APN visits in retirement and nursing homes

Advanced Practice Nurses (APN) can improve the treatment and care of chronically ill patients. Little is known about quality indicators for outreach APNs in nursing homes and the associated costs.

Factsheet

Schools involved School of Health Professions
Institute(s) Nursing
Research unit(s) Innovation in the Field of Health Care and Human Resources Development
Funding organisation Others
Duration (planned) 01.09.2024 - 31.12.2025
Head of project Prof. Dr. Maya Zumstein-Shaha
Project staff Prof. Dr. Maya Zumstein-Shaha
Prof. Dr. Christian Eissler
Dr. Ursula Klopfstein
Dr. Christoph Golz
Tanja Siegenthaler
Elvira Schmid
Daniel Flach
Partner Domicil
Südland Health AG
KPT Krankenkasse AG
Keywords Advanced Practice Nurses, APN, ward rounds, outreach, retirement and nursing homes, chronic diseases, family medicine, geriatrics

Situation

Long-term inpatient care is an important pillar of basic medical care in Switzerland. In this country, around 100,000 people live in retirement and nursing homes (APH). The majority of residents have multiple illnesses and polymedication. As a result, they are generally more fragile and require comprehensive care and support. Due to their frailty, many residents are no longer able to visit their GP themselves. They are dependent on visits from the medical specialists in the APH. The increasing shortage of specialists exacerbates the already limited time resources of medical specialists. Advanced Practice Nurses (APNs) can be deployed to meet these challenges. Recent data shows that the use of APNs in the care of APH residents leads to fewer illness-related complications, emergency consultations or unplanned hospital admissions. The number of depression, urinary incontinence, pressure ulcers (decubitus ulcers) or measures that restrict freedom are reduced and treatment goals are achieved more frequently.

Course of action

A pilot study will be conducted in which the influence of weekly visits by APNs in GP practices on residents and their relatives will be investigated and the processes of cooperation between the various specialists will be examined, how the APNs provide medical and nursing support to the APH specialists and how the total costs per APH resident and across all residents as a whole develop. To carry out this pilot study, four case studies will be conducted over two years. The context, APN, APH professionals, APH residents, their outcomes, relatives and insurance data will be examined (Bentley et al., 2016; Strachan et al., 2022). The data will be collected quantitatively and qualitatively.

Looking ahead

This project can be used to determine indicators for the contribution of APNs who are employed in GP practices and regularly carry out visits to retirement and nursing homes. Findings on cost aspects will also be compiled. From this, recommendations for the future use of APNs can be derived in order to make their use more resource-efficient and targeted.