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Skill mix change between physicians, nurse practitioners, physician assistants, and nurses in nursing homes: A qualitative study

Skill mix change between physicians, nurse practitioners, physician assistants, and nurses in nursing homes: A qualitative study
Skill mix change between physicians, nurse practitioners, physician assistants, and nurses in nursing homes: A qualitative study

Nursing home physicians face heavy workloads, because of the aging population and rising number of older adults with one or more chronic diseases. Skill mix change, in which professionals perform tasks previously reserved for physicians independently or under supervision, could be an answer to this challenge. The aim of this study was to describe how skill mix change in nursing homes is organized from four monodisciplinary perspectives and the interdisciplinary perspective, what influences it, and what its effects are. The study focused particularly on skill mix change through the substitution of nurse practitioners, physician assistants, or registered nurses for nursing home physicians. Five focus group interviews were conducted in the Netherlands. Variation in tasks and responsibilities was found. Despite this variation, stakeholders reported increased quality of health care, patient centeredness, and support for care teams. A clear vision on skill mix change, acceptance of nurse practitioners, physician assistants, and registered nurses, and a reduction of legal insecurity are needed that might maximize the added value of nurse practitioners, physician assistants, and registered nurses.

nurse practitioner, nursing home, physician assistant, qualitative research, skill mix change, the Netherlands
1441-0745
Lovink, Marleen H.
aed51dc8-008a-4036-a81d-36524c564f7c
van Vught, Anneke (J A.H.).
3b8e053a-b83f-44ff-9426-2de16073ab0f
Persoon, Anke
c4be7b8e-8f71-486c-bdc0-f984c8e3cfcc
Koopmans, Raymond T.C.M.
3df55d8d-a5cb-4353-80ff-87fdfbba5ab5
Laurant, Miranda G.H.
d6b4e83a-0fed-46a4-9738-e11b9150a5e8
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Lovink, Marleen H.
aed51dc8-008a-4036-a81d-36524c564f7c
van Vught, Anneke (J A.H.).
3b8e053a-b83f-44ff-9426-2de16073ab0f
Persoon, Anke
c4be7b8e-8f71-486c-bdc0-f984c8e3cfcc
Koopmans, Raymond T.C.M.
3df55d8d-a5cb-4353-80ff-87fdfbba5ab5
Laurant, Miranda G.H.
d6b4e83a-0fed-46a4-9738-e11b9150a5e8
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de

Lovink, Marleen H., van Vught, Anneke (J A.H.)., Persoon, Anke, Koopmans, Raymond T.C.M., Laurant, Miranda G.H. and Schoonhoven, Lisette (2019) Skill mix change between physicians, nurse practitioners, physician assistants, and nurses in nursing homes: A qualitative study. Nursing and Health Sciences. (doi:10.1111/nhs.12601).

Record type: Article

Abstract

Nursing home physicians face heavy workloads, because of the aging population and rising number of older adults with one or more chronic diseases. Skill mix change, in which professionals perform tasks previously reserved for physicians independently or under supervision, could be an answer to this challenge. The aim of this study was to describe how skill mix change in nursing homes is organized from four monodisciplinary perspectives and the interdisciplinary perspective, what influences it, and what its effects are. The study focused particularly on skill mix change through the substitution of nurse practitioners, physician assistants, or registered nurses for nursing home physicians. Five focus group interviews were conducted in the Netherlands. Variation in tasks and responsibilities was found. Despite this variation, stakeholders reported increased quality of health care, patient centeredness, and support for care teams. A clear vision on skill mix change, acceptance of nurse practitioners, physician assistants, and registered nurses, and a reduction of legal insecurity are needed that might maximize the added value of nurse practitioners, physician assistants, and registered nurses.

Text
Lovink et al 2019 Nursing & Health Sciences - Version of Record
Available under License Creative Commons Attribution.
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More information

Accepted/In Press date: 20 January 2019
e-pub ahead of print date: 1 April 2019
Keywords: nurse practitioner, nursing home, physician assistant, qualitative research, skill mix change, the Netherlands

Identifiers

Local EPrints ID: 430111
URI: https://eprints.soton.ac.uk/id/eprint/430111
ISSN: 1441-0745
PURE UUID: 0a374b59-f82e-4145-bdf1-ba6d0d4e52e0
ORCID for Lisette Schoonhoven: ORCID iD orcid.org/0000-0002-7129-3766

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Date deposited: 12 Apr 2019 16:30
Last modified: 20 Jul 2019 00:43

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Contributors

Author: Marleen H. Lovink
Author: Anneke (J A.H.). van Vught
Author: Anke Persoon
Author: Raymond T.C.M. Koopmans
Author: Miranda G.H. Laurant

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