Implementation of A Nurse Practitioner in Emergency Ambulance Care in The Netherlands: A Study Protocol for The IMPACT-Study

Abstract

Background Ambulance care professionals face an increasing demand for ambulance care, which is caused by a changing patient population with more complex healthcare problems and comorbidities, accessibility of emergency care, repeated requests for ambulance care and the request of ambulance care for primary care problems. These changes might require an ambulance care professional at master level, such as the nurse practitioner (NP). The objective is to (1) determine characteristics of patients and ambulance runs in situations where NP care was provided, and to evaluate the effect of implementing the NP in Dutch ambulance on (2) patient safety and (3) patient experience compared to non-NP care.Methods/design A prospective mixed-methods implementation design will be used. The intervention is the implementation of a NP as solo ambulance unit within this EMS, to (1) determine characteristics of the patients and ambulance runs, and the effects on (2) patient safety and (3) patient, compared to regular ambulance care. Within this pilot the NP can apply additional diagnostic and therapeutic interventions in addition to regular ambulance care. Data will be collected through databases, additional apps, and questionnaires.

A survey of the current nurse practitioner and physician assistant workforce in Dutch ambulance care

“…An ambulance service in the South Netherlands has implemented nurse practitioners even before the national framework was published and evaluated the impact of employing nurse practitioners in ambulance care on patient safety and patient experience compared to standard emergency medical service care. This IMPACT study ( Ebben et al., 2020 ) could provide insight into whether the framework is applicable. If so, that evidence can provide additional input for integrating nurse practitioners and physician assistants in ambulance care throughout the Netherlands.…”