leonie burdack, australian college of nursing: trialled and proven; time to move on: how health...
DESCRIPTION
Leonie Burdack, Vice President, Australian College of Nurse Practitioners (ACNP) delivered this presentation at the 2013 Developing the Role of the Nurse Practitioner conference. The event is designed for organisations and managers looking to better understand, utilise and grow the role of the nurse practitioner in their health service. For more information about the annual event, please visit the conference website: http://www.healthcareconferences.com.au/nursepractitionersconferenceTRANSCRIPT
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transforming health care.
australian college of nurse practitioners
Trialed and Proven: Time to Move on
Getting the most out of the NP role
Leonie Burdack NP, FFACNP MNP; Grad Dip Ed, A&E Cert, Grad Cert BA, BApSc
Vice President ACNP
March 2013
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transforming health care.
australian college of nurse practitioners
Overview
• Background
• Role implementation
- NP role and leadership
- NP role in practice
• Future direction and challenges
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transforming health care.
australian college of nurse practitioners
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transforming health care.
australian college of nurse practitioners
Potted History https://www.acnp.org.au/australian-college-of-nurse-practitioners-potted-history.html
• 1990 First Nurse Practitioner authorised in NSW
(2002-SA; 2003-WA; 2004 - ACT, VIC; 2006-QLD; 2008-NT)
• 2005 ANMC NP Competency Standards
• 2005 Inaugural National Conference ANPA
• 2007 3 yr funded ARCS: Australian NP Research Project
• 2008 Primary Health Care Round Table
• 2009 ACNP registered
• 2010 MBS & PBS reforms announced
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transforming health care.
australian college of nurse practitioners
The journey so far.......
• Safety and efficacy
• Patient satisfaction
• Improved quality and access
• Comparative analysis
• Cost
• “Outcomes”
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transforming health care.
australian college of nurse practitioners
Specialists raise doubts about the quality of nurse referrals
Dumbing down the Australian health system.
Beware the ‘gift’ of nurse practitioners “I think there is a Trojan horse lurking in the weeds trying to pull a fast
one on the American people.” George W Bush
Debate rages over push for more nurse practitioners
Push to restrict rights of solo nurse practitioners
Nurse prescribing: a risky proposition
Nurse practitioners: insurance status warning
Inferior health care
A dangerous and irresponsible path to follow
IN THE NEWS
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transforming health care.
australian college of nurse practitioners
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transforming health care.
australian college of nurse practitioners Practice reality.......
• Effective partnerships – patient-centred
• Diverse models of care –good patient outcomes
Aged care, Chronic disease, Acute care , Mental Health,
Palliative Care, Community, Primary Health Care
• Public + Private
• Metropolitan, urban, rural + remote
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transforming health care.
australian college of nurse practitioners
Distribution
Source:ACNP Survey 2012
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transforming health care.
australian college of nurse practitioners
Practice areas
Source:ACNP Survey 2012
Employment settings
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transforming health care.
australian college of nurse practitioners
Getting the most from the role
• Empowering and enhancing leadership
• Communicating benefits and considerations for establishing NP role
• Changes in healthcare : future implications for NP models of care
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transforming health care.
australian college of nurse practitioners
Leadership • NP leadership role is multi-faceted
• Learned or innate
• May “manage” clinics but focus is advanced clinical practice
• Not necessarily leading group/people - NPs work alongside
• Integral to establishment of role (Source: Watson, ANMC Competency standards)
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transforming health care.
australian college of nurse practitioners
Qualities? • Advocate quality care
• Collaborator
• Communication
• Mentor
• Risk taker
• Role model
• Visionary
(Source: Carter et al 2010)
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transforming health care.
australian college of nurse practitioners
Leadership in practice......... • Clinical nursing role - setting standards, resource, expertise
• Change – policy, professional, patient level
• Mentoring or facilitating; Education and teaching
• Promoting and contributing to evidence based practice
• Maintaining an ethical practice;
• Promoting or developing the nursing profession;
• Developing new initiatives
• Inspiring or motivating others;
(Source: Watson, ANMC Competency standards)
• (Watson, ANMC Competency standards
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transforming health care.
australian college of nurse practitioners
Enabling factors
• Infrastructure + resource
• Policies and systems
• Clinical and professional governance
• Clarification around the role
• Integration + utilisation of the role dimensions
• Role design
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transforming health care.
australian college of nurse practitioners
Benefits and other considerations
• Complementary role that provides expert nursing knowledge and skills
• Grounded in nursing theory and not a substitute medical role
• NP, RN, PN not mutually exclusive
• Role differentiation + scope
• Individually liable + accountable
• Constant
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transforming health care.
australian college of nurse practitioners
Benefits and other considerations
Optimization + full utilization of the role benefits:
• Patient
• Organization
• Professional/clinician
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transforming health care.
australian college of nurse practitioners
Benefits of NP role and practice
• Improved access
• Early intervention prevents deterioration/exacerbation
• Longer appointments with patients
• Improved coordination of care
• Expert case management
• Provision of new services
• Enhanced team work
• Constant
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transforming health care.
australian college of nurse practitioners Responsibilities include ................
Source:ACNP Survey 2012
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transforming health care.
australian college of nurse practitioners
Source:ACNP Survey 2012
Discharge process
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transforming health care.
australian college of nurse practitioners
Other considerations • Identify need/benefits
• Determine scope and profile
– Experience and qualifications
– Clinical services, procedures, interventions -competency +skills
• Verify quality of health services to be provided
• Capability of employer or health service provider
• Stakeholders
Source: 2011 Queensland Health Office of the Chief Nursing Officer Clinical Governance for Nurse Practitioners in Queensland: A Guide
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transforming health care.
australian college of nurse practitioners
Future : where to from here?
• Dynamic and evolving
• NPs as part of the solution?
Aged care and Community
Acute and sub-acute
Primary healthcare
Outreach models
• Decisive implementation
• Purposeful planning models of care, workforce
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transforming health care.
australian college of nurse practitioners
Future : where to from here?
• Cyclical funding/economic factors
• Health service factors
• Professional
• NP specific outcome measures
• Educational preparation
• Policy framework
•
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transforming health care.
australian college of nurse practitioners
Critical Success Factors Source: 2011 Queensland Health Office of the Chief Nursing Officer Clinical Governance for Nurse Practitioners in Queensland: A Guide
• Safety + quality
• Collaboration
• Autonomy
• Role clarity
• Innovation
• Respect + recognition
Patient- C
en
tred
Supportive environment
Full Potential
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transforming health care.
australian college of nurse practitioners
Questions?