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Alyson Wheelhouse, Southern Health: Understanding Role Development, Fostering Clinical Leadership And Ensuring A Sustainable Model: The Nurse Practitioner Candidate Journey
 

Alyson Wheelhouse, Southern Health: Understanding Role Development, Fostering Clinical Leadership And Ensuring A Sustainable Model: The Nurse Practitioner Candidate Journey

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Alyson Wheelhouse, Nurse Practitioner, Wellness and Recovery Centre - Eating Disorders, Southern Health delivered this presentation at the 2013 Developing the Role of the Nurse Practitioner ...

Alyson Wheelhouse, Nurse Practitioner, Wellness and Recovery Centre - Eating Disorders, Southern Health 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/nursepractitionersconference

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    Alyson Wheelhouse, Southern Health: Understanding Role Development, Fostering Clinical Leadership And Ensuring A Sustainable Model: The Nurse Practitioner Candidate Journey Alyson Wheelhouse, Southern Health: Understanding Role Development, Fostering Clinical Leadership And Ensuring A Sustainable Model: The Nurse Practitioner Candidate Journey Presentation Transcript

    • Role Development and Ensuring a Sustainable Model: Mental Health Eating Disorder Nurse Practitioner Alyson Wheelhouse Nurse Practitioner (Mental Health) Wellness and Recovery Centre – Eating Disorders, Southern Health
    • Southern Health
    • Workforce Sustainability • “Sustainable models of Nurse Practitioners in public mental health and drug clinical services” prepared for Nurse Policy Brach, DoH • Increased need for high level mental health expertise • Overall decline in the workforce – need for ED specialists • Emergence of increasing numbers of patients with complex needs
    • Role Development • SH Internal service review (2010) • ED exceeding current resources • Interface between psychiatry and medicine fragmented • Significant growing burden on health and illness • Need to improve capacity and expertise • NP role identified as key priority in the workforce • Funding required to develop effective model
    • Key Principles • Model does not replace existing services, or positions • Role is to fill the gap where positions do not already exist • To be an extension of the current service, allowing improved capacity and expertise • Aim to utilise advanced knowledge and skills (leadership and clinical) in psychiatric, physical and nutritional assessment and treatment
    • Referrals from: General Practitioners, and other Health Care Providers Referrals from: Southern Health Psychiatric Triage Service Referrals from: GPs, Paediatricians, Primary care, SH and regional CAMHS Adolescent Medicine – ED Clinic Primary Mental Health and Early Intervention Team Assessed as Suitable for Shared Care Community Models (tier 1 & 2). Nurse Practitioner/Coordinator to facilitate in partnerships with PMH&EI or General Medicine Eating Disorder Wellness and Recovery Centre: Intake and Assessment (Diagnostic, Evaluation and Treatment Planning) Southern Health/ Butterfly Eating Disorder Day Program Southern Health Intensive Outpatient Treatment Program/ Adult Day Program Outpatient Treatment (clinic based) Child and Youth Adult Inpatient Medical Psychiatric
    • Case Study • • • • • • 21 year old medical student referred by GP Weight 38kg, BMI 13 Obesity one year ago Rapid weight loss Seen in emergency x 2. Discharged home Ax by NP one week later, further weight loss and medical instability • Patient offered a medical admission
    • Support Sustainability • Clearly defined Governance – individual and service driven steering committees • Strategic Management – direction of goals / vision • Organisational support • Mentoring – clinical and professional support • Education and training • External supports - collaborative
    • Governance • Governed by the Nursing and Midwifery Executive Leadership Team (NMELT) – shows commitment the role • SH NP Steering Committee identifies and prioritises areas for future development • Identifies education requirements • Allows the service to evaluate the current roles and explore future roles
    • Steering Committee • • • • • • • Ensures Governance and oversight of role Ensures preparation Forum to share and discuss common themes Clarify expectations Facilitate updates Networking Collectively meet key stakeholders / experts
    • Organisational Support • Implications for ongoing role development • Support for Education (university studies) – funding and time • Willingness of Senior Management including the Director of Nursing and Executive Director to provide support and mentorship • Philosophical approach to the NP being seen as a clinical leader working as part of a MDT
    • NP/NPC Meetings • NP/NPC Group meet monthly • Supported by Nurse Consultant – Professional Practice • 1 hour to discuss common challenges • 1 hour for professional development (usually presented by a member of the group) • Quarterly 3 hour professional development Master class – usually provided by craft experts
    • Communities of Practice • • • • • • • Opportunity to develop support networks Capacity building Provide forum for advice Facilitate sharing of resources Practice innovation and development Role profiling Group representation
    • Education • • • • • • • • 20% non clinical role ( 1 day week FT NPC/NP) Built into budget Initial and ongoing education requirement Medical and Nursing supervision Attendance internal and state-wide Seminars and conferences Yearly plan Keep a log
    • Mentoring and Supervision • Access (time and support) to Medical Consultants, Psychiatrists, Dietitians and Physicians • Need to ensure NP can perform the role • Access to clinical guidelines, and training needs • Link to existing training
    • Funding • Government funding based on delivery of target domains • Need to demonstrate effective and efficient use of resources • 2010 DoH approved SH service model • Pilot funding for 18mths based on data analysis and feedback forums • Secure funding was granted June 2012
    • Evaluation Tools • Required to ensure quality of delivery and responsiveness • Requirement that NP demonstrates outcomes • Develop Key Performance Indicators • Develop audit tools – identify expanded role and assess impact on service • Include in annual performance appraisal- DON and Manager
    • Leadership • Envisioning a better service – quality activities • Motivating / empowering others – encouraging change, and role modeling • Enticing others to join the vision – being available, consultation and liaison • Thinking in a different way – evidence based practice, initiate and contribute to quality improvement, assist in policy development, taking risks, propose alternatives
    • Interpersonal Qualities • • • • • • • Be committed, resilient and driven Academic ability Operate independently Organised Manage conflict / draw backs Good communication skills Collaborate – representation on committees and conferences, liaison
    • Barriers to Sustainability • • • • • • • Endorsement process seen as a deterrent Inability to identify suitable candidate Lack of support Lack of resources Inability of NP to meet expectations Productivity limited by current legislation Fill a service gap
    • Barriers to Sustainability • Risk of evaporating into existing position • View that the role is not transferable across the service • Model - Answer to all the problems!!
    • Benefits of Role • • • • • • Efficient and timely assessment Reduction in admissions Engagement in early treatment and detection Enhancing clinical and professional leadership Improvement in research activities Enhancement in opportunities for the nursing profession • Enhancement of opportunities for collaboration
    • Key take home message • Recognise positions require extensive availability of support • Clear and sustainable model • Research and consult prior to employing into Candidate positions • Ensure Governance arrangements • Organisation and Candidate to commit • Shared vision and understanding of the Scope of Practice
    • Questions Alyson Wheelhouse Nurse Practitioner Wellness and Recovery Centre – Eating Disorders, Southern Health 03 9594 1300 0438 353 722 alyson.wheelhouse@southernhealth.org.au