Nurses have been described as leaders in
transforming an acute care driven health care system
into a system of care that is designed to fit the
needs of the exponentially growing group of
chronically ill. [28] Indeed, patients living with
chronic conditions cannot be cured. Once patients
are diagnosed and state of the art medical
treatment is established, the course of the illness
and the clinical outcome will be significantly determined
by how well the patient is able to manage
his/her condition in daily life. Patient self
management refers to actions taken by the patient
in daily life to manage his/her illness. [29, 30] Patient
self management is a key concept in the successful
treatment of the chronically ill. Support
for patient self management is largely absent in
acute care driven systems as time, resources and
incentives are lacking. APNs can support patients
and families across the full continuum of health
care settings in order to integrate the best strategies
for self-management in their daily lives,
whilst at the same time contributing importantly
to continuity of care. Self management has been
SWISS MED WKLY 2 0 0 8 ; 13 8 ( 4 3 – 4 4 ) : 6 2 1 – 6 2 8 · www. smw. ch Reflecting on advanced practice roles: Five drivers to be considered
Figure 1
Framework to guide
the analysis on advanced
practice roles.
Health care
needs
of the
population
Education
Practice
patterns
Legal,
policy and
economic
context
Workforce
Issues
Drivers influencing APN/NP role development
found to be a building block of chronic illness
management that is consistently associated with
better outcomes [29]. Technologies such as telephone,
email, videophone and internet applications
are increasingly used to guarantee continuity
of care in addition to person to person meetings.
Thus APNs are well positioned in view of
their sophisticated clinical skills, scientific, clinical
and system change knowledge to contribute to
the challenge of developing adequate care models
and care provision for the chronically ill
Nurses have been described as leaders in
transforming an acute care driven health care system
into a system of care that is designed to fit the
needs of the exponentially growing group of
chronically ill. [28] Indeed, patients living with
chronic conditions cannot be cured. Once patients
are diagnosed and state of the art medical
treatment is established, the course of the illness
and the clinical outcome will be significantly determined
by how well the patient is able to manage
his/her condition in daily life. Patient self
management refers to actions taken by the patient
in daily life to manage his/her illness. [29, 30] Patient
self management is a key concept in the successful
treatment of the chronically ill. Support
for patient self management is largely absent in
acute care driven systems as time, resources and
incentives are lacking. APNs can support patients
and families across the full continuum of health
care settings in order to integrate the best strategies
for self-management in their daily lives,
whilst at the same time contributing importantly
to continuity of care. Self management has been
SWISS MED WKLY 2 0 0 8 ; 13 8 ( 4 3 – 4 4 ) : 6 2 1 – 6 2 8 · www. smw. ch Reflecting on advanced practice roles: Five drivers to be considered
Figure 1
Framework to guide
the analysis on advanced
practice roles.
Health care
needs
of the
population
Education
Practice
patterns
Legal,
policy and
economic
context
Workforce
Issues
Drivers influencing APN/NP role development
found to be a building block of chronic illness
management that is consistently associated with
better outcomes [29]. Technologies such as telephone,
email, videophone and internet applications
are increasingly used to guarantee continuity
of care in addition to person to person meetings.
Thus APNs are well positioned in view of
their sophisticated clinical skills, scientific, clinical
and system change knowledge to contribute to
the challenge of developing adequate care models
and care provision for the chronically ill
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