Abstract :
[en] Introduction: Advanced nurse practitioners (APNs) have been internationally recognized for their role in improving patient outcomes and enhancing the quality of care. Some countries like United Kingdom or United States have included these nurses in critical care, particularly in intensive care units (ICUs) In Belgium, the legislation governing this role is expected to be enacted soon, but the practical integration of APNs into the healthcare system remains under consideration.
Aim: This study aimed to explore the challenges, opportunities and perceptions of healthcare staff on the integration of APNs in ICUs in French-speaking Belgium.
Setting & participants: This study included intensive care nurses and physicians from various units in French-speaking Belgium.
Methods: A multicentric, mixed-method study was conducted using a sequential explanatory design. Quantitative data were collected via an online survey to assess perceptions of APNs in practice, while qualitative insights were obtained through semi-structured interviews to gain.
Results: The quantitative phase included 128 nurses and 12 physicians (n = 140). The most strongly supported APN competencies in ICU context were mechanical ventilation management (72,1%), care coordination in cases of brain death (72,1%), the role of educator (78,4%) and care plan coordination (60,9%). Identified barriers to APN implementation included ambiguous legislative frameworks (84%), insufficient recognition (77%) and reluctance among medical personnel (66,5%). Facilitators for successful implementation were clear legislative guidelines (77,7%) and pilot programs (64%). Fourteen in-depth interviews highlighted the need for role clarification, emphasing APNs potential contributions to both practical care and non-technical skills.
Conclusion: The study provided an innovative perspective on the introduction of APNs into ICUs in French-speaking Belgium, identifying both potential roles and key, particularly regarding legislative hurdles. Solutions proposed included the development of specialized training programs to support successful integration, tailored to meet the specific needs of intensive care in Belgium.
