Advanced practice nursing; an expanded nursing role on an international level

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Eduprof Expertmeeting 14-15 April 2011 Groningen.

Workshop Nursing

presentation on Advanced practice nursing; an expanded nursing role on an international level by Mrs. P. Roodbol, Hanze University of Applied Sciences Groningen. The Netherlands

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Advanced practice nursing; an expanded nursing role on an international level

  1. 1. dr. Petrie F. Roodbol, Hanze University of Applied Science, UMCG Netherlands, Chair ICN APN/NP Advanced practice nursing; an expanded nursing role on an international level
  2. 2. Content <ul><ul><li>APN in context of the ICN- scope and definitions </li></ul></ul><ul><ul><li>APN Worldwide </li></ul></ul><ul><ul><li>Netherlands </li></ul></ul><ul><ul><li>Future </li></ul></ul>
  3. 3. International Council of Nurses
  4. 4. <ul><li>Regulation </li></ul><ul><li>Socio-economic welfare </li></ul><ul><li>Professional practice </li></ul><ul><ul><ul><li>ICNP </li></ul></ul></ul><ul><ul><ul><li>Lederschip in change </li></ul></ul></ul><ul><ul><ul><li>APN </li></ul></ul></ul>
  5. 5. APN: an umbrella term
  6. 6. RN APN Specialization BACHELOR APN RN NP CNS Midwife Anesth.
  7. 7. Characteristics <ul><li>Educational preparation </li></ul><ul><li>Nature of practice </li></ul><ul><li>Regulatory mechanism </li></ul>
  8. 8. Educational preparation <ul><li>Educational preparation on advanced level </li></ul><ul><li>Formal recognition of educational programs </li></ul><ul><li>A formal system of licensure, registration certification or credentialing </li></ul>
  9. 9. Nature of practice <ul><li>Integration research, education, clinical management </li></ul><ul><li>Independency, autonomy </li></ul><ul><li>Advanced assessment, decision-making skills </li></ul><ul><li>Recognized advanced clinical competencies </li></ul><ul><li>Recognized first point of service </li></ul><ul><li>Consultation </li></ul>
  10. 10. Http://www.youtube.com/watch?v=WmYBxOVo4oc -
  11. 11. <ul><li>Right to diagnose </li></ul><ul><li>Authority to prescribe </li></ul><ul><li>Authority to refer to other professionals </li></ul><ul><li>Authority to admit to hospitals </li></ul><ul><li>Title protection </li></ul><ul><li>Legislation specific to advanced practice </li></ul>Regulatory Mechanism (country specific)
  12. 12. NP HOW Patient service Staff Input Process outcome Review N=70 effectiveness, efficiency, and quality
  13. 13. Patient <ul><li>Satisfaction equal or increase (special groups) </li></ul><ul><li>Increase compliance </li></ul><ul><li>Less antibiotics, shorter hospitalized </li></ul><ul><li>Self management </li></ul>
  14. 14. Quality <ul><li>Health: equal or increased (assessment, treatment, less complications) </li></ul><ul><li>Safety; equal or increased </li></ul>
  15. 15. Service <ul><li>Shorter waiting times, faster access </li></ul><ul><li>Rural areas, vulnerable populations </li></ul><ul><li>Less hospitalization </li></ul><ul><li>Equal mortality </li></ul><ul><li>Cost effective </li></ul><ul><li>Equal number of consultations for patients longer consultancies </li></ul>
  16. 16. Impact on the staff <ul><li>Substitution </li></ul><ul><li>Increase coordination and organization </li></ul>
  17. 17. Disease, illness Consequences of diseases, illnesses
  18. 18. Starting an APN……. <ul><li>A definition of the ANP role </li></ul><ul><li>Recommendations for collaborative practice </li></ul><ul><li>A curriculum </li></ul><ul><li>Recruitment, retention and deployment strategies </li></ul><ul><li>Recommendations for legislation and regulation </li></ul><ul><li>Strategies to reduce barriers to practice </li></ul>
  19. 20. Country Physicians Nurses Netherlands 3,8 13,73 South Africa 0,77 4,08 UK 2,2 9,9 Italy 3,8 7,79 Greece 5 4,2 Germany 3,9 9,2 Mexico 1,9 2,3 US 2,4 10,5 Hong Kong 1,7 5,28 Korea 2,0 3,58
  20. 27. Asia <ul><li>Taiwan </li></ul><ul><li>Hong Kong </li></ul><ul><li>Japan </li></ul><ul><li>Singapore </li></ul><ul><li>Macau </li></ul><ul><li>Thailand </li></ul><ul><li>Korea </li></ul>
  21. 29. European Nations <ul><li>UK (England, Wales, Scotland, Northern Ireland) </li></ul><ul><li>Sweden, Finland </li></ul><ul><li>Netherlands, Belgium </li></ul><ul><li>France </li></ul><ul><li>Germany, Switzerland </li></ul>
  22. 31. Characteristics <ul><li>16.4 Million inhabitants </li></ul><ul><li>Life expectancy 77.3 – 80.4 </li></ul><ul><li>HDI no.6 </li></ul><ul><li>Healthy 81,2% </li></ul><ul><li>Required insurance </li></ul>
  23. 32. Health Care typology <ul><li>Affordable, accessible </li></ul><ul><li>Solidarity </li></ul><ul><li>Focus on primary care </li></ul><ul><li>Government determines </li></ul>
  24. 33. Healthcare problems <ul><li>Chronically ill (1 million diabetes!) </li></ul><ul><li>Hearth diseases, cancer </li></ul><ul><li>Child obesity </li></ul><ul><li>Elderly (frailty) </li></ul>
  25. 34. History <ul><li>NP 1997 (CNS: 1986) </li></ul><ul><li>Hospital based </li></ul><ul><li>Individual initiative </li></ul><ul><li>Answer on human resource problems </li></ul><ul><li>Fast, uncontrolled grow </li></ul><ul><li>Governmental (financial) support 2002 </li></ul>
  26. 36. 2011 <ul><li>Program in nine cities </li></ul><ul><li>National competency profile </li></ul><ul><li>Association </li></ul><ul><li>Number +/- </li></ul><ul><li>Legislation </li></ul><ul><ul><li>Independency </li></ul></ul><ul><ul><li>Prescriptive authority </li></ul></ul><ul><ul><li>Registration (previously acquired skills) </li></ul></ul>
  27. 37. Positive effects (1) <ul><li>Bridging the cap: physicians/nurses </li></ul><ul><li>Integration cure and care </li></ul><ul><li>(Cost) effective care </li></ul><ul><li>Self management </li></ul><ul><li>Patient centred care </li></ul><ul><li>Easily accessible </li></ul><ul><li>Innovation, quality driven </li></ul>
  28. 38. <ul><li>Experienced, motivated nurses </li></ul><ul><li>Increasing continuity </li></ul><ul><li>Role models in holistic care </li></ul><ul><li>Organizational innovation </li></ul><ul><li>Positive research results </li></ul>Positive effects (2)
  29. 39. Negative effects <ul><li>Medical socialization </li></ul><ul><li>Medical classification </li></ul><ul><li>Money driven </li></ul><ul><li>Diverse perception </li></ul><ul><li>Unverified grow </li></ul>
  30. 40. Acceptance <ul><li>Government +++ </li></ul><ul><li>Public ++ </li></ul><ul><li>Physicians + </li></ul><ul><li>RN ++ </li></ul><ul><li>(overcapacity of physicians; Physician assistants less acceptance) </li></ul>
  31. 41. Healthy Aging: statistics
  32. 42. Prevalence of selected chronic diseases 65+
  33. 43. Key strategies <ul><li>Healthy life style behavior </li></ul><ul><li>Injury prevention </li></ul><ul><li>Delivery of culturally clinical preventive services </li></ul><ul><li>Immunization and preventive screenings </li></ul><ul><li>Self management for chronically ill </li></ul>
  34. 46. Fit as possible Dementia
  35. 48. Advanced nursing practice

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