The Lived Experience of Advanced Practice Nursing

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The Lived Experience of Advanced Practice Nursing

• Towards Meeting the Demands

2
Introduction

• ANP Core Concepts
• The realities in practice
• Education
• MSc courses
• Role Development Nationally

3
Site Preparation/Job Description

• Service Need
• Role Description/Scope of Practice
• Consultation with stakeholders
• Identify secure resources
• Guidelines for practice
• NMPDU
• NCNM

4
Accreditation as ANP/AMP

• Job description
• Portfolio
• Evidence of education
• Competence
• Professional development

5
Core Concepts (NCNM 2002)

• Autonomy in Clinical Practice
• Clinical Leadership
• Expert
• Research Audit

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Autonomy

• Competent practitioner
• Extensive clinical experience
• Specific education at advanced practice level
• Can articulate demonstrate competency related
  to specialist area of practice
• Capable of higher level decision making
• Responsible accountable for actions decisions
• Defined caseload scope of practice
• Operates within guidelines for best practice
  legislation
• Service need identified
• Continues to evolve, change, shift according to
  service need

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Advanced Nurse Practitioner Scope of Practice

• Type of Injury
• Minor Head Facial Injury
• Laceration face, trunk limb
• Skeletal Soft tissue injury
• Initial management of fractures
• Hand fingertip Injury
• Minor burns lt 2 TBSA
• Soft tissue infection
• Incision drainage abscess

• Referral Arrangement
• Radiology
• OPD
• Physiotherapy
• Occupational therapy
• Social Work Department
• Primary care provider
• Outside Agencies Homeless, Drug treatment
  services, woman's aid

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Clinical Leadership

• Role Model
• Change agent
• Innovator
• Clinical lead
• Educator

• Succession planning
• Resource allocation
• Promulgation within outside of organisation

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Expert / Educator

• Clients/Patients/Families
• In-service education
• Undergraduate post-graduate courses
• Nursing
• Professions allied to medicine
• Continuing professional development across
  professions
• National International meetings conferences

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Audit Research

• Audit
• Workload
• Outcome measurement
• Rationale for expansion of WTEs
• Research
• Clinical practice issues
• Innovations in practice (expansion)
• Collaboration

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Education

• Masters in Nursing Midwifery
• Specific course
• Generic strand
• Clinical environment conducive to teaching
• Mentor commitment to support learning and
  progression

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Clinical Diagnostic Skills for Advanced Nurse
Practitioner (Emergency)

• Module on MSc in Nursing, TCD
• Course taught in E.D SJH (500hrs)
• 10 weeks theory
• 10 weeks observation of expert practice/practice
  under supervision
• Further 500 hrs supervised clinical practice
  based in E.D
• Stand alone option available/strict entry
  criteria
• 13 Students completed course 5 currently

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Generic Advanced Practice Strand

• Module on MSc in Nursing UCD, UCG
• Systems Model of assessment not specific to
  specialist area
• Students negotiate own clinical placement with
  mentor specific to area of practice
• Major teaching commitment required by clinical
  mentor/supervisors

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Approved Advanced Nurse Practitioner Posts
(Nationally)

• 12 Emergency (Dublin Drogheda)
• 1 Sexual Health
• 1 Rheumatology
• 1 Breast Care
• 1 Diabetes
• 1 Chronic Disease Management

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2 Key Issues

• NO QUICK FIX
• NOT A CHEAP OPTION

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QUESTIONS ?