Advanced Nursing Practice for people with learning disabilities in Germany

Background: In Germany, people with learning disabilities (PLD) are currently underserved in terms of healthcare, and the goals of the UN Convention on the Rights of Persons with Disabilities are not fully met. Internationally, Advanced Practice Nurses (APNs) have been successful in improving care for this population, but they have not yet been established in Germany. Objectives: The aim of this study was to determine the need for APNs among PLD in Germany and explore potential priorities for their work. Specifically, the study aimed to identify the individuals and typically complex circumstances that require the services of APNs, to create starting points for the development of Advanced Nursing Practice in this area. Methods: A scoping review was conducted, followed by a qualitative exploratory study using 14 expert interviews with nursing scientists and clinicians. The analysis was based on qualitative content analysis. Results: There are numerous problems in the care of PLD. Factors such as multiple disabilities, comorbidities, high care needs, and individual living and care conditions can result in complex care situations. However, complexity often only arises when a person interacts with the healthcare system. Based on the results it is suggested that an APN should be involved in the care of PLD in cases of newly developed symptoms, acute illnesses, deteriorating health, increasing care requirements, or transition to another care setting. Conclusion: There are several indications of a need for APNs for PLD, but further research is required to determine the exact factors that indicate this need. This study represents a first approximation. Significance (Impact and Reach): This is the first study, conducted as part of a master’s thesis, to explore the need for APNs in the care of PLD in Germany, provide reasons for their implementation, and propose priorities for the shaping of this new nursing role.