Role Development, Implementation and Evaluation of Nurse Practitioners

NCT05520203 | Active Not Recruiting

• 5 other identifiers: KW2196/DVE/001/001B6702021000685B6702021000300B6702021000479B6702021000046
• Study Type: observational
• Target: 1,000
• Locations: 1 country
• Sites: 2

Brief Summary

Hospitals face new challenges in providing sustainable high quality care as the prevalence of chronic conditions, multimorbidity and the complexity of care increases. The high burden on healthcare teams, the growing costs and the increasing scarcity in healthcare providers (HCPs) result in unmet needs of patients and their families and a high workload on HCPs. Worldwide there is growing recognition that new care models integrating nurse practitioners (NPs) in interdisciplinary teams could contribute to respond to these challenges. ANP is defined as an "advanced practice nurse (APN) who integrates clinical skills associated with nursing and medicine in order to assess, diagnose and manage patients in primary healthcare settings and acute care populations as well as ongoing care for populations with chronic illness". Despite the proven benefits of integrating NPs in interdisciplinary teams, the introduction of NPs in Belgium is at an early stage. Advanced practice nurses, including NPs, are formally recognized in Belgium since 2019, but there is still no legal framework in which additional rights or agreements compared to other nursing groups are defined. Given the early stage of introduction, little is known about the development, implementation and impact of NPs in the Belgian health care context. Insights in implementation processes and the effectiveness of NP roles at different levels can inform healthcare managers and policy makers for future (nation-wide) implementation in a hospital setting. The overall objective of this longitudinal pre-post mixed methods study is to develop, implement and evaluate the integration of the role of NPs in four different departments in a Belgian university hospital.

Conditions

Nurse Practitioners; Implementation Research; Quality of Care

Keywords

advanced practice nursing; interdisciplinary health team; participatory action research; longitudinal mixed methods study; nursing

Outcome Measures

Primary Outcomes (4)

• Change in quality of care NPSS - ambulatory

  Satisfaction with NP/doctor consultation. The data will be collected by use of a questionnaire for patients (and their parents). Validated tools, the Nurse Practitioner Satisfaction Survey (NPSS) and the Quality of care through the patients eyes will be used.

  The data will be collected at three points during the study: baseline T0 (before introduction), T1 (6 months after introduction) and T2 (1 year after introduction)

• Change in quality of care though the patients eyes - ambulatory liver cirrhosis

  Satisfaction with NP/doctor consultation. The data will be collected by use of a questionnaire for patients (and their parents). A validated tool, the Quality of care through the patients eyes will be used.

  The data will be collected at three points during the study: baseline T0 (before introduction), T1 (6 months after introduction) and T2 (1 year after introduction)

• Change in Quality of care (GS-PEQ) - hospitalization

  Patient perception and experiences of quality of care provided during hospitalisation. The data will be collected by use of a questionnaire for patients. A validated tool the Generic Short Patient Experiences Questionnaire will be used.

  The data will be collected at three points during the study: T0 (before introduction), T1 (6 months after introduction) and T2 (1 year after introduction)

• Change in Quality of care (Picker) - hospitalization

  Patient perception and experiences of quality of care provided during hospitalisation. The data will be collected by use of a questionnaire for patients. A validated tool the Picker Patient Experience Questionnaire will be used.

  The data will be collected at three points during the study: T0 (before introduction), T1 (6 months after introduction) and T2 (1 year after introduction)

Secondary Outcomes (15)

• Change in hospital admissions - ambulatory

  All admissions one year before and after introduction will be registered. The data will be collected at three points during the study: baseline T0 (before introduction), T1 (6 months after introduction) and T2 (1 year after introduction)

• Length of stay hospital admissions - ambulatory

  Length of stay of all admissions 12 months before and 12 months after introduction of the Nurse practitioner will be registered.

• Change in readmission - hospitalization

  The data will be collected at three points during the study: baseline T0 (before introduction), T1 (6 months after introduction) and T2 (1 year after introduction)

• Change in mortality rates

  The data will be collected at three points during the study: baseline T0 (before introduction), T1 (6 months after introduction) and T2 (1 year after introduction)

• Change in pain Scores

  The data will be collected at three points during the study: baseline T0 (before introduction), T1 (6 months after introduction) and T2 (1 year after introduction)

Other Outcomes (1)

• Change in Quality of life (QOL)

  The data will be collected at three points during the study: baseline T0 (before introduction), T1 (6 months after introduction) and T2 (1 year after introduction)

Study Arms (3)

Patient - cohort 1

Patients (and their parents) recruited before introduction of the NP

Other: Care provided by the Nurse Practitioner

Patient - cohort 2

Patients (and their parents) recruited after introduction of the NP

Other: Care provided by the Nurse Practitioner

Healthcare providers

Healthcare providers involved in the process of development, implementation and evaluation as well as all healthcare providers who come into close contact with the Nurse Practitioner

Other: Care provided by the Nurse Practitioner

Interventions

Care provided by the Nurse Practitioner OTHER

Introduction of a Nurse Practitioner in the interdisciplinary care team

Healthcare providers; Patient - cohort 1; Patient - cohort 2

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Patients \- Patients (or their parents in the paediatric department) HCPs * Representatives of all relevant stakeholders (from each department) will be invited to participate (eg. head(s) of the medical department(s), physicians, physicians in training, (head) nurses, care managers, the chief medical officer, specialised nurses, social worker, pharmacist). * All HCPs who are currently involved in the care process of the targeted patient population.

You may qualify if:

• Admitted on the participating ward (digestive surgery) or diagnosed stable liver cirrhosis or pediatric epilepsy
• Be conscious
• Speak Dutch

You may not qualify if:

• \- Dementia or other severe cognitive/mental disorders
• Health care providers
• Have at least three months of clinical experience on the ward
• Key stakeholders in the process of development, implementation and/or evaluation
• No contact with the nurse practitioner
• Internship

Sponsors & Collaborators

• University Hospital, Ghent: lead
• University Ghent: collaborator

Study Sites (2)

Ghent University Hospital

Ghent, East Flanders, 9000, Belgium

Location

University Hospital Ghent

Ghent, 9000, Belgium

Location

Related Publications (1)

• Dehennin L, Kinnaer LM, Vermassen F, Van Hecke A. Role development, implementation and evaluation of nurse practitioners in a Belgian university hospital: a mixed methods study protocol. BMJ Open. 2023 May 3;13(5):e068101. doi: 10.1136/bmjopen-2022-068101.

  PMID: 37137560 DERIVED

Study Officials

• Frank Vermassen, MD, PhD

  Ghent University/Ghent University Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Year
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 15, 2022
• First Posted: August 29, 2022
• Study Start: November 1, 2021
• Primary Completion: November 23, 2023
• Study Completion: December 1, 2024
• Last Updated: September 19, 2024

Record last verified: 2024-09

Data Sharing

• IPD Sharing: Will not share

Locations

BE (2)