scholarly journals Nurse practitioners in Swiss family practices as potentially autonomous providers of home visits: an exploratory study

2020 ◽  
Author(s):  
Stefan Gysin ◽  
Iren Bischofberger ◽  
Rahel Meier ◽  
Anneke van Vught ◽  
Christoph Merlo ◽  
...  
Keyword(s):  
Clinical Supervision ◽  
Nurse Practitioners ◽  
Rural Areas ◽  
Work Experience ◽  
Home Visits ◽  
Postgraduate Education ◽  
Practical Experience ◽  
Coding System ◽  
Health Insurance Data ◽  
Family Practices

Abstract Background Switzerland is challenged by impending shortages of general practitioners (GPs) in rural areas and decreasing number of GP home visits. In Anglo-Saxon and many other countries, nurse practitioners (NPs) have been implemented and provide high quality, patient-centred home visits autonomously. In Switzerland, the NP role is new and there are currently only a handful of ongoing pilot projects in family practices. Hence, studies are lacking and data collection is challenging as NPs are not yet registered providers who could be identified in billing or health insurance data. Our aims were to gain insights in the frequency of home visits by NPs in Swiss family practices, and to determine their autonomy during visits and consultations based on the required level of GP supervision. Methods We used consultation data from two pilot practices in rural Switzerland. In “Practice A”, the NP was in postgraduate education and data was gathered electronically between August 2017 and 2018. In “Practice B”, the NP had completed her education, and had two years of work experience as a NP when data was collected manually between April and June 2018. We used a coding system based on five levels of GP supervision to identify NP consultations and home visits, and to determine the NPs’ autonomy in each consultation. Results We analysed data from 1375 consultations. The share of home visits in all NP consultations was 17% in Practice A and 51% in Practice B. Both NPs had a higher share of autonomously conducted consultations during home visits than in the office. In Practice A, the proportion of consultations in which the NP was autonomous increased from 0% in the first month of her employment to 19% after 13 months of GP supervision. In Practice B, the NP was autonomous in about three-quarters of her consultations. Conclusions First cases provide some evidence that after completing postgraduate education with clinical supervision by GPs, and few years of practical experience in their role, NPs could reach a relatively high degree of autonomy and might pose a potential solution to the decreasing numbers of GP home visits in Swiss primary care.

scholarly journals Nurse practitioners in Swiss family practices as potentially autonomous providers of home visits: an exploratory study

2019 ◽  
Author(s):  
Stefan Gysin ◽  
Iren Bischofberger ◽  
Rahel Meier ◽  
Anneke van Vught ◽  
Christoph Merlo ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Supervision ◽  
Nurse Practitioners ◽  
Rural Areas ◽  
Work Experience ◽  
Home Visits ◽  
Postgraduate Education ◽  
Coding System ◽  
Family Practices ◽  
Swiss Primary Care

Abstract Background Swiss primary care is challenged by impending shortages of general practitioners (GPs) in rural areas and decreasing number of GP home visits. In Anglo-Saxon and many other countries, nurse practitioners (NPs) have been implemented and provide high quality, patient-centred home visits autonomously. In Switzerland, the NP role is new and there are currently only a handful of ongoing pilot projects in family practices. Hence, studies are lacking and data collection is challenging as NPs are not yet registered providers who could be identified in billing or health insurance data. Our aims were to gain insights in the frequency of home visits by NPs in Swiss family practices, and to determine their autonomy based on the required level of GP supervision during consultations.Methods We used consultation data from two pilot practices in rural Switzerland. In “Practice A”, the NP was in postgraduate education and data was gathered electronically between August 2017 and 2018. In “Practice B”, the NP had completed her education, and had two years of work experience as a NP when data was collected manually between April and June 2018. We used a coding system based on five levels of GP supervision to identify NP consultations and home visits, and to determine the NPs’ autonomy in each consultation.Results We analysed data from 1375 consultations. The share of home visits in all NP consultations was 17% in Practice A and 51% in Practice B. Both NPs had a higher share of autonomously conducted consultations during home visits than in the office. In Practice A, the proportion of consultations in which the NP was autonomous increased from 0% in the first month of her employment to 19% after 13 months of GP supervision. In Practice B, the NP was autonomous in about three-quarters of her consultations.Conclusions After completing postgraduate education with clinical supervision by GPs, and few years of practical experience in their role, NPs can reach a relatively high degree of autonomy and might pose a potential solution to the decreasing numbers of GP home visits in Swiss primary care.

Nurse Practitioners in Swiss Family Practices as Potentially Autonomous Providers of Home Visits: An Exploratory Study of Two Cases

2020 ◽  
Vol 33 (1) ◽  
pp. 8-13 ◽  
Author(s):  
Stefan Gysin ◽  
Iren Bischofberger ◽  
Rahel Meier ◽  
Anneke van Vught ◽  
Christoph Merlo ◽  
...  
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Rural Areas ◽  
Home Visits ◽  
Patient Characteristics ◽  
Pilot Projects ◽  
Family Practices ◽  
Multimorbid Patients ◽  
High Degree ◽  
Swiss Primary Care

In Swiss primary care, general practitioner (GP) home visits have decreased due to impending GP shortages particularly in rural areas. Nurse practitioners (NP) are newly introduced in family practices and could potentially offer home visits to the increasing number of multimorbid elderly. We analysed consultation data from two pilot projects (Practice A and Practice B) with the goal to measure the frequency and patient characteristics of NP consultations both in the practice and on home visits, and to determine the NPs’ autonomy based on the required GP supervision. In Practice A, 17% of all NP consultations were home visits, in Practice B 51%. In both practices, the NPs saw older patients and reported higher autonomy on home visits compared to consultations in the practice. In Practice A, the NP encountered a higher share of multimorbid patients on home visits than in the practice, and the NP’s proportion of autonomously conducted consultations increased from 0% in the first month to 19% after 13 months of GP supervision. In Practice B, the NP was autonomous in about three-quarters of consultations after 2 years on the job. These first cases provide some evidence that NPs could reach a relatively high degree of autonomy and might pose a potential solution for the decreasing numbers of GP home visits to multimorbid elderly in Swiss primary care.

scholarly journals In-hours acute home visits by advanced nurse practitioners in primary care: a qualitative study

2021 ◽  
Vol 30 (13) ◽  
pp. 788-792
Author(s):  
Alison Wells ◽  
Edward Tolhurst
Keyword(s):  
Primary Care ◽  
Clinical Supervision ◽  
Nurse Practitioners ◽  
Role Ambiguity ◽  
Qualitative Data ◽  
Home Visits ◽  
Holistic Care ◽  
Structured Interviews ◽  
Home Setting ◽  
The Uk

Background: The extension of roles within the primary care team is one approach recommended to address the shortage of GPs in the UK. A key aspect of care that advanced nurse practitioners (ANPs) can undertake is acute home visits. Aim: To evaluate the perspectives of ANPs performing acute in-hours home visits in primary care. Methods: Qualitative data were gathered in eight semi-structured interviews across a primary care locality, then analysed via a process of thematic analysis. Findings: Three key themes were identified: providing holistic care; engaging with the home setting; and negotiating role ambiguity. Conclusion: Practices wishing to involve ANPs in acute home visits should ensure clear definition and good understanding of the ANP role. Effective interprofessional relationships should be fostered with appropriate mentorship and clinical supervision to support ANPs in optimising their contribution to acute home visits.

scholarly journals Prospects and problems in the field of modern education in Kazakhstan

2021 ◽  
Vol 102 (2) ◽  
pp. 40-47
Author(s):  
K. Tleuzhanova ◽  
◽  
Z. Kupeeva ◽  
A. Igembekova ◽  
G. Magauina ◽  
...  
Keyword(s):  
Education System ◽  
Rural Areas ◽  
Postgraduate Education ◽  
Practical Experience ◽  
The State ◽  
Education Sector ◽  
University Graduates ◽  
State Program ◽  
Cost Of Education ◽  
The Republic

This article discusses an important for education topic of the application of programs and standards of effective education in the Republic of Kazakhstan. It also analyzes the current state of the education sector and the main policy documents in the education sector that regulate its effectiveness. The article reveals the problems of Kazakh higher education, such as the oversaturation of the market with educational institutions (universities), the expensive cost of education, and the lack of technical specialists. The State Program for the Development of Education of the Republic of Kazakhstan for 2019–2025 adopted in 2019 is substantiated as the idea of one of the possible ways to eliminate defects and gaps in education. Summarizing practical experience, the article examines the key stages of changing the state of the education system and its modernization. The improvement of entrance exams to leading universities of our country as a part of increasing the competence of specialists is being considered. In order to saturate production and enterprises of labor-deficient regions with personnel the implementation of the social project “Mangilik El Zhastary Industryaga” continues. This implies providing jobs for university graduates, including in rural areas, taking into account the needs of the labor market. In conclusion, all possible ways of improving the education system are examined, which are reflected as the planned changes in the State program and should have a beneficial effect on the system of higher and postgraduate education in the republic and increase its prestige in the eyes of potential applicants.

International Telesupervision: The Clinical Fellowship Experience

2017 ◽  
Vol 2 (11) ◽  
pp. 73-78
Author(s):  
David W. Rule ◽  
Lisa N. Kelchner
Keyword(s):  
Graduate Students ◽  
Clinical Supervision ◽  
Rural Areas ◽  
The United States ◽  
Speech Language Pathology ◽  
Access To Services ◽  
East African ◽  
The World ◽  
Language Pathology ◽  
National Certification

Telepractice technology allows greater access to speech-language pathology services around the world. These technologies extend beyond evaluation and treatment and are shown to be used effectively in clinical supervision including graduate students and clinical fellows. In fact, a clinical fellow from the United States completed the entire supervised clinical fellowship (CF) year internationally at a rural East African hospital, meeting all requirements for state and national certification by employing telesupervision technology. Thus, telesupervision has the potential to be successfully implemented to address a range of needs including supervisory shortages, health disparities worldwide, and access to services in rural areas where speech-language pathology services are not readily available. The telesupervision experience, potential advantages, implications, and possible limitations are discussed. A brief guide for clinical fellows pursuing telesupervision is also provided.

scholarly journals COVID-19 Vaccine Acceptance in Azuay Province, Ecuador: A Cross-Sectional Online Survey

Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 678
Author(s):  
Julio Jaramillo-Monge ◽  
Michael Obimpeh ◽  
Bernardo Vega ◽  
David Acurio ◽  
Annelies Boven ◽  
...  
Keyword(s):  
Rural Areas ◽  
Online Survey ◽  
Vaccination Campaign ◽  
Postgraduate Education ◽  
Effective Vaccine ◽  
Cross Sectional ◽  
Lower Education Level ◽  
Vaccination Acceptance ◽  
History Of ◽  
High Level

We investigated the COVID-19 vaccination acceptance level in Azuay province, Ecuador through an online survey from 12th to 26th February (before the start of the COVID-19 vaccination campaign in Ecuador). Overall, 1219 respondents participated in the survey. The mean age was 32 ± 13 years; 693 participants (57%) were female. In total, 1109 (91%) of the participants indicated they were willing to be vaccinated with a COVID-19 vaccine, if the vaccine is at least 95% effective; 835 (68.5%) if it is 90% effective and 493 (40.5%) if it is 70% effective; 676 (55.5%) participants indicated they feared side effects and 237 (19.4%) thought the vaccine was not effective. Older age, having had a postgraduate education, a history of a negative COVID-19 test, a high level of worry of contracting COVID-19, believing that COVID-19 infection can be prevented with a vaccine and understanding there is currently an effective vaccine against COVID-19 were associated with higher vaccination acceptance. A vaccination education campaign will be needed to increase the knowledge of Ecuadorians about the COVID-19 vaccine and to increase their trust in the vaccine. People with a lower education level and living in rural areas may need to be targeted during such a campaign.

scholarly journals Evaluation of an unscheduled care model delivered by advanced nurse practitioners in a primary-care setting

2019 ◽  
Vol 24 (8) ◽  
pp. 696-709
Author(s):  
Calum F Leask ◽  
Heather Tennant
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Care Setting ◽  
Primary Care Setting ◽  
Home Visits ◽  
Rejection Rate ◽  
Service Level ◽  
Average Score ◽  
Unscheduled Care ◽  
Viable Solution

Background Considering new models of delivery may help reduce increasing pressures on primary care. One potentially viable solution is utilising Advanced Practitioners to deliver unscheduled afternoon visits otherwise undertaken by a General Practitioner (GP). Aims Evaluate the feasibility of utilising an Advanced Nurse Practitioner (ANP) to deliver unscheduled home visits on behalf of GPs in a primary care setting. Methods Following a telephone request from patients, ANPs conducted unscheduled home visits on behalf of GPs over a six-month period. Service-level data collected included patient-facing time and outcome of visits. Practice staff and ANPs participated in mind-mapping sessions to explore perceptions of the service. Results There were 239 accepted referrals (total visiting time 106.55 hours). The most common outcomes for visits were ‘medication and worsening statement given’ (107 cases) and ‘self-care advice’ (47 cases). GPs were very satisfied with the service (average score 90%), reporting reductions in stress and capacity improvements. Given the low referral rejection rate, ANPs discussed the potential to increase the number of practices able to access this model, in addition to the possibility of utilising other practitioners (such as paramedics or physiotherapists) to deliver the same service. Conclusions It appears delivering unscheduled care provision using an ANP is feasible and acceptable to GPs.

Assessment on Biogas Utilizations in Rural Areas in Urumqi, Xinjiang

2012 ◽  
Vol 512-515 ◽  
pp. 343-346
Author(s):  
Xiao Li Ma ◽  
I Shin Chang ◽  
Jing Wu
Keyword(s):  
Rural Areas ◽  
Alternative Energy ◽  
Practical Experience ◽  
Biomass Energy ◽  
Development Mode ◽  
Ecological Benefits ◽  
Engineering Construction ◽  
Comprehensive Utilization ◽  
Existing Problems ◽  
Reliable Source

As the effective and efficient means of resources utilization, biomass energy has become a very valuable and reliable source of alternative energy in China, especially for remote areas and countryside. First, in order to facilitate the development of biogas applications and promote the economic, social and ecological benefits from comprehensive utilization of biogas in rural areas in Urumqi (Capital of Xinjiang Uygur Autonomous Region, XUAR), the biogas potential was estimated, the biogas engineering construction and biogas comprehensive utilization were evaluated, and the existing problems of biogas development were analyzed, in this study. Second, countermeasures and recommendations were proposed in trying to resolved existing problems, based on international practical experience. And, according to local climatic situation and regional characteristics in Urumqi, ecological agriculture was proposed in this study as the development mode for the rural areas in Urumqi, based on the development of biogas technologies and international practical experience.

Postgraduate Academic Desires: Senior Doctor of Pharmacy Students

1988 ◽  
Vol 22 (5) ◽  
pp. 422-424 ◽  
Author(s):  
Robert M. McNulty ◽  
Jay M. Mirtallo
Keyword(s):  
Clinical Practice ◽  
Work Experience ◽  
Postgraduate Training ◽  
General Medicine ◽  
Postgraduate Education ◽  
Senior Doctor ◽  
Bachelor Of Science ◽  
Or Practice ◽  
Doctor Of Pharmacy ◽  
Selection Of

Senior Doctor of Pharmacy (Pharm.D.) students were surveyed by questionnaire to glean information about academic training, and residency, fellowship, or practice positions sought after graduation. There were 227 (27 percent of total surveys) responses. Of those responding, 71 percent were Bachelor of Science graduates, 29 percent were Pharm.D. primary degree students, and 18 percent completed a residency either before or during Pharm.D. training. Fifty percent had an average of three years of clinical services work experience prior to their Pharm.D. education. There was strong interest in postgraduate education by respondents: 41 percent for residencies and 26 percent for fellowships. Of resident candidates, 18 percent and 49 percent, respectively, considered research essential and important to the program. Areas of greatest interest in residencies were general medicine, infectious disease, and pharmacokinetics. Important to the selection of a fellowship was the research proposal and concurrent clinical practice. Pharm.D. students are interested in postgraduate training as residents (60 percent), fellows (38 percent), or both (2 percent). Desired activities are research and clinical practice independent of residency or fellowship interest.

scholarly journals Clinical teaching of student nurses by unit managers of selected hospitals in Limpopo Province

Curationis ◽  
2005 ◽  
Vol 28 (1) ◽  
Author(s):  
LA Murathi ◽  
M Davhana-Maselesele ◽  
VO Netshandama
Keyword(s):  
Nurse Practitioners ◽  
Clinical Teaching ◽  
Quality Care ◽  
Student Nurses ◽  
Phenomenological Approach ◽  
Practical Experience ◽  
Limpopo Province ◽  
Theory And Practice ◽  
Major Theme ◽  
Nurse Training

The comprehensive nature of nurse training needs the involvement of almost all health team personnel, including unit managers to gain practical experience and learn to correlate theory and practice. The overall aim of the study was to explore and describe the experiences of unit managers regarding teaching of student nurses in the clinical area and to develop recommendations that will enhance clinical teaching, for the production of competent future nurse practitioners who will render quality care to patients. A qualitative design, which is explorative, descriptive and contextual in nature, was employed, utilizing a phenomenological approach to capture the experiences of unit managers regarding teaching of student nurses at selected hospitals, where students are allocated for their clinical exposure. Ethical measures as well as measures to ensure trustworthiness were adhered to. In-depth phenomenological interviews were conducted with unit managers who shared their experiences regarding clinical teaching of student nurses. Data analysis was done according to Tesch’s (1990) open coding method. One major theme emerged, namely that unit managers experienced problems when doing clinical teaching of student nurses. Based on the findings the following recommendations were made: Colleges should open a two-way communication with unit managers, involvement of unit managers in the activities that take place at the college like courses, seminars and workshops on clinical teaching, learning contracts should be developed for the students and issues of clinical learning should be addressed and unit managers should be included in both summative and formative evaluations.

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