Objective: This qualitative study explores the experienced impact, barriers, and facilitators of real-world nurse-led care implementation.

Background: As Parkinson’s disease prevalence rises, it strains already overburdened healthcare systems. The PRIME model [1] tackles this through nurse-led care, expanding nurses’ roles with new responsibilities and task differentiation between nurses and neurologists, positioning nurses as care coordinators and primary patient contacts. This approach aims to improve the professionals work-life balance and achieve better outcomes without additional costs.

Method: Nurse-led care was implemented in five outpatient hospital clinics in the Netherlands. Between April and July 2024, 25 semi-structured interviews and two group interviews were conducted with 11 nurses, two nurse specialists, 12 Parkinson’s neurologists, and five managers. Two researchers performed inductive thematic analysis.

Results: 9 themes emerged: (1) The education program empowered nurses to cope with their novel responsibilities and fostered a regional learning climate; (2) Supervision was essential for nurse-led care yet hindered by time and logistics; (3) Collaboration between nurses and neurologists can facilitate nurse-led care, but is jeopardized by high workload, infrequent team meetings, and organizational inefficiencies; (4) Unclear task division hinders nurse-led care; (5) Workload both hindered and exacerbates due to nurse-led care; (6) Financial incentives hinders nurse-led care; (7) Nurse-led care was implemented through adjusted consultation structures; (8) Variation in neurologists’ involvement shapes the nurse’s role; (9) Strengthened nurses care coordinator role.

Conclusion: Nurse-led care was implemented in varying ways and to different extents across hospitals. Nurses were generally empowered to play a more central role, and overall efficiency and job satisfaction improved for healthcare professionals, although this was not consistent across all outpatient hospital clinics. Successful implementation of nurse-led care requires careful consideration of nurse education, supervision, collaboration, task division, workload, and financial incentives.

References: [1] Bloem BR, Henderson EJ, Dorsey ER, Okun MS, Okubadejo N, Chan P, Andrejack J, Darweesh SKL, Munneke M. Integrated and patient-centred management of Parkinson’s disease: a network model for reshaping chronic neurological care. Lancet Neurol. 2020 Jul;19(7):623-634. doi: 10.1016/S1474-4422(20)30064-8. Epub 2020 May 25. PMID: 32464101; PMCID: PMC9671491.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-nurse-led-future-of-parkinson-care-a-thematic-analysis-of-healthcare-professionals-experiences-with-nurse-led-care-implementation/