Registered nurses in expanded roles improve care in nursing homes: Swiss perspective based on the modified Delphi method

Kornelia Basinska; Nathalie I. H. Wellens; Michael Simon; Andreas Zeller; Reto W. Kressig; Franziska Zúñiga

doi:10.1111/jan.14644

journal article Open Access Nov 22, 2020

Registered nurses in expanded roles improve care in nursing homes: Swiss perspective based on the modified Delphi method

Kornelia Basinska

Nathalie I. H. Wellens Michael Simon

Andreas Zeller Reto W. Kressig Franziska Zúñiga

Journal of Advanced Nursing Vol. 77 No. 2 pp. 742-754 · Wiley

View at Publisher Save 10.1111/jan.14644

Abstract

Abstract

Aim
To define both competencies and envisaged outcomes for registered nurses in expanded roles in Swiss nursing homes to be implemented and evaluated within a new model of care.

Background
In regions where Advanced Practice Nurses are rare or absent, registered nurses take up clinical leadership and expanded roles. To allow effective implementation, monitoring and evaluation of these nurses, stakeholders need a shared understanding of the competencies they require and what outcomes they should achieve.

Design
RAND/UCLA Appropriateness Method – a modified Delphi method.

Methods
A critical literature review and case studies were conducted to identify possible competencies and outcomes for registered nurses in expanded roles. In 2017, a two‐round rating process and an in‐person panel discussion was completed by a group of multi‐professional stakeholders.

Findings
Two rounds generated 190 competencies and 72 outcomes relevant to registered nurses in expanded roles.

Conclusion
The relevant competencies and outcomes of registered nurses in expanded roles indicate their support for care teams and development of nursing care in nursing homes. Their geriatric expertise allows them to function as role models and innovators, reinforcing overall perceptions of nursing as a profession. These nurses are especially important in countries and settings where Advanced Practice Nurses are scarce or unavailable.

Impact
The identified competencies clarify the duties of expanded‐role registered nurses, thereby differentiating them from other care providers. Although conducted in the Swiss healthcare system, our methods and findings can be adapted to other healthcare settings. The results of this study will guide the development of an educational programme in a multi‐centre study to reduce avoidable hospitalizations, while the defined outcomes guide the evaluation of their impact.

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Details

Published: Nov 22, 2020
Vol/Issue: 77(2)
Pages: 742-754
License: View

Authors

K

Kornelia Basinska

Nursing Science (INS) Department Public Health (DPH) Faculty of Medicine University of Basel Basel Switzerland

N

Nathalie I. H. Wellens

Department of Public Health and Social Affairs of the Canton of Vaud Lausanne Switzerland

M

Michael Simon

Nursing Science (INS) Department Public Health (DPH) Faculty of Medicine University of Basel Basel Switzerland; Nursing Research Unit Inselspital Bern University Hospital Bern Switzerland

A

Andreas Zeller

Faculty of Medicine University of Basel Basel Switzerland; Center for Primary Health Care University of Basel Basel Switzerland

R

Reto W. Kressig

Faculty of Medicine University of Basel Basel Switzerland; University Department of Geriatric Medicine FELIX PLATTER Basel Switzerland

F

Franziska Zúñiga

Nursing Science (INS) Department Public Health (DPH) Faculty of Medicine University of Basel Basel Switzerland

Funding

Ebnet-Stiftung Award: 407440_167458

Cite This Article

Kornelia Basinska, Nathalie I. H. Wellens, Michael Simon, et al. (2020). Registered nurses in expanded roles improve care in nursing homes: Swiss perspective based on the modified Delphi method. Journal of Advanced Nursing, 77(2), 742-754. https://doi.org/10.1111/jan.14644

Registered nurses in expanded roles improve care in nursing homes: Swiss perspective based on the modified Delphi method

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