Background The medical services at Dorothy House Hospice were reconfigured with an aim to extend the medical capacity in the community. Two Advanced Nurse Practitioners (ANPs) were recruited to the inpatient unit. Full integration of ANPs into a medical team was innovative and it was important to evaluate this new service.
Aim(s) To evaluate the impact ANPs have had on the service. To understand from a multidisciplinary team (MDT) perspective the impact. To evaluate whether the introduction of the role has improved patient access to the inpatient unit.
Methods Qualitative methodology using in-depth interviews (eight in total) were conducted to a purposeful sample of a cross-section of the hospice MDT. Thematic analysis was used to analyse the data and identify themes for further discussion. Comparative data analysed activity in and times of admissions.
Results The ANP role has overwhelmingly been considered a success throughout the MDT. Key themes were identified following thematic analysis. The role was perceived to enhance team working across all teams, and in particular the medical team. There is evidence that the ANP role has increased flexibility for admissions. One area identified by several interviewees was the need to enable the ANP role to certify death in the future.
Conclusions The ANP role has enhanced the medical service in the inpatient unit of the hospice. This study provided evidence to base further integration of nurses using advanced skills to be recruited into the hospice and to be clinically supported and supervised by senior medical colleagues. The predicted national increase of people with complex multi-comorbidities and the anticipated rise in the death rate will add to the existing strain on medical services. Nurses with advanced clinical practice skills can be part of a wider clinical solution.
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