Advanced NurseMidwife Practitioner Development Our experience as Project Officers

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Advanced Nurse/Midwife Practitioner Development-
Our experience as Project Officers

• Joan Gallagher, NMPDU HSE South (Carlow,
  Kilkenny, South Tipperary, Waterford and Wexford)
• Ann Kelleher, NMPDU HSE South (Cork Kerry)

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Introduction

• Various approaches to ANP/AMP development
• SE experience
• South experience
• Similarities
• Discussion

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HSE South (Carlow, Kilkenny, South Tipperary,
Waterford and Wexford)

• 7 Care of the Older Person
• 5 District Hospitals
• 5 Mental Health
• 5 Acute General
• 5 Community Care areas
• 4 ID Centres

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ANP/AMP Development - SE
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Site Development Process in the SE

• NCNM site development funding 2006 ? NMPDU
• Submission by services to NMPDU for funding
• Master class
• Site Selection Process
• Release of project officer for 6 months (CNM2
  level)
• Site Development

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Deliverables required for Site Development Part
1 Approval

• Service Need Business case (for HSE)
• Job Description caseload, scope of practice,
  referral criteria, decision-making process, roles
  and responsibilities competencies.
• Site Development Details Why how site
  developed, guideline development, how it fits
  within a nursing framework, meets service plan
  needs, resource implications NCNM (2004)
  Framework.
• Financial Approval
• Application Form for ANP/AMP post approval
• Part 2 Accreditation of individual post holder.

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Professional Development Officer Role in
supporting ANP/AMP Development

• Managing process and site development NCNM
  project funding
• Site selection / readiness
• Clarifying deliverables for site development
• Mentorship/ supervision for ANP candidate or
  dedicated project officer in site development
• Steering group member
• Proof reader/format/content management etc!

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Role of Project Officers

• Project Plan
• Consultation collaboration with key
  stakeholders
• Drafting key documents for approval by steering
  group
• Finalising and submitting site development
  documents
• Preparing site for site visit
• Handouts job profile and expected deliverables

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Learning from Project to date

• Secure WTE and financial approval asap
• Project Officers for Site Development vs ANP
  Candidate
• Protected time for site development
• Timeframe for site development
• Key Stakeholder involvement consultation and
  steering group
• Seek support from NCNM open days and ongoing
  consultation re development

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The future - SE

• Support existing approved sites to achieve
  individual accreditation
• Identify future sites for ANP/AMP site
  development
• More opportunities for submission for funding to
  support site development January 2008
• Commence needs analysis, scoping out feasibility
  and submitting NCNM ANP grant applications /-
  HSE business case
• ANP/AMP supporting integration, innovation for
  service users in a wide range of areas.

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Overseeing Accreditation of ANP Posts

• HSE South Cork Kerry

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The Accreditation Process
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Site Preparation Process in HSE South

• Need for ANP post identified
• Meeting with DoN, Director of NMPDU, Projects
  Officer
• Identification of projects person
• Key stakeholders identified
• Support sought from IT and other departments
• Service Need Analysis conducted
• Financial Approval Secured
• Achieve role integration
• Application of approval of Job Description and
  Site Preparation made to the National Council

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Site Preparation Process

• Need for ANP post identified
• Meeting with DoN, Director of NMPDU, Projects
  Officer
• Identification of projects person
• Key stakeholders identified
• Support sought from IT and other departments
• Service Need Analysis conducted
• Financial Approval Secured
• Achieve role integration
• Application of approval of Job Description and
  Site Preparation made to the National Council

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HSE South Cork Kerry

• Population 621,130
• Size 1, 224, 223 Hectares
• Health Care 6 Acute Hospitals and 5 Local Health
  Offices

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Project Officer and Project Person

• Projects Officer Role
• Provide leadership and management of project
• Knowledge of specialist field and relevant health
  care policy
• Meets with projects person on a need basis
• Research Conducts Service Needs Analysis
• Acts as a consultant on all aspects of the
  process
• Edits all relevant documents
• Acts as link between NC, organisation and NMPDU
• Projects Persons Activities
• Involvement in the preparation for Service Needs
  Analysis
• Convene project and steering group meetings
• Write job description and site preparation
  document
• Draw up practice guidelines and other supportive
  material

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Current ANP Projects HSE (Cork Kerry)
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ANP Post Development ED, CUH
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Challenges

• Identifying Service Need and Securing Funding
• Identifying Scope of Practice
• Guidelines to support the role
• Establishing referral pathways

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Challenges and Solutions1 Identifying Scope of
Practice
Identifying Caseload Include or exclude
children in ANP (Emergency) service

• Set up a project team
• Discussed options with key stakeholders
• Looked at resources
• Consider Best Interest of the Child and Service
  Needs
• Realistic goals getting it right first time

• Conducted an investigation to inform best
  practice
• Professional and legal factors explored
• Experts in the fields consulted
• Report written outlining findings and
  recommendations

Present report finding to the steering group
Caseload lt or gt 16 yrs?
Outcome ANP Caseload lt 16 yrs of age Subject to
review in the future
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Challenges and Solutions2. Health Care Need to
be Addressed by an ANP
Healthcare need to be addressed By the
ANP Provide data to support ANP post
Identify the following with key
stakeholders Patients healthcare Journey, Nos
and Demographics Professional involvement and
treatment/services required Discharge or
follow-up arrangements
Carry out survey of practice (Database) Identify
key fields, timeframe, methodology, supporting
research health care policies Analyse Data
Discuss findings in relation to Health Need to
be addressed by ANP Write report and present to
Management Board
Identify follow-up plan with key stakeholders
No
Financial Approval Gained?
Yes
Continue with process of ANP Site Preparation
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Challenges and Solutions3 Interdisciplinary
Referrals
Clinical Support Team do not take non medical
referrals
Discussion in Project Team and Steering Group
Meetings Discussion with managers and other sites
Project Officer meet with each Support Service
Manager Chairperson of Support Services had
membership on the Steering Group Open
communication on role development Clarified ANP
role and Scope of Practice Stakeholder analysis
performed Listen to rationale
ANP Referral to be Accepted by Clinical Support
Team?
Team identified clinical pathway in absence of
direct referrals ANPs Clinical leadership
Continue to build greater interdisciplinary
links
Yes
No
Clinical Guidelines reflect direct referral
pathways
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Tips

• Have an achievable vision, plan and timeframe
• Involve key stakeholders in the process
• Choose your battles
• Be creative
• Team encouragement
• Network, Network and Network
• Work closely with National Council and NMPDU

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Key Points

• 1. PATIENT NEED is primary
• 2. Show clarity in ANP Competence,
• Scope of Practice, Autonomy Levels of
  Clinical Decision Making
• 3. Identify key stakeholders and involve them in
  the process
• 4. Gather factual information
• 5. Form a strong team to help develop the
  process
• 6. Secure early organisational commitment to the
  role

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Site Similarities

• NC framework invaluable
• Organisational based
• business plan beneficial
• Service ownership is important
• Projects persons/assigned persons are pivotal to
  site development
• Project Facilitators are seen to be beneficial in
  ANP post development

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Questions?
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Contact Number
Ann Kelleher Former Nurses Residence Cork
University Hospital Wilton Road, Cork
Joan Gallagher NMPDU Office Complex Kilcreene
Hospital Grounds Kilkenny
Telephone [phone]
Telephone [phone]
E-mail AnnM.Kelleher_at_mailp.hse.ie
E-mail JoanE.Gallagher_at_hse.ie