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Swedish stakeholders' views of the preparatory work needed before introducing the nurse practitioner role inmunicipal healthcare–A focus group study
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Municipal Healthcare in Hässleholm, Management of Care and Welfare, Malmö.ORCID iD: 0000-0002-4714-4752
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).ORCID iD: 0000-0003-0077-9061
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).ORCID iD: 0000-0002-3594-3944
2024 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 38, no 2, p. 284-293Article in journal (Refereed) Published
Abstract [en]

Background: The nurse practitioner role has become important globally in handlingthe growing healthcare needs of older adults with chronic diseases. Nevertheless,research shows that introducing the role is a complex process, and more studies areneeded to prepare for its introduction into different healthcare contexts, such as municipalhealthcare.Aim: The aim is to investigate what Swedish stakeholders identify as the preparatorywork needed before introducing the nurse practitioner role into municipalhealthcare.Methods: Data were collected through four focus group interviews conducted virtuallyon the TEAMS digital platform, with three to six participants in each groupand 18 participants total. The transcribed interviews were analysed using a six-stepthematic approach: familiarisation with the data, coding the data, generating initialthemes, reviewing themes, defining and naming the themes and producing thereport.Findings: The findings are divided into two main themes, each with two sub-themes.In the first, clarifying why the nurse practitioner role is needed, participants stressedthe importance of having a clear intention for introducing the role. The second, ensurea national framework to bolster the introduction at the local level, demonstratesthe need for collaboration among national actors to clarify the role's mandate andauthority before its introduction.Conclusions: Adding the nurse practitioner role to municipal healthcare can helpincrease the supply of nursing competence and the quality of patient care, but preparationfor introducing the role requires extensive work. The development of thenurse practitioner role requires decision-makers and leaders to take primary responsibilityfor its introduction. This study can support countries in the early phase ofdeveloping the nurse practitioner role by identifying both best practices and pitfalls.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2024. Vol. 38, no 2, p. 284-293
National Category
Nursing
Research subject
Care science
Identifiers
URN: urn:nbn:se:mau:diva-63798DOI: 10.1111/scs.13224ISI: 001109244400001PubMedID: 37984433Scopus ID: 2-s2.0-85177455643OAI: oai:DiVA.org:mau-63798DiVA, id: diva2:1813627
Available from: 2023-11-21 Created: 2023-11-21 Last updated: 2024-07-30Bibliographically 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, BirgittaCarlson, ElisabethSjögren Forss, Katarina

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