Background
Fragmented health systems can lead to over-, under-, or misuse of services. Specific challenges arise for newly arrived population groups, such as refugees, who encounter barriers to health services. These include legal restrictions and language discordance with service providers, that further exacerbate these issues. Although nurses can play an important role in improving the response of the health system, little is known about their scope of practice and their role in caring for refugees in primary healthcare contexts.
Objective
To investigate key characteristics of three nurse-led models of care for refugees in Germany, the roles and responsibilities of nurses and to describe their potential to improve coordination and continuity.
Methods
A qualitative, multiple-case study was conducted using a purposeful sampling strategy. Data collection included semi-structured interviews with three programme managers and five nurses from three operational nurse-led models of care in Germany, a social network questionnaire and a review of documents. Data analysis comprised developing logic models and using qualitative content and social network analysis methods.
Results
Examined models involve nurses by allowing for independent management of tasks such as observation, counselling, and care coordination, providing support to patients and linking them to other healthcare services. In the absence of specific training programmes, nurses rely on on-the-job learning.
Conclusions
Nurse-led models of care can effectively improve healthcare for refugees. Policymakers should recognise and advance nursing practice through legislative measures and sustainable funding models. In order to prepare nurses for working in these settings, nursing curricula should incorporate refugee-specific aspects.
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