Integrating nursing activities into general practices in Switzerland: a mixed-methods study

Area of Science:

• Primary Health Care
• Nursing Practice
• Health Services Research

Background:

• Pilot study integrating nursing activities into general practitioner (GP) practices to enhance primary care services.
• Evaluation of the rollout and integration of new nursing roles and activities within the first year.

Purpose of the Study:

• To describe the implementation and evolution of nursing activities over the first 12 months of a pilot project.
• To assess how nursing activities aligned with the initially planned job descriptions.

Main Methods:

• Mixed-methods observational study utilizing quantitative data on nursing activity duration and qualitative data from interviews and focus groups.
• Combined quantitative and qualitative findings for comprehensive analysis of nursing activity implementation.

Main Results:

• Progressive rollout of nursing activities, with significant increases in follow-up care for chronically ill patients over 12 months.
• One-off clinical activities were more readily integrated than complex care plan activities.
• Key factors influencing implementation included nurse's prior experience, GP referral willingness, and patient acceptance of nurse-led care.

Conclusions:

• Nursing activities in primary care settings expanded progressively over the study period.
• Integration of chronic care and care plan activities progressed more slowly due to adaptation challenges for GPs and nurses.
• Successful implementation hinges on multifactorial elements including professional experience, interprofessional collaboration, and patient engagement.