The Way to Regulation of APN Roles – Project Planning
Due to demographic developments and the increase of non-communicable diseases NCDs, the Swiss health system faces new challenges. The increased care needs of an aging population suffering from, e.g. diabetes, cancer, depression, dementia as well as polymorbidity, require new models of care based on coordination and continuity of care, self-management support and interprofessional collaboration. Within these new models of care, due to their specific educational profile, Advanced Practice Nurses (APNs) play a central role (Schweizerische Gesundheitsdirektorenkonferenz & Schweizerisches Bundesamt für Gesundheit, 2012). The contribution of Advanced Practice Nurses to an affordable, easy accessible and patient- and family-centred health care focusing self-management, continuity, coordination, and interprofessionality has also gained momentum in Switzerland within the last years. International experiences and a variety of research findings as well as different national pilot projects have demonstrated that APNs can contribute substantially to high quality health care (Imhof, Naef, Wallhagen, Schwarz, & Mahrer-Imhof, 2012; Johnson, 2015; Moore & McQuestion, 2012; Newhouse et al., 2011; Skilbeck & Payne, 2003; van der Biezen et al., 2016). It has been shown that APNs are beneficial in acute care, long term care as well as in primary care (Bryant-Lukosius et al., 2015; van der Biezen et al., 2016). However, in order for APNs to unfold their full scope of competencies and to meet the needs of the population, the health care system and the patients, role clarity constitutes a core element. The regulation of APN roles is one step toward achieving role clarity on the structural level. This has been shown to be pivotal for quality assurance adding to patient safety and is found to be of utmost importance to increase role acceptability by health care professionals as well as patients and families (Bryant-Lukosius et al., 2015; Burgt, Roij, Derckx, & Meuleoas, 2015; Freund et al., 2015; Martínez-González et al., 2014; Ullmann et al., 2017).
In September 2016 the Swiss parliament voted on the law for health professionals on undergraduate (BSc) level. This law represents a legal basis provision for the accreditation of educational programs at university level, the regulation of independent practice, as well as a register for all nurses. Currently, the necessary bylaws and regulations are being prepared. The implementation of the law for health professionals is expected by 2020. Nursing stakeholders lobbied together to additionally obtain a legal basis provision for a separate regulation of the APN role, which is per definition a role on Master’s level.
The Swiss National Parliament eventually did not agree to include a separate regulation of APN in the law for health professionals. However, the joint efforts of the nursing stakeholders and allied health professionals led to more awareness for the necessity of definition and regulation of the APN roles. Therefore, the proposed project targets the development of a regulatory framework to capture the developing APN roles, the definition of a self-regulatory body, and adds to clarity of educational and clinical requirements to register as an APN.