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Introduction <p>Primary care in Switzerland is facing major challenges. New care models, e.g., with new roles such as advanced practice nurse (APN), are needed; however, it is not yet well-known in which areas APNs work and how much time they need for their work. In addition, the lack of remuneration for APN activities poses a&#xa0;major challenge for Swiss outpatient primary care.</p> Method <p>A&#xa0;time and motion study was conducted. A&#xa0;total of 12&#xa0;APNs working in 6 general practices in German-speaking Switzerland were observed over <i>N</i> = 20&#xa0;days. The temporal data were treated statistically and descriptively.</p> Results <p>A&#xa0;total of <i>N</i> = 81&#xa0;activities were observed in seven areas of work. The APNs spend over 40% of their time in direct clinical practice, where they primarily take medical histories and make clinical assessments; however, one third of their time is spent on indirect activities but which arise from their direct work. A&#xa0;total of 26% of the activities observed are consistent with the corresponding regulation in Swiss law and can currently be financed.</p> Discussion <p>Direct clinical practice accounts for a&#xa0;large part of the work performed by APNs. Indirect activities are closely linked to direct clinical practice and cannot be outsourced. Accordingly, the area of indirect activities needs to be redesigned. The regulatory and legal hurdles are substantial and hinder the deployment of APNs in Swiss outpatient primary care. A&#xa0;regulation is urgently needed.</p>

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Tätigkeiten von Advanced Practice Nurses in der hausärztlichen Grundversorgung

  • 期刊论文

  • 发表日期：

    2026年3月18日

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  • Maya Zumstein-Shaha,
  • Claudia Ortoleva Bucher,
  • Janine Hosner,
  • Denise Steinmann,
  • Maria Rosa Joller

摘要

Introduction

Primary care in Switzerland is facing major challenges. New care models, e.g., with new roles such as advanced practice nurse (APN), are needed; however, it is not yet well-known in which areas APNs work and how much time they need for their work. In addition, the lack of remuneration for APN activities poses a major challenge for Swiss outpatient primary care.

Method

A time and motion study was conducted. A total of 12 APNs working in 6 general practices in German-speaking Switzerland were observed over N = 20 days. The temporal data were treated statistically and descriptively.

Results

A total of N = 81 activities were observed in seven areas of work. The APNs spend over 40% of their time in direct clinical practice, where they primarily take medical histories and make clinical assessments; however, one third of their time is spent on indirect activities but which arise from their direct work. A total of 26% of the activities observed are consistent with the corresponding regulation in Swiss law and can currently be financed.

Discussion

Direct clinical practice accounts for a large part of the work performed by APNs. Indirect activities are closely linked to direct clinical practice and cannot be outsourced. Accordingly, the area of indirect activities needs to be redesigned. The regulatory and legal hurdles are substantial and hinder the deployment of APNs in Swiss outpatient primary care. A regulation is urgently needed.