2. WHAT IS CONSULTATION
IN ADVANCED PRACTICE
NURSING ?
• Building of relationships with healthcare
professionals
3. OBJECTIVES:
• Define case management and consultation
• Describe the model of APN consultation
• Identify common APN consultation situations
• Discuss different applications of case management
• Discuss challenges in APN case management
4. KEY WORDS
Case management / Consultation- between two professionals
Referral- to consult with another clinician
Collaboration- brings all interactions together
Consultee- clinician asking for the consultation
6. TYPES OF CONSULTATION
1) Client-centered (patient-centered)
• most common, assist consultee to develop an effective
plan of care for a patient
2) Consultee-centered (clinician-centered)
• focused directly on consultee’s ability to handle a
difficult situation
3) Program-centered (clinical programs)
4) Consultee-centered administrative (group of
administrators)
7. MODEL OF ADVANCED PRACTICE
NURSING CONSULTATION
pppppPurposes &
Outcomes
Consultation
process & phases
Characteristics of
APN consultant
Characteristics
of consultee
Situational factors Characteristics of
patient/family
Ecological field of the consultation
8. MODEL OF ADVANCED PRACTICE
NURSING CONSULTATION
Ecological field of the
consultation
Ecological field of
the consultation
APNs have a holistic view
and understanding of
systems theory that allow
them to apply the model
in practice
9. MODEL OF ADVANCED PRACTICE
NURSING CONSULTATION
Purposes
Purposes &
outcomes of
consultation
Improving systems &
patient outcomes,
enhancing problem
solving, education, and
development of
consultee
10. MODEL OF ADVANCED PRACTICE
NURSING CONSULTATION
Consultation
process & phases
Assessment,
Intervention,
Evaluation, and
Reassessment
13. Model of advanced practice
nursing consultation
Characteristics of
consultee
Characteristics of
APN consultant
Experience, specialty,
interpersonal skills,
competence in consultation
process, knowledge of
systems
Experience, education,
level of concern/distress
regarding the problem,
time constraints, free to
accept or reject
consultant’s advice
14. Characteristics of
patient/family
Situational factors
Acuity of the clinical
problem, medical & social
history, support, level of
personal distress
Staff-patient
interactions, staff-
staff interactions,
available resources
Model of advanced practice nursing consultation
16. APN CONSULTATION IN PRACTICE
“Could you please take
a look at these results?
“
“I don’t know what else
to do with this patient.
What are your
suggestions?”
17. APN-PHYSICIAN CONSULTATION
“APNs deep
appreciation for
the human
responses related
to health &
illness”
“Physician’s deep
understanding of
disease & treatment”
What connects the APN and physician
in providing excellent patient care?
18. APN-STAFF NURSE
“I’m not too familiar with
complications associated with
Guillain-Barre syndrome. Let’s ask
our CNS on what she thinks about
this disease process.”
“There’s evidence of illicit drug
use before the surgery, which is in
15 minutes. Do we cancel? What’s
next?”
21. ISSUES IN APN CONSULTATION
Developing
consultation
skills in APN
students
Using
technology
Billing for
consultation
Establishing good rapport,
structuring the
consultation, prioritizing,
clinical reasoning
Definition of telehealth
activities and understanding
current legal and ethical
issues related privacy and
confidentiality
Specific CMS criteria
before you can bill
individually
