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Eileen Furlong

Eileen Furlong. School of Nursing & Midwifery University College Dublin. The Emerging Role of the Advanced Nurse Practitioner. 16th October 2004. Objectives. To provide background information To outline the development of an educational framework for advanced nursing practice

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Eileen Furlong

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  1. Eileen Furlong School of Nursing & Midwifery University College Dublin The Emerging Role of the Advanced Nurse Practitioner 16th October 2004

  2. Objectives • To provide background information • To outline the development of an educational framework for advanced nursing practice • To present the framework process • To consider the role of the advanced nurse practitioner in cancer care

  3. Historical Review • Development of specialist and advanced practice roles • Increase in knowledge and educational reforms • Technological advances • Service need / public need / economic forces • Desire by nursing to develop its full potential in service provision

  4. Clinical Career Pathway Advanced NursePractitioner Registered Nurse Clinical Nurse Specialist (Government of Ireland 1998)

  5. Influences • Department of Health and Children • An Bord Altranais • National Council for the Professional Development of Nursing and Midwifery • Nursing and Midwifery Planning and Development Units • Reports

  6. European Working Directive on Medical Manpower Hanley & Brennan Medication Management Cancer Nursing Cancer Strategy Quality and Fairness

  7. How I Became Involved • Interest • Persistence !! • Curriculum work (2000 onwards) • London City University (March 2001) • Summer in Penn (2001) • Started programme (Sept 2001)

  8. MSc Nursing Programme UCD • Advanced Practice • Clinical • Education • Management • Public Health

  9. Core Modules on Masters Degree: Theory & Practice Advanced Research Leadership & Management CQI MSc Nursing (Advanced Practice)

  10. Advanced Practice Modules: Pathology Physiology Physical Assessment Pharmacology Case Management Clinical Practicum MSc Nursing (Advanced Practice)

  11. Speciality Areas Adult / Paediatric • Oncology / haematology • Critical care • Palliative care • Primary care / community nursing • Emergency / diabetes / renal nursing • Dermatology /Gastro–intestinal nursing • Stroke care

  12. Current Status - UCD • 4 graduates • 3 due to finish next month • 16 on programme currently • No one yet accredited from UCD programme • UCG commenced programme in Jan 2002

  13. Current Irish Status • 14 accredited • Emergency • Sexual Health • Rheumatology Map of ireland to go here

  14. Current Irish Status • Refers to nursing practice that focuses on the client and situations which enhance positive outcomes for the client, family and community (Hamric et al. 2000) • Advanced nursing practice is carried out by autonomous, experienced practitioners who are competent and responsible for their own practice (NCNM 2001)

  15. Advanced Nurse Practitioner (ANP) • “ANP’s promote wellness, offer healthcare interventions and advocate healthy lifestyle choices for patient / clients, families and carers in a wide variety of settings in collaboration with other healthcare professionals according to an agreed scope of practice guidelines” (NCNM 2001)

  16. ANP Involves • Specialisation, expansion and advancement • Higher skill and knowledge to allow for the adoption of independent and autonomous roles • Clinical practice that focuses on direct clinical care…emphasis is on experiental development of competencies, underpinned by theoretical knowledge

  17. Core Concepts Expert practitioners Pioneering professional & clinical leadership ANP Autonomy in clinical practice Researcher (NCNM 2002)

  18. Differentiation(Commission on Nursing 1998) Advanced Nurse Practitioner: Clinical Nurse Specialist: • Higher level that CNS • MSc – theoretical & clinical modules • Extensive experience & advanced expertise • Works independently in collaborative role • Conducts research • Beyond level of initial qualification • (H.Dip/Post Graduate Dip) • Experience & expertise • Work with interdisciplinary team • Research utilisation • Teaching/advisory

  19. MAY 2001

  20. Criteria for ANP • Registered nurse • Masters Degree or higher • 7 years post registration • 5 years in speciality area • Supervised practice • Demonstrate competencies • Evidence of professional development (www.ncnm.ie)

  21. ANP Establishment Process Part 1. Organisational Application Approval of Site Preparation and Job Description Part 2. Individual Application Accreditation of ANP

  22. Site Preparation- Organisational • Identify healthcare need to be addressed • Understand laws, rules, regulations and guidelines governing nursing practice • Accept the legal principle of vicarious liability • Ensure good practice guidelines are developed collaboratively • Determine the patient / client benefit from ANP service

  23. Site PreparationApproval • Service to be consistent with organisational philosophy • Project how change will help to meet the service plan • Consider optimal location of service • Consider integration into MDT • Define role content • Identify resource implications

  24. Job Description Approval • Job title • Grade • Reporting relationship • Location • Background to post • Specific factors • Purpose of post

  25. Part 2 Process for Accreditation • Application form • A professional portfolio demonstrating extensive experience, knowledge and skills in the context of practice in which the accreditation is sought in line with National Council criteria • Accreditation valid for 5 years • Non-transferable

  26. Role Development • Definitions • Core concepts • Responsibilities • Framework • Scope of practice • Literature

  27. Setting Your Own Agenda • ANP role – grounded in nursing theory ensuring holistic practice • Role development must occur in the context of service need and be established within the framework of the service plan

  28. Challenges Ahead • AA process • Role development in cancer nursing • Competencies • Outcomes research (quality and cost) • Accessibility of programme • Evaluate educational framework

  29. Contribution to Cancer Nursing

  30. Email eileen.furlong@ucd.ie Webwww.ucd.ie/nursing Webwww.ncnm.ie

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