scholarly journals Interdisciplinary Team Care for Diabetic Patients by Primary Care Physicians, Advanced Practice Nurses, and Clinical Pharmacists

2011 ◽  
Vol 29 (2) ◽  
pp. 60-68 ◽  
Author(s):  
D. Willens ◽  
R. Cripps ◽  
A. Wilson ◽  
K. Wolff ◽  
R. Rothman
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Interdisciplinary Team ◽  
Advanced Practice Nurses ◽  
Diabetic Patients ◽  
Advanced Practice ◽  
Practice Nurses ◽  
Clinical Pharmacists ◽  
Team Care

scholarly journals Advanced practice nurses in primary care in Switzerland: an analysis of interprofessional collaboration

2019 ◽  
Author(s):  
Renata Josi ◽  
Monica Bianchi ◽  
Sophie Brandt
Keyword(s):  
Primary Care ◽  
Medical Practice ◽  
Health Professionals ◽  
Interprofessional Collaboration ◽  
Advanced Practice Nurses ◽  
Advanced Practice ◽  
Practice Nurses ◽  
Care Models ◽  
Team Functioning ◽  
Swiss 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.

scholarly journals 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 ◽  
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.

Community Care Management: Advanced Practice Nurses as Care Managers

2000 ◽  
Vol 2 (3) ◽  
pp. 148-152 ◽  
Author(s):  
Christine M. Waszynski ◽  
Wendy Murakami ◽  
Mary Lewis
Keyword(s):  
Health Care ◽  
High Risk ◽  
Primary Care Physicians ◽  
Advanced Practice Nurses ◽  
Advanced Practice ◽  
Model Of Care ◽  
Practice Nurses ◽  
Coordination Model ◽  
Hospital Days ◽  
Care Costs

A group of advanced practice nurses partnered with a major insurer in the design and implementation of a care coordination model for high-risk older adults. This article will discuss the process of such an undertaking, highlighting the successes and barriers encountered. The key elements of this program included early identification and regular reassessment of each member’s acuity level; fostering close partnerships between individual or teams of APRNs and groups of physicians; and uninterrupted clinical management of high-risk members across the health care continuum. This model was designed to achieve the following outcomes: to support the physician management of high-risk, chronic individuals; to increase or maintain the health of members; and to reduce health care costs. Outcome studies have demonstrated a substantial net savings by decreasing acute care admissions by 54%, reducing hospital days by 42%, and trimming primary care physicians’ and specialists’ visit costs by 37%. There was a 33% reduction in the overall costs of health care for members enrolled in this program. Physicians and members both rated their satisfaction with the APRN-based model of care as very high.

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