Job content of advanced practice nurses in Flanders

Abstract

Background: Current evolutions in medicine, the emphasis on cost-effectiveness in healthcare and the increase of complex healthcare needs addressed the need for highly educated and specialised nurses, such as advanced practice nurses (APN). By means of scientifically specialised knowledge, skills and competences, APN should enhance expansion, advancement and innovation in nursing care. Method(s): A cross sectional design was used to explore the job content performed by APN. 58 APN in Flemish hospitals participated. A validated self-reported questionnaire was used, combined with non-participant observational data (40 days). Result(s): APN in Flanders are mainly experts in the domain of oncology, pain and wound care. Based on the self-reported data, the job content of APN is diverse and is linked with the APN roles as described by Hamric. 94.8% are involved in professional development and teaching of nurses in the hospital. 65.5% develops a nursing consultation and 63.8% performed these consultations autonomously. Medical delegated tasks are performed to a lesser extent. 87.9% of APN reads and evaluates scientific literature to enhance evidence based nursing in practice. Initiating and executing domain-specific nursing research is performed by 70.7%. 91.4% participates in quality improvement projects in their specific domain. APN actively participate in international and national professional organizations. There is a limited participation in working groups within governmental agencies, national and international advisory boards. Based on observational data, APN spent the following working percentages to: clinical expert (33,2%), educator (11,7%), innovator and implementation (7,3%), research (7,2%), leader and policy advisor (5,1%) and facilitator in ethical decision making (0,1%). Conclusion(s): APN are 'young' professionals, in age and in working experience in the specialist domain. They are less involved in policy-making and work related to extramural activities. The focus is mainly on clinical expert care. Although APN can significantly contribute to high-quality, evidence-based patient care by providing training and coaching to nurses, initiating and guiding quality projects, conducting research and translating research findings into practice, there is room for further growth.