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Skill mix change between physicians, nurse practitioners, physician assistants, and nurses in nursing homes: A qualitative study

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  • Marleen H. Lovink
  • Anneke (J.A.H.) van Vught
  • Anke Persoon
  • Raymond T.C.M. Koopmans
  • Miranda G.H. Laurant
  • Lisette Schoonhoven

Abstract

Nursing home physicians face heavy workloads, because of the aging population and rising number of older adults with one or more chronic diseases. Skill mix change, in which professionals perform tasks previously reserved for physicians independently or under supervision, could be an answer to this challenge. The aim of this study was to describe how skill mix change in nursing homes is organized from four monodisciplinary perspectives and the interdisciplinary perspective, what influences it, and what its effects are. The study focused particularly on skill mix change through the substitution of nurse practitioners, physician assistants, or registered nurses for nursing home physicians. Five focus group interviews were conducted in the Netherlands. Variation in tasks and responsibilities was found. Despite this variation, stakeholders reported increased quality of health care, patient centeredness, and support for care teams. A clear vision on skill mix change, acceptance of nurse practitioners, physician assistants, and registered nurses, and a reduction of legal insecurity are needed that might maximize the added value of nurse practitioners, physician assistants, and registered nurses.

Suggested Citation

  • Marleen H. Lovink & Anneke (J.A.H.) van Vught & Anke Persoon & Raymond T.C.M. Koopmans & Miranda G.H. Laurant & Lisette Schoonhoven, 2019. "Skill mix change between physicians, nurse practitioners, physician assistants, and nurses in nursing homes: A qualitative study," Nursing & Health Sciences, John Wiley & Sons, vol. 21(3), pages 282-290, September.
    • Handle: RePEc:wly:nuhsci:v:21:y:2019:i:3:p:282-290
    DOI: 10.1111/nhs.12601
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    References listed on IDEAS

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    1. Mojtaba Vaismoradi & Hannele Turunen & Terese Bondas, 2013. "Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study," Nursing & Health Sciences, John Wiley & Sons, vol. 15(3), pages 398-405, September.
    2. Niezen, Maartje G.H. & Mathijssen, Jolanda J.P., 2014. "Reframing professional boundaries in healthcare: A systematic review of facilitators and barriers to task reallocation from the domain of medicine to the nursing domain," Health Policy, Elsevier, vol. 117(2), pages 151-169.
    3. Marja Härkänen & Alwiena Blignaut & Katri Vehviläinen‐Julkunen, 2018. "Focus group discussions of registered nurses’ perceptions of challenges in the medication administration process," Nursing & Health Sciences, John Wiley & Sons, vol. 20(4), pages 431-437, December.
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    1. Kathleen Abrahamson & Rebekah Fox & Aimee Roundtree & Kristen Farris, 2020. "Nursing assistants' perceptions of their role in the resident experience," Nursing & Health Sciences, John Wiley & Sons, vol. 22(1), pages 72-81, March.

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