["Feeling secure at home" starts in the hospital: A qualitative study about the experience of patients with a APN hematology]. / "Sich zuhause sicher fühlen" beginnt im Spital.

"Feeling secure at home" starts in the hospital: A qualitative study about the experience of patients with a APN hematology Abstract. Background: High dose chemotherapy (HDC) and hematopoietic stem cell transplantation (HSCT) are complex procedures bringing about physical and mental stress for the persons affected. In preparation for the time after their stay in the hospital, patients need individual support and education already during their hospital stay. Aim: The study investigated how patients after HDC with or without HSCT experienced the preparations by a hematology Advanced Practice Nurse (APN) for the post hospitalization phase and how they experienced managing their day-to-day life back at home. Methods: The qualitative research approach "Interpretive Description" was applied by conducting and subsequently transcribing eleven individual interviews with six participants. The texts were read multiple times before being coded. They were continuously compared with each other and similar contents were assigned the same codes. Results: Patients find themselves in a "process of increasingly feeling secure". This process is supported by the preparation of the APN. This is reflected in three themes during their hospitalization: the relationship of trust with the APN, the comprehensive overview of the APN and the APN strengthening the feeling of security. The experience of finding back to daily life at home shows that the process of "increasingly feeling secure" is ongoing. Themes within this phase were: arriving at home, resuming daily routines and implementing the information received from the APN. Conclusions: The companionship provided by the APN enables patients to appropriately cope with their day-to-day life at home. The findings suggest that the preparations of the APN facilitate the transition from the hospital to day-to-day life back home.

Framework for Evaluating the Impact of Advanced Practice Nursing Roles.

PURPOSE: To address the gap in evidence-based information required to support the development of advanced practice nursing (APN) roles in Switzerland, stakeholders identified the need for guidance to generate strategic evaluation data. This article describes an evaluation framework developed to inform decisions about the effective utilization of APN roles across the country. APPROACH: A participatory approach was used by an international group of stakeholders. Published literature and an evidenced-based framework for introducing APN roles were analyzed and applied to define the purpose, target audiences, and essential elements of the evaluation framework. Through subsequent meetings and review by an expert panel, the framework was developed and refined. FINDINGS: A framework to evaluate different types of APN roles as they evolve to meet dynamic population health, practice setting, and health system needs was created. It includes a matrix of key concepts to guide evaluations across three stages of APN role development: introduction, implementation, and long-term sustainability. For each stage, evaluation objectives and questions examining APN role structures, processes, and outcomes from different perspectives (e.g., patients, providers, managers, policy-makers) were identified. CONCLUSIONS: A practical, robust framework based on well-established evaluation concepts and current understanding of APN roles can be used to conduct systematic evaluations. CLINICAL RELEVANCE: The evaluation framework is sufficiently generic to allow application in developed countries globally, both for evaluation as well as research purposes.