ORCID iD: 0000-0002-3594-3944
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Municipal Healthcare in Hässleholm, Management of Care and Welfare, Malmö, Sweden.ORCID iD: 0000-0003-0077-9061
2023 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 37, no 1, p. 216-228Article in journal (Refereed) Published
Abstract [en]

Introduction Worldwide, countries are struggling with strained healthcare systems, especially due to the growing number of frail elderly. Developing the role of nurse practitioner in the care of the frail elderly is therefore of interest to make the care chain more efficient. In Sweden, the role is in an early development phase, but more research is needed. Aim The aim was to investigate how stakeholders at the national level express the challenges and opportunities of the evolving nurse practitioner role in Swedish municipal elderly care. Method A Delphi survey technique with three rounds of electronic questionnaires was used. Twenty-seven experts responded to the first questionnaire, containing two open questions; what opportunities respectively challenges do you see in developing and implementing the nurse practitioner role in municipal elderly care? The following questionnaires consisted of statements to rate using a four-grade Likert scale, and 20 and 17 responded to the second and third, respectively. The first round was analysed using content analysis, and the other two with descriptive statistics. Results Thirty-four statements about challenges and opportunities related to the nurse practitioner role in municipal elderly care were identified and rated as important. Conclusion The findings provide knowledge that can contribute to discussions and decisions to refine the nurse practitioner role in Swedish municipal elderly care. The nurse practitioner role may contribute with much-needed competence to the elderly care. However, it is important to consider the challenges that need to be overcome before the development of the role. To solve this, it is necessary to have clear national guidelines concerning issues of education, title protection and the mandate and authority of the NP role.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023. Vol. 37, no 1, p. 216-228
Keywords [en]
Delphi technique, frail elderly, municipal elderly care, nurse practitioner
National Category
Rheumatology and Autoimmunity
Identifiers
URN: urn:nbn:se:mau:diva-54470DOI: 10.1111/scs.13116ISI: 000837573400001PubMedID: 35942613Scopus ID: 2-s2.0-85135588410OAI: oai:DiVA.org:mau-54470DiVA, id: diva2:1689168
Available from: 2022-08-22 Created: 2022-08-22 Last updated: 2024-06-17Bibliographically approved
In thesis
1. Exploring the pioneering nurse practitioner role in Sweden: insights and perspectives for potential role development into municipal healthcare
Open this publication in new window or tab >>Exploring the pioneering nurse practitioner role in Sweden: insights and perspectives for potential role development into municipal healthcare
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The nurse practitioner role is undergoing a global evolution to meet the increasing demands of healthcare. The growing population of older adults with chronic illnesses and complex healthcare requirements presents a significant challenge to healthcare resources. These patients require person-centred care with consistent access to healthcare providers, a need that the nurse practitioner role might be equipped to fulfil. Nurse practitioners are seasoned professionals who have pursued additional education, typically at the master’s level. Their specialized expertise in advanced nursing and expanded medical skills enable them to autonomously manage both nursing and medical needs in clinical practice. In Sweden, the advancement of the nurse practitioner role is in its early phases, it lacks national regulation and formal recognition as a professionally protected title. Nonetheless, local initiatives to develop the role have been undertaken, and there is ongoing dialogue at the national level with interest from the Swedish Government in formalizing the role. This aligns with the evolving healthcare reform, and the transition from hospital-based care to home-based care. Consequently, this transition necessitates a heightened level of nursing expertise in municipal healthcare, a demand that could potentially be met by the nurse practitioner role. Nevertheless, the development of the nurse practitioner role is complex and necessitates further research and preparation. Therefore, the overall aim of this thesis is to explore the pioneering Nurse Practitioner role by situating it within the Swedish context, across diverse viewpoints to guide its potential role development into municipal healthcare. The thesis comprises four studies: three qualitative (I, III, IV) and one employing iterative qualitative and quantitative components (II). Study I involves a scoping review, that uses qualitative content analysis to examine 16 papers on content in nurse practitioner education. Study II, uses a Delphi survey approach in corporating three rounds of questionnaires with the aim of establishing consensus on challenges and opportunities for nurse practitioner role development. Content analysis was followed by descriptive statistics in subsequent rounds. Study III, a focus group study, uses thematic analysis to help identify the preparatory work required before introducing the nurse practitioner role into municipal healthcare. The final study (IV) is centred on Swedish nurse practitioners’ experiences working in this pioneering nursing role. The data collection for the fourth study involved 15 semi-structured individual interviews, which were examined using content analysis. The findings from these studies offer insights into the nurse practitioner role in a Swedish context across diverse viewpoints to guide potential role development in municipal healthcare. Study I presents the core content of nurse practitioner education, while Study II identifies challenges and opportunities. Study III deals with the preparatory work needed before role development and encompasses areas such as education, national and local regulation, and strategies to foster acceptance for the nurse practitioner role within the healthcare team. The findings from Study IV provide insights into the reality of working as a nurse practitioner in Sweden, providing crucial perspectives to consider in on-going role development. The thesis as a whole offers insights that can be of value in the preparatory phase for developing the nurse practitioner role. There must be a clear and compelling intention to enhance patient satisfaction when developing the NP role. For it to be accepted as a new professional nursing role, national guidelines are required to bolster local role development in healthcare teams.

Place, publisher, year, edition, pages
Malmö: Malmö University Press, 2024. p. 96
Series
Malmö University Health and Society Dissertations, ISSN 1653-5383, E-ISSN 2004-9277 ; 2024:8
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:mau:diva-67407 (URN)10.24834/isbn.9789178774586 (DOI)978-91-7877-457-9 (ISBN)978-91-7877-458-6 (ISBN)
Public defence
2024-05-24, Allmänna sjukhuset, HS aula AS:E002, Jan Waldenströms gata 25, Malmö, 09:15
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Supervisors
Note

Paper IV in dissertation as manuscript

Paper IV is not included in the fulltext online

Available from: 2024-05-24 Created: 2024-05-24 Last updated: 2024-12-17Bibliographically approved

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Ljungbeck, BirgittaSjögren Forss, KatarinaCarlson, Elisabeth

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