Publikationer från Malmö universitet
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Exploring the pioneering nurse practitioner role in Sweden: insights and perspectives for potential role development into municipal healthcare
Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).ORCID-id: 0000-0002-4714-4752
2024 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
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.

Ort, förlag, år, upplaga, sidor
Malmö: Malmö University Press, 2024. , s. 96
Serie
Malmö University Health and Society Dissertations, ISSN 1653-5383, E-ISSN 2004-9277 ; 2024:8
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:mau:diva-67407DOI: 10.24834/isbn.9789178774586ISBN: 978-91-7877-457-9 (tryckt)ISBN: 978-91-7877-458-6 (digital)OAI: oai:DiVA.org:mau-67407DiVA, id: diva2:1860519
Disputation
2024-05-24, Allmänna sjukhuset, HS aula AS:E002, Jan Waldenströms gata 25, Malmö, 09:15
Opponent
Handledare
Anmärkning

Paper IV in dissertation as manuscript

Paper IV is not included in the fulltext online

Tillgänglig från: 2024-05-24 Skapad: 2024-05-24 Senast uppdaterad: 2024-05-28Bibliografiskt granskad
Delarbeten
1. Content in nurse practitioner education - A scoping review.
Öppna denna publikation i ny flik eller fönster >>Content in nurse practitioner education - A scoping review.
2021 (Engelska)Ingår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 98, artikel-id 104650Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVE: Globally, the role of nurse practitioner is evolving to meet increased healthcare demands. Nevertheless, there are factors hindering the development of this role, one of which involves differences in nurse practitioner education worldwide. Therefore, the objective of the present study is to identify what is known in the research field on the content of nurse practitioner educational programmes.

DESIGN AND DATA SOURCES: The literature scoping review follows a six-stage methodological framework including: i) formulate research questions, ii) identify relevant studies, iii) select studies, iv) chart data, v) collate, summarize and report the results, vi) consultations. Data bases searched included CINAHL, PubMed and ERIC and were followed by manual searching of reference list in the included papers. Of the 1553 papers identified, 16 met the aim of this study.

REVIEW METHODS: To answer the research questions 'what is the content of curricula in nurse practitioner education?' a deductive content analysis was used.

RESULTS: Two main categories emerged. The first was related to the professional nurse practitioner role and includes research and nursing theories, leadership and collaboration, and organizational, political, economic, regulatory and legislative issues. The second is related to becoming an autonomous practitioner and includes health promotion and disease prevention, and other medically oriented content.

CONCLUSIONS: The content identified is consistent with the core competencies that nurse practitioners are expected to have after graduation, which have been described by the International Council of Nurses and by other researchers. Given the lack of recent research in nurse practitioner education, the results of the present study advance knowledge in this research field. Additionally, this study may be of practical value in developing new nurse practitioner educational programmes.

Ort, förlag, år, upplaga, sidor
Elsevier, 2021
Nyckelord
Content, Education, Nurse practitioner, Scoping review
Nationell ämneskategori
Omvårdnad
Identifikatorer
urn:nbn:se:mau:diva-37404 (URN)10.1016/j.nedt.2020.104650 (DOI)000752141400008 ()33203544 (PubMedID)2-s2.0-85096171950 (Scopus ID)
Tillgänglig från: 2020-12-08 Skapad: 2020-12-08 Senast uppdaterad: 2024-06-17Bibliografiskt granskad
2. Nurse practitioner in Swedish municipal elderly care: A Delphi study of challenges and opportunities
Öppna denna publikation i ny flik eller fönster >>Nurse practitioner in Swedish municipal elderly care: A Delphi study of challenges and opportunities
2023 (Engelska)Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 37, nr 1, s. 216-228Artikel i tidskrift (Refereegranskat) 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.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2023
Nyckelord
Delphi technique, frail elderly, municipal elderly care, nurse practitioner
Nationell ämneskategori
Reumatologi och inflammation
Identifikatorer
urn:nbn:se:mau:diva-54470 (URN)10.1111/scs.13116 (DOI)000837573400001 ()35942613 (PubMedID)2-s2.0-85135588410 (Scopus ID)
Tillgänglig från: 2022-08-22 Skapad: 2022-08-22 Senast uppdaterad: 2024-06-17Bibliografiskt granskad
3. Swedish stakeholders' views of the preparatory work needed before introducing the nurse practitioner role inmunicipal healthcare–A focus group study
Öppna denna publikation i ny flik eller fönster >>Swedish stakeholders' views of the preparatory work needed before introducing the nurse practitioner role inmunicipal healthcare–A focus group study
2023 (Engelska)Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Artikel i tidskrift (Refereegranskat) Epub ahead of print
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.

Ort, förlag, år, upplaga, sidor
Wiley-Blackwell, 2023
Nationell ämneskategori
Omvårdnad
Forskningsämne
Vårdvetenskap
Identifikatorer
urn:nbn:se:mau:diva-63798 (URN)10.1111/scs.13224 (DOI)001109244400001 ()37984433 (PubMedID)2-s2.0-85177455643 (Scopus ID)
Tillgänglig från: 2023-11-21 Skapad: 2023-11-21 Senast uppdaterad: 2024-05-24Bibliografiskt granskad
4. Nurse practitioners' experiences of working in the pioneering nursing role: an interview study
Öppna denna publikation i ny flik eller fönster >>Nurse practitioners' experiences of working in the pioneering nursing role: an interview study
(Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
Abstract [en]

Background: Nurse practitioners play a crucial role in healthcare by providing person-centred and high-quality care. Their contributions encompass enhanced accessibility to healthcare, reduced hospital admissions and cost-effectiveness. They usually hold a master’s degree in nursing, incorporating expanded clinical skills to manage patients in different settings and address both nursing and medical needs. Despite the global development of the role, its implementation varies, presenting challenges related to role clarity, regulation and acceptance by other healthcare professionals. Aim: To explore how nurses who are or have been employed as nurse practitioners describe their experiences of transitioning to and working in the nurse practitioner role in Sweden. Method: This qualitative study explores the experiences of 15 nurse practitioners in Sweden, using a snowball sampling strategy and semi-structured interviews. The data were collected through interviews on the Microsoft Teams digital platform and analysed with inductive content analysis. Transcriptions were coded and organized into main categories and subcategories. Findings: The present study explores the experiences of nurse practitioners as they transition from experienced nurses to nurse practitioners, emphasizing motivations, educational challenges, acceptance and autonomy. Transitioning into the nurse practitioner role initially brought isolation that evolved into acceptance. They recognized their strength in integrating medical and nursing competencies for holistic care. Leadership was pivotal, with managerial support crucial for the successful implementation of the role. Autonomy-related challenges, such as prescriptions rights and dependency on physicians, underscored the need for aprotected professional title and national guidelines. Conclusion: This study enriches the evolution of the nurse practitioner role in Sweden, offering vital insights into the ongoing national-level dialogues on nurse practitioner role development in Sweden. Impact: The paper’s relevance extends globally by providing valuable perspectives on nurse practitioners practicalities and fostering international understanding and advancement.

Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:mau:diva-67392 (URN)
Tillgänglig från: 2024-05-23 Skapad: 2024-05-23 Senast uppdaterad: 2024-05-24Bibliografiskt granskad

Open Access i DiVA

fulltext utan manuskript(2891 kB)78 nedladdningar
Filinformation
Filnamn FULLTEXT02.pdfFilstorlek 2891 kBChecksumma SHA-512
7519f1e13c1315fa8631bd96347fabdb58734ee9d7ad0b7c002513b0579a0750bb3d9f4dba8de724877bab9ddf32ff03c0b21b1bc57d0966e1df2a7fee853d4c
Typ fulltextMimetyp application/pdf
Errata(63 kB)11 nedladdningar
Filinformation
Filnamn FULLTEXT03.pdfFilstorlek 63 kBChecksumma SHA-512
5e8396c49aaddcb718535c3778a24fb968cd56889fa4e84efba3faf8dce69d3cfb52503486534cdf8ba9ad58f47c744a1dfb7ef983d1b6f5c8c39355a74dc4f9
Typ fulltextMimetyp application/pdf
Beställ online >>

Övriga länkar

Förlagets fulltext

Person

Ljungbeck, Birgitta

Sök vidare i DiVA

Av författaren/redaktören
Ljungbeck, Birgitta
Av organisationen
Institutionen för vårdvetenskap (VV)
Medicin och hälsovetenskap

Sök vidare utanför DiVA

GoogleGoogle Scholar
Totalt: 90 nedladdningar
Antalet nedladdningar är summan av nedladdningar för alla fulltexter. Det kan inkludera t.ex tidigare versioner som nu inte längre är tillgängliga.

doi
isbn
urn-nbn

Altmetricpoäng

doi
isbn
urn-nbn
Totalt: 337 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf