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Valerie Small RANP Emergency Department, St James’s Hospital, Dublin

A Guide to Enhance ANP Nursing Services across Emergency Care Networks (2013) Project Update National Emergency Medicine Programme Seminar 2016. Valerie Small RANP Emergency Department, St James’s Hospital, Dublin ANP Advisor – National Emergency Medicine Programme. Introduction.

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Valerie Small RANP Emergency Department, St James’s Hospital, Dublin

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  1. A Guide to Enhance ANP Nursing Services across Emergency Care Networks (2013)Project UpdateNational Emergency Medicine ProgrammeSeminar 2016 Valerie Small RANP Emergency Department, St James’s Hospital, Dublin ANP Advisor – National Emergency Medicine Programme

  2. Introduction • Context of ANP Role • Key Objectives of ANP Strategy • Current Status / Service Activity • Patient Caseload • Next Steps

  3. Context Advanced Nurse Practitioner Role • Established St James’s Hospital 1996 • Commission on Nursing recommended career pathway 1998 • Variable development over 10-15 years • National Emergency Medicine Programme Strategy (2012)

  4. ANP Strategy (June 2013)Key Objectives Provide guidance on optimum number and location of ANP’s required in EDs/LIUs Standardise role profile and scope of practice Standardise recruitment and education requirements Support continuous professional development needs of ANP’s Sustain established ANP services through career and succession planning support

  5. At a Glance In Development In Development • Capacity • Capability • Caseload In Development NO SERVICE DEVELOPED

  6. Capacity 1 2 3 ANP Forum Established 33 Established ANP Services (39 Units) • ANP Specific CPD Education Study Days (6) • National ANP activity data set • Nurse Prescribing Ionising Radiation in Children (2015) • 27 (28) EDs • 6 (11) LIUs • Standardised ANP Job Descriptions • Standardised ANP candidate grade code to support recruitment • 25 nurses undertaking education • 52 nurses required to be recruited to education/career pathway 78 Registered ANPs (150 Total)

  7. Capability • Role changing expanding and increasing in levels of complexity & responsibility • Medicinal & ionising radiation prescribing • X-Ray referral (children approved) • Strong collaborative working with MDT • Commitment to CPD & innovation in clinical practice

  8. 70,000+ patients managed by ANP’s in 2015 Average 14-16% of total new ED patient attendances Hours of Service mainly 8.00am-20.00hrs Triage Cat 4= 60% Triage Cat 3= 21% Triage Cat 2= 3% 90% pt seen within recommended Manchester Triage times Average time from consultation to discharge 52mins Average PET = 93mins Service Activity

  9. Caseload /Patient Profile

  10. Musculoskeletal Injuries

  11. Initial Fracture Management ED Fracture Reviews

  12. Head & Facial Injuries

  13. Max Fax/Dental Trauma

  14. Skeletal and Soft Tissue Injuries

  15. Reduction of Fracture / Dislocations

  16. Management of Soft Tissue Infection

  17. Complex Wound Management

  18. Specific Hand Injuries

  19. Medical & Surgical conditions Non-cardiac chest pain ENT conditions Hip fracture Expanding Scope of Practice

  20. NEXT STEPS! • Workforce planning/Service needs analysis • Recruit & Train 52 additional ED nurses to continue capacity building

  21. SO FINALLY !! WHAT ABOUT THOSE MIN RS !!

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