The role of the registered advanced nurse practitioner (RANP) in gerontological nursing is summarized as follows: 1) RANPs aim to support quality and timely care for older adults by performing comprehensive assessments, planning and initiating treatment, promoting healthy aging and independence, and supporting transition to long-term care. 2) Key roles of RANPs include demonstrating autonomous clinical decision-making and expert practice in managing older adult caseloads, engaging in health promotion, and developing standards of care through research, education, and quality improvement. 3) RANPs work to address the complex health issues of an aging population and support aging in place through programs focused on falls prevention, bone health, chronic

1. The Role of the Registered Advanced
Nurse Practitioner in Gerontological
Nursing
Daragh Rodger
RANP
Care of the Older Adult
Community
3rd May 2018
AIGNA Annual Conference

2. Advanced Nurse Practitioner
Background
Report of The Commission on
Nursing
A Blueprint for the Future 1998
Progressed Career Structure for
Nurses
Clinical Nurse Specialist
Advanced Nurse Practitioner

3. INTERIM REPORT WGAP 2014: © NMBI
Advanced Nurse Practitioner

4. Advanced Nurse Practitioner
Core concepts
• Autonomy in Clinical Practice
• Expert Practice
• Professional and Clinical Leadership
• Research

5. Advanced Nurse Practitioner
Six domains
• Professional Values and Conduct of the
Registered Advanced Nurse Practitioner
• Clinical-Decision Making
• Knowledge and Cognitive Competencies
• Communication and Interpersonal
Competences
• Management and Team Competences
• Leadership and Professional Scholarship
Competences

6. First Advanced Nurse Practitioner (ANP) – 2001
Currently 195 RANP 3 RANP Older Persons
120 cANP undergoing Advanced Practice Programme
43 cANP older persons
Advanced Nurse Practitioner

7. Global View
Global population over 60 years
688 million in 2006, projected to grow to 2 billions
by 2050.
Incidence in chronic disease rising
18.7% of 65-69 year olds and 58.6% of those over
85 have various levels of disability. That increases
their inability to cope.
Impact of falls and falls related injuries
Globally are a leading cause of morbidity and
mortality in older population.
Action
Investment into future healthcare management of
older people to support healthy ageing
An Ageing Population
Facts, Figures & Related Health Concerns

8. Ireland
• CSO 2016 – 12.9% over 65 years of
age – 609310
• Increase in over 85’s by 150% on last
census – 286,481
• Increase in over 100 years - 456
• By the year 2021 there will be 17.3%
increase in the number of people
aged over 65 years by 107,600, &
additional 15,200 over 85 years
(ICPOP, 2017).
An Ageing Population
Facts, Figures & Related Health Concerns
% Increase in over 65’s since 2011

9. Advanced Nurse Practitioner
Impact of Ageing
As people age their health needs tend to become more
chronic and complex (WHO,2015)
Increased chronic illnesses - Health care costs up by
approximately 213% between 65–69years and 400%
between 75-79years (HSE 2005)
26.7% (156,799) over 65 year olds live alone
4% (22,762) live in residential care settings (CSO, 2016 )
Average age of residents is 84 years (Drennan et al. 2016)
https://www.publichealth.ie/files/chronic_main.pdf

10. Role of ANP in Gerontological Nursing
Disease processes
• High Blood Pressure
• Coronary Heart disease
• Stroke
• Diabetes
• Chronic obstructive
pulmonary disease
• Osteoarthritis
• Osteoporosis
• Dementia

11. Role of ANP in Gerontological Nursing
The ANP aims :
• To support the provision of a timely, quality
service to the older person and their family
• To enhance the quality of life of older
people,
• To promote healthy ageing and optimum
levels of independence
• To support older people in their own homes
and communities
• To support carers of older people by
providing access to respite care and day care
• To support transition to residential care

12. Role of ANP in Gerontological Nursing
Autonomy in Clinical Practice
• Performs comprehensive
holistic health assessments,
plans and initiates care and
treatment for older adults
in order to achieve
optimum patient outcomes
• Intra-professional and
inter-professional referral
and communication
Expert Practice
• Demonstrates advanced
clinical decision-making
skills to manage a patient
caseload
• Health promotion in clinical
setting
“One of the benefits we want to clearly
articulate is the holistic approach that
advanced nurse practitioners bring to
their care.”

13. Role of ANP in Gerontological Nursing
Healthy Active Ageing
• healthy eating
• being active
• mental well being
• social interaction
• monitoring own health
• medication compliance
• bone health
• falls prevention
• wellness in Winter

14. Role of ANP in Gerontological Nursing
Professional & Clinical
Leadership
Monitors and improves standards
of care and develops practice by
active involvement in
• Advanced clinical practice,
• Carrying out audits,
• Teaching older adults, families
& carers to manage their health
• Supporting colleagues & other
healthcare professionals in CPD
Research
Identifies research priorities
relating to care of older adults
Leads, conducts, disseminates
and publishes nursing research
and collaborative research
that advances nursing practice,
education, policy and the
wider health agenda for the
care of older adults
“The ANP as a nurse researcher has an important role to play in increasing the
understanding of the most pressing problems that impact on the health and quality
of life of older adults.”

15. Bone Health in the Park
www.bonehealth.co

16. Bone Health Education
For All Ages
•Children
•Teenagers
•Young Adults
•People with Physical
Disability
•People with an Intellectual
Disability
•Adults
•Older Adults living in
residential care
www.bonehealth.co

17. Forever Autumn Falls Prevention Programme
Development &
implementation of a falls
awareness programme for all
staff – clinical and non clinical,
illustrating the potential for
falls amongst the older adults
in our care.

18. Development of an online COP to offer
support, guidance and continued education in
falls prevention and management across the
care spectrum for older adults:-
• Acute Hospital Care
• Community Care
• Intellectual Disabilities Care
• Palliative Care
• Residential Care
We are seeking a proactive collaborative
approach to falls prevention by providing a
platform for continuing engagement
Forever Autumn
Community of Practice
www.foreverautumn.co

19. Happy Bones
Paula’s Story (& Una!) Chrissie’s Story –
Best Foot Forward
www.happybones.ie

20. Dissemination of innovations &research
• Present posters at local,
national and international
conferences – RCSI, DCU,IGS,
BGS, IAGG, IAANMP, NI2016,
FFBH, ICIC,
• Oral presentations – RCSI, NHI,
ONA, IOS, DCU, INECMA,
ACENDIO, NI2016
• Journal publications – NIGPP,
BJCN,WIN, JAIGNA
• Web repositories – Doras,
Lenus, ios Press

21. Role of ANP in Gerontological Nursing
Member of Local & National groups
• AIGNA – management committee
• HISINM – committee member older
person services
• FACOP – Project lead – special
interest group for falls prevention
• Gerontological Nursing Framework
Strategy Working Group
• National Working Group Falls & Bone
Health – AFFINITY – Residential Work
Stream Chair

22. Thank you
daragh.rodger@hse.ie
Websites
www.bonehealth.co
www.nursinginthepark.
com
www.happybones.ie