[IDAOH-95 Study - Identifying Organisational Improvement Areas to Enhance Resident Care in Nursing Homes in...

The shortage of coordinating physicians in French nursing homes raises concerns about care organization and task distribution. The integration of advanced practice nurses (APNs) is a possible approach that remains underexplored in this setting. Objective. To explore healthcare professionals' perceptions of the APN role in nursing homes and to identify tasks that could potentially be shared with coordinating physicians. A multicenter descriptive study was conducted in the Val-d'Oise department (France) between November 2024 and February 2025. Three self-administered questionnaires were distributed to coordinating physicians, coordinating nurses, and nursing home directors. The analysis combined descriptive and comparative approaches, including a cross-analysis of perceived delegation and reported practices. A total of 131 professionals from 75 facilities participated. Several tasks were identified as potentially shareable, including geriatric assessment, care coordination, staff training, and risk management. Medication prescribing was largely perceived as non-delegable. Differences in perception were observed between professional groups, with coordinating nurses generally more supportive of expanded APN roles than physicians, consistent with observed differences in practice patterns. This study shows a gradient in the acceptability of task sharing with APNs, depending on the type of task. It identifies clinical and organizational areas where roles could evolve. Experience from other countries suggests that structured task-sharing models can improve care coordination and access to care. These findings support the need for pilot studies to assess the integration of APNs in French nursing homes.