Tackling obesity: the challenge of obesity management for practice nurses in primary care

Abstract Background: The increase in the number of chronically ill patients due to ageing is calling existing models of primary care into question. New care models have recently been implemented in Swiss primary care and involve interprofessional teams. This paper aimed to analyze the practice of interprofessional collaboration between advanced practice nurses, registered nurses, and medical practice assistants within new models of primary care in Switzerland using the National Interprofessional Competency Framework (NICF). Methods: An ethnographic design comprising semi-structured interviews and non-participant observations was conducted. Sixteen interviews were conducted with care providers at their primary care practice. Interviewees included four advanced practice nurses, two registered nurses, six medical practice assistants, and four general practitioners. Nine other health professionals were subsequently observed in their practice. Interviews and observations were conducted by the first author from February to April 2019. Results: Our analysis confirmed that role clarification, team functioning, collaborative leadership, interprofessional conflict resolution, patient-centered care, and interprofessional communication have a significant influence on the interprofessional collaboration among health professionals in Swiss primary care. Among these domains, role clarification and team functioning were the most frequently raised issues. Both were found to have the potential to negatively influence and, therefore, hinder efficient interprofessional collaboration within primary care. The observation of APNs and MPAs working in practice confirmed these results. Conclusion: From the analysis, it emerged that role clarification is crucial for effective interprofessional collaboration within new care delivery models in the Swiss primary care context. Our study results may inform international health policymakers and practitioners about six important domains of interprofessional care when implementing new care models. Practical experience with new models of care involving advanced practice nurses and medical practice assistants may also influence the regulation of the scope of practice of these health professionals in Switzerland.

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Facilitators and barriers for promoting healthy eating among primary care patients: results of a qualitative study among practice nurses

Family Practice ◽

10.1093/fampra/cmab092 ◽

2021 ◽

Author(s):

Geertruida J Groenendijk-van Woudenbergh ◽

Marlies C van Hell-Cromwijk ◽

Ytje J J van der Veen ◽

Hylkje F Algra ◽

Willemieke Kroeze

Keyword(s):

Primary Care ◽

Communication Skills ◽

Healthy Eating ◽

Patient Encounter ◽

Structured Interviews ◽

Good Communication ◽

Practice Nurses ◽

Professional Characteristics ◽

Primary Care Patients ◽

Facilitators And Barriers

Abstract Background Practice nurses have an important role in promoting healthy eating to prevent or delay long-term complications from chronic lifestyle-related diseases. Objective To identify the facilitators and barriers encountered by practice nurses at a professional level when promoting healthy eating among patients. Methods Face-to-face semi-structured interviews were conducted with 21 Dutch practice nurses. Data were recorded, transcribed and analysed using inductive thematic analysis. Results Two main themes were determined: professional characteristics and professional–patient encounter. Professional characteristics included good communication skills and experience facilitated the successful promotion of healthy eating, while a lack of communication skills and lack of knowledge about diet were perceived as barriers. The most frequently identified facilitators for professional–patient encounter included ensuring a personal connection with patients, creating food awareness, focussing on small changes, adopting a tailored approach, motivating and arranging extra consultations. Barriers included lack of skills to raise the topic, lack of persistence, inability to find a common understanding, lack of competence in handling patients’ own choices and underuse of existing educational materials. Conclusions Further research using the identified facilitators and barriers for promoting healthy eating in primary care patients with chronic diseases could assist in the development of future training programmes for practice nurses.

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An Approach to Obesity Management in Primary Care

10.1542/9781581104073-an_approach ◽

2005 ◽

pp. 91-108

Author(s):

Kathy Love-Osborne

Keyword(s):

Primary Care ◽

Obesity Management

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Nurses’ impact on care, role, training, and career pathway

10.1093/med/9780198842248.003.0002 ◽

2021 ◽

pp. 7-20

Author(s):

Debra Holloway

Keyword(s):

Primary Care ◽

Career Development ◽

Reproductive Health ◽

Women's Health ◽

Sexual And Reproductive Health ◽

School Nurses ◽

Hospital Nurses ◽

Practice Nurses ◽

Career Pathway ◽

Specialist Nurses

This chapter outlines the key roles of nurses in primary care and the community in the context of women’s health. This includes practice nurses, sexual and reproductive health nurses, and school nurses, alongside healthcare assistants and associates. Hospital nurses (both clinic and ward) and specialist nurses have their roles defined, and aspects of relevant training and accreditation are covered. The chapter also discusses the evolution of specialist role in the context of prescribing. Finally, mentorship, supervision, and career development is covered.

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Advanced practice nurses, registered nurses and medical practice assistants in new care models in Swiss primary care: a focused ethnography of their professional roles

BMJ Open ◽

10.1136/bmjopen-2019-033929 ◽

2019 ◽

Vol 9 (12) ◽

pp. e033929

Author(s):

Renata Josi ◽

Monica Bianchi

Keyword(s):

Primary Care ◽

Health Professionals ◽

Chronic Care ◽

Advanced Practice Nurses ◽

Models Of Care ◽

Advanced Practice ◽

Practice Nurses ◽

New Models ◽

Care Models ◽

Swiss Primary Care

ObjectivesWe aimed to analyse roles and tasks of advanced practice nurses (APNs), registered nurses (RNs) without advanced practice education and medical practice assistants (MPAs) with regard to chronic care in Swiss primary care (PC). The objective of this study was to explore the potential of new care models, involving these health professionals, which could meet changing future healthcare needs.DesignAn ethnographic design comprising semi-structured interviews and non-participant observations was conducted.SettingHealth professionals who worked in 10 primary care practices in the German-speaking part of Switzerland were included in the study.ParticipantsIn total, 16 interviews were conducted with four APNs, six MPAs, two RNs and four general practitioners (GPs). Nine of the health professionals were subsequently observed in their primary care practice.ResultsAPNs and MPAs were both involved in chronic care in the PC practice. While APNs cared for older, multimorbid patients with more complex needs, MPAs were involved in counselling of younger patients with chronic disease such as type 2 diabetes. Additionally, APNs were involved in many home visits and visits in elderly peoples — and nursing homes. APNs worked with a high degree of autonomy while MPAs had worked mostly in delegation. Task division between GPs and APNs or MPAs was not clear in every case yet.ConclusionsAPNs and MPAs have a high potential to contribute to optimal care in new care models, which address needs of the elderly population. The experience from our sample may inform international health policymakers and practitioners about the tasks and responsibilities those health professionals can take over in PC when implementing new models of care. The practical experience with new models of care involving APNs and MPAs may also influence the future regulation with regard to the scope of practice of these health professionals in Switzerland.

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