gms | German Medical Science

Background: The care of nursing home (NH) residents is becoming more complex due to multimorbidity and dementia, thus requiring higher levels of geriatric expertise. Evidence shows that the introduction of nurse experts in NHs increases quality of and satisfaction with care. However, the local introduction of nurse experts is dependent on the legal, regulatory and educational context. Accordingly, before its introduction, the scope of practice, competencies and expected outcomes of such roles need to be defined. The development of corresponding roles has been poorly described and under-researched in view of stakeholders’ perceptions.

Purpose: To assess stakeholders’ perceptions of geriatric nurse expert competencies and expected outcomes relevant for Swiss NHs.

Methods: A modified RAND/ UCLA Appropriateness Method was used to rate both competencies and expected outcomes. Items for both were retrieved from a literature search of international nurse-led models of care and from multiple case studies in Switzerland. Their relevance for the Swiss health care system was rated by a panel of purposefully selected national experts. Components were included in the final set if they received an overall panel median score of ≥7 with agreement in accordance to the interpercentile range adjusted for symmetry (IPRAS).

Results: A total of 194 competencies and 62 outcomes on the level of residents and relatives, organization, quality of care, and healthcare system were rated according to their relevance for the Swiss healthcare system in two separate rounds.

Conclusions: A set of geriatric nurse competencies and outcomes relevant for the Swiss NH were agreed upon.