Implementation of Advanced Practice Nurses for Specific Patient Groups (IPAP)

Implementation of Advanced Practice Nurses for Specific Patient Groups - Scientific Supervision

Problem and Relevance Due to the complexity of caring for individuals with various health conditions and their individual needs, new care models aligned with the current state of scientific knowledge are highly relevant in nursing practice. One such model involves the deployment of Advanced Practice Nurses (APNs), who are educated at master's level and therefore possess an advanced understanding of theories and models, as well as enhanced competencies in patient care. The implementation of APNs has been associated with, among other outcomes, reduced hospital readmission rates, improved patient quality of life, enhanced quality of care and nursing services, and increased job satisfaction among nursing staff.

Objective The objective of the accompanying study is to evaluate structures, processes, and experiences related to the implementation of APN roles at Salzkammergut Hospital Vöcklabruck, part of Oberösterreichische Gesundheitsholding, within the clinical areas of urology and andrology, pulmonology, visceral surgery, and vascular surgery. The aim is to identify facilitating and hindering factors affecting APN implementation. Furthermore, recommendations for the sustainable integration of APNs into clinical practice will be developed.

Design The evaluation is planned as a mixed-methods study using a convergent parallel design.

Methods As part of the accompanying research on APN role implementation, existing structures and processes within the hospital, as well as the perspectives of APNs and members of the intra- and interprofessional healthcare team, will be examined and jointly interpreted within a convergent parallel design. Based on these findings, recommendations for sustainable APN implementation will be derived. Both qualitative data (collected through individual interviews and focus group interviews) and quantitative data (collected through standardized questionnaires and a structure-process assessment tool) will be gathered. Qualitative data will be analyzed using Kuckartz's qualitative content analysis with the support of the software MAXQDA24. Quantitative data from the standardized questionnaires will be analyzed descriptively using SPSS version 30, while data from the structure-process assessment tools will be analyzed using Microsoft Excel.

Study Overview

• Status: Enrolling by invitation
• Conditions: Evaluate Structures, Processes, and Experiences Related to the Implementation of APN Roles

• Study Type: Observational
• Enrollment (Estimated): 125

Contacts and Locations

Study Locations

• Austria
  • Upper Austria
    • Vöcklabruck, Upper Austria, Austria, 4840
      • Salzkammergut Klinikum Vöcklabruck

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

• Registered Nurses holding a consecutive master's degree (300 ECTS credits), Junior APN
• Senior APN (master's degree holder), responsible for mentoring and supporting the Junior APNs within the hospital setting;
• Members of the intraprofessional team (Registered Nurses and Nursing Assistants); and
• Members of the interprofessional team who collaborate with the APNs in the care of the respective patient populations (physicians, allied health professionals, and therapists).

Description

Inclusion Criteria:

• Registered Nurses holding a consecutive master's degree (300 ECTS credits), Junior APN
• Senior APN (master's degree holder), responsible for mentoring and supporting the Junior APNs within the hospital setting;
• Members of the intraprofessional team (Registered Nurses and Nursing Assistants); and
• Members of the interprofessional team who collaborate with the APNs in the care of the respective patient populations (physicians, allied health professionals, and therapists).

All employees at Salzkammergut Hospital Vöcklabruck

Exclusion Criteria:

• not an employee at Salzkammergut Hospital Vöcklabruck

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
APN Implentation; Evaluation of Structures, Processes, and Intra- and Interprofessional Team Experiences in the Context of Advanced Practice Nurse (APN) Role Implementation

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Structure-Process-Matrix	developed in-house survey of structures (resources, time allocations) and processes (requirements, consultations) regarding APN implementation	From enrollment to the end lasts 12 month

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cologne Role Development in Advanced Practice Nursing Questionnaire revised	Identification of APN's responsibilities and role during the APN implementation process	at three timepoints during the implementation phase at the beginning, after 6 months and after 12 months
Questionnaire on the Perception of Advanced Practice Nurses - Practice Patterns and Role Perception	developed in-house survey on collaboration with APNs across 7 subcategories (direct patient care, support for departmental/institutional processes and workflows, research and evidence-based practice, education, publishing and professional leadership, perception of improvements in health care, anticipated expanded APN role in patient care) in 27 items using a 5-point Likert scale (ranging from "to a very high degree" to "not at all") nd four items using a 3-point Likert scale (ranging from "improve" to "no effect") and two open-ended statements.	at the end of implementation phase in month 12

Collaborators and Investigators

• Sponsor: Paracelsus Medical University
• Collaborators: Oberösterreichische Gesundheitsholding GmbH
• Investigators: Principal Investigator: Stefanie Berger, MScN, BScN, Paraceslsus Medical Private University

Publications and helpful links

General Publications

• Tracy, M. F. & O´Grady, E. (Hrsg.). (2019): Hamric and Hanson´s advanced practice nurs-ing: an integrative approach. (6.Aufl.). St. Louis, Missouri: Elsevier.
• Schober, M., Lehwaldt, D., Rogers, M., Steinke, M., Turale, S., Pulcini, J., Roussel, J., Stewart, D. (2020). Guidelines on advanced practice nursing. Geneva, Switzerland

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2026
• Primary Completion (Estimated): September 30, 2027
• Study Completion (Estimated): September 30, 2027

Study Registration Dates

• First Submitted: June 24, 2026
• First Submitted That Met QC Criteria: July 3, 2026
• First Posted (Actual): July 9, 2026

Study Record Updates

• Last Update Posted (Actual): July 9, 2026
• Last Update Submitted That Met QC Criteria: July 3, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Advanced Practice Nursing; Structure-Process-Evaluation
• Other Study ID Numbers: IPAP

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: only IPD used in the results publication

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No