advanced practice nursing; an expanded nursing role on an international level
DESCRIPTION
Eduprof Expertmeeting 14-15 April 2011 Groningen.Workshop Nursingpresentation on Advanced practice nursing; an expanded nursing role on an international level by Mrs. P. Roodbol, Hanze University of Applied Sciences Groningen. The NetherlandsTRANSCRIPT
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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
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Content
APN in context of the ICN- scope and definitionsAPN WorldwideNetherlandsFuture
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International Council of Nurses
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RegulationSocio-economic welfare Professional practice
ICNP Lederschip in change APN
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APN: an umbrella term
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RN APN
Specialization
BACHELOR
APN
RN
NPCNSMidwifeAnesth.
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Characteristics
Educational preparationNature of practiceRegulatory mechanism
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Educational preparation
Educational preparation on advanced levelFormal recognition of educational programsA formal system of licensure, registration
certification or credentialing
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Nature of practice
Integration research, education, clinical management
Independency, autonomyAdvanced assessment, decision-making skillsRecognized advanced clinical competenciesRecognized first point of serviceConsultation
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Http://www.youtube.com/watch?v=WmYBxOVo4oc -
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Right to diagnoseAuthority to prescribeAuthority to refer to other professionalsAuthority to admit to hospitalsTitle protectionLegislation specific to advanced practice
Regulatory Mechanism (country specific)
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NP HOW
Patient
service Staff
Input Process outcome
Review N=70
effectiveness, efficiency, and quality
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Patient
Satisfaction equal or increase (special groups) Increase compliance Less antibiotics, shorter hospitalizedSelf management
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Quality
Health: equal or increased (assessment, treatment, less complications)
Safety; equal or increased
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Service
Shorter waiting times, faster accessRural areas, vulnerable populationsLess hospitalizationEqual mortalityCost effectiveEqual number of consultations for patients longer
consultancies
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Impact on the staff
SubstitutionIncrease coordination and organization
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Disease, illness Consequences of diseases, illnesses
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Starting an APN…….
A definition of the ANP roleRecommendations for collaborative practiceA curriculumRecruitment, retention and deployment strategiesRecommendations for legislation and regulationStrategies to reduce barriers to practice
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Country Physicians Nurses
Netherlands 3,8 13,73South Africa 0,77 4,08 UK 2,2 9,9Italy 3,8 7,79Greece 5 4,2Germany 3,9 9,2Mexico 1,9 2,3US 2,4 10,5Hong Kong 1,7 5,28Korea 2,0 3,58
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AsiaTaiwanHong KongJapanSingaporeMacauThailandKorea
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European Nations
UK (England, Wales, Scotland, Northern Ireland)Sweden, FinlandNetherlands, BelgiumFranceGermany, Switzerland
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Characteristics
16.4 Million inhabitantsLife expectancy 77.3 – 80.4HDI no.6Healthy 81,2%Required insurance
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Health Care typology Affordable, accessible Solidarity Focus on primary care Government determines
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Healthcare problemsChronically ill (1 million diabetes!)Hearth diseases, cancer Child obesity Elderly (frailty)
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History
NP 1997 (CNS: 1986)Hospital based Individual initiative Answer on human resource problems Fast, uncontrolled growGovernmental (financial) support 2002
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2011Program in nine citiesNational competency profileAssociation Number +/-Legislation
IndependencyPrescriptive authority Registration (previously acquired skills)
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Positive effects (1)
Bridging the cap: physicians/nurses Integration cure and care (Cost) effective care Self management Patient centred care Easily accessible Innovation, quality driven
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Experienced, motivated nursesIncreasing continuity Role models in holistic careOrganizational innovation Positive research results
Positive effects (2)
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Negative effects
Medical socializationMedical classificationMoney drivenDiverse perceptionUnverified grow
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Acceptance Government +++Public ++Physicians +RN ++(overcapacity of physicians; Physician assistants
less acceptance)
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Healthy Aging: statistics
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Prevalence of selected chronic diseases 65+
20,40%
49,20%
19,90%
15,20%
8,60%
35,90%
0,00% 10,00% 20,00% 30,00% 40,00% 50,00% 60,00%
heart desease
hypertension
cancer
diabetes
stroke
artritic symptoms
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Key strategiesHealthy life style behaviorInjury preventionDelivery of culturally clinical preventive
servicesImmunization and preventive screeningsSelf management for chronically ill
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Fit as possible
Dementia
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Advanced nursing practice