[The contribution of advanced practice nurses in Swiss family practices: Multiple case study design]

The contribution of advanced practice nurses in Swiss family practices: Multiple case study design Abstract. Background: The increase in chronic diseases, multimorbidity and shortage of health professionals make it essential to adapt primary health care. New models of care are needed which are oriented towards patient needs and thus ensure comprehensive care for chronically ill people. In this context, there is great potential for the use of advanced practice nurses in Swiss family practices. Aims: In this study we investigated the contribution of advanced practice nurses in the interprofessional context in two family practices. Methods: We conducted a multiple case study design. We investigated two advanced practice nurses, located in family practices in rural and in mountainous regions. We used qualitative and quantitative methods. As an intermediate step, within-case analyses were performed and we summarized data inductively to create case vignettes. Results: The cases showed that advanced practice nurses contribute to self-management, prevention and health promotion in complex, stable and unstable patients. These areas have not been covered adequately by other health professionals in family practices. They strengthened interface management through hybrid employment and flexible, addressee-appropriate communication. Conclusions: Similarities and differences between family practices with and without new professional roles should be elicited to specifically identify gaps in care for the chronically ill.