Advanced Practice Nurses and Their Roles in Swiss Cancer Care: A Cross-Sectional Study

Franziska Geese; Denise Bryant-Lukosius; Sandra Zwakhalen; Sabine Hahn

doi:10.1016/j.soncn.2024.151626

Advanced Practice Nurses and Their Roles in Swiss Cancer Care: A Cross-Sectional Study

Semin Oncol Nurs. 2024 Apr 18:151626. doi: 10.1016/j.soncn.2024.151626. Online ahead of print.

Authors

Franziska Geese¹, Denise Bryant-Lukosius², Sandra Zwakhalen³, Sabine Hahn⁴

Affiliations

¹ Academic Practice Partnership, School of Health Professions, Bern University of Applied Sciences, Switzerland; University Hospital Bern, Inselspital, Insel Gruppe, Freiburgstrasse, Switzerland. Electronic address: franziska.geese@insel.ch.
² School of Nursing and Department of Oncology, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
³ Department of Health Services Research, Maastricht University, Netherlands.
⁴ Division of Nursing, School of Health Professions, Bern University of Applied Sciences, Switzerland.

PMID: 38641521
DOI: 10.1016/j.soncn.2024.151626

Abstract

Objectives: To examine the advanced practice nurse workforce in Swiss cancer care and how their roles are being implemented (eg, role structures, processes) to achieve optimal outcomes for patients and their families, care organizations, and the broader health care system.

Methods: A cross-sectional study was conducted. The sample included master-prepared advanced practice nurses in cancer care, who completed an online questionnaire from December 2021 to January 2022. Thirty-nine items assessed structures (eg, role characteristics, utilization), processes (eg, role activities, interventions), and perceived outcomes (eg, for patients, the health care system) of advanced practice nurses in Swiss cancer care. Data from closed questions were analyzed using descriptive statistics. Data from open-ended questions were organized and summarized into categories related to domains of advanced practice nursing and its reported frequency by the advanced practice nurses.

Results: The participating advanced practice nurses (n = 53), worked in half of the 26 Swiss cantons. Interventions were identified within nine categories, of which most were targeted to patients and their families (n = 7), followed by health care professionals (n = 2). Perceived positive outcomes were patient symptom management, length of hospital stay, and health care costs. Participants felt less confident in cancer care (eg, autonomous practice) and reported 15 professional development needs (eg, medical interventions, teaching).

Conclusions: This study provides a comprehensive examination of 53 advanced practice nurses, detailing the characteristics of their roles and utilization across various jurisdictions and health care settings. The results highlight the diverse dimensions of advanced practice nursing and its potential to enhance cancer services and outcomes in Switzerland. Opportunities for role development support and expansion are identified.

Implications for nursing practice: More systematic health human resource planning is needed to expand the deployment of advanced practice nurses across jurisdictions, practice settings, and more diverse patient populations. Role development needs show the desire for specialized educational preparation in cancer care.

Keywords: Access to care; Advanced practice nursing; Clinical nurse specialist; Neoplasm; Nurse practitioner; Oncology; Workforce issues.