Pathway to Advanced Practice by sdfwerte

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									Reflections on the Advanced
           Practice Pathway
                 PAULA THOMPSON

                    Hospital At Night
          Advanced Nurse Practitioner
              NHS Ayrshire and Arran
Objectives
 Motivations for participation
 An overview of my initial aims vs my actual outcomes as
    Leadership
    Facilitating Learning
    Advanced Clinical Practice
    Research and Development

    As a Learner
My Background
 2002 A+E (SGH)
 2002 Ordinary Degree (Nursing Studies)
 2004 Honors Degree (Specialist Practice)
    Pathophysiology
    Ethics
 2006 H@N (Crosshouse and Ayr)
 2006 Clinical Assessment
 2007 Independent Nurse Prescribing
    Pharmacology (hons level)
 2008 MSc Advance Practice
 2008 NES Advanced Practice Pathway
 2009 ANP clinical nurse manager
Motivations
 Contribution to the creation of a replicable
  pathway
 Funding and accelerated learning opportunity
 Creation of an academic trail
 Overcoming the insecurities that come about
  with becoming an ANP
  Loss of status
  Loss of confidence
  Questioning ability
The Role of the Advanced
   Nurse Practitioner
       “Do not be content with mediocrity.
Do your job so well that nobody could do it better. “
                Martin Luther King
                                   Multidisciplinary
                                 approach to planned
                                 And unplanned care
                                                           Enhancing
              1st Responder to
                                                          Nursing role
                Unwell Adults                             development




    Integration                                                           Support
of science and art                                                   multi-professional
 Bridging the gap                                                          teams

                                   Advance Nurse
                                     Practitioner
                                    H@N/H@D


Promote evidence                                                          Reducing
  based practice                                                         clinical Risk




                 Lead audit                             Identification and
                 and quality                           management of the
                 assurance                             acutely unwell adult
                                    Ensuring high
                                      standards
                                    of clinical care
Pathway Tools and Outcomes
o   Training Needs Analysis tool
o   Critical companion
o   Action learning
o   Academia
Expectations of Leadership
 Challenging the status quo
 Msc level Clinical Leadership module
 Improving existing practice
    Audit and research/development
    Clinical Governance
    Introducing evidence based practise to the ‘shop floor’
 Improving communication
    Patient handover
    Linking Nursing/Medical staff
    Facilitation
Pathway Tools and Outcomes
 Completion of Masters level Leadership module
TRANSLATION TO PRACTICE
 Successful integration into a training grade
  medical rota
    Strong clinical leader
 Aspirin PGD
 Handover guidelines
 Involvement in the Safer Patient initiative
 Falls assessment guideline


Expectations of Facilitating Learning
Bridging the theory practice gap
Direct supervision of nursing/junior
 medical staff
Inspiring creativity and innovation
Creating the learning environment
Promoting health
  Patient centred education
Pathway Tools and Outcome
 Advanced Life Support GIC
 Clinical Supervision discussions
 Mentor for Post Grad Cert
 Regular Teaching session for nursing/medical
  staff
 Teach Physical examination
 Lecturer at UWS in neurology
 Examiner for the Scottish Ambulance Service
Expectations of Advanced Clinical
Practice Skills
Clinical Assessment
Diagnosis and intervention
  Managing the acutely unwell adult
Independent Nurse Prescribing
Clinical Supervision
Clinical Leadership
Service Development
  Opportunity for Research
ANP, advanced practitioner or
               ‘mini medic’?
      Did I really grasp the concept of
                gaining competence…
Multi faceted Clinical Support from
Critical Companion

 Competence             Critical incident
  Framework               debrief
 Log Book / System
  Electronic             Case note review
 OSCE and Simulator     Msc Advanced
 Training Needs          Practice
  Analysis Annually
 CPD including Non
  Medical Prescribing
Clinical Competence Framework
Evidencing Competence
 Completion of HaN framework
  Based on national template
  Used and implemented with great success
 Development of HaD with Critical Companion
Case Note Review
 Performed by nursing
  and medical
  consultants
 Safe and Effective
  practice
 Autonomy
Expectations as a Researcher
Msc level qualification in research
Ability to change and affect practice by
 R+D
Outcomes as a Reasearcher
Completion of Msc Module
Development of research proposal looking
 at the efficacy of SBAR as a
 communication tool
4 audits of HaD workload
Infection control
National non medical prescribing survey
Expectations as a Learner
Masters level education
 Diagnosis and Intervention
  To Support and further current practice
 Pathophysiology
 Clinical Leadership
 Formal Teaching Qualification
 Research and Development
How has the pathway helped me
learn?
Academia
Experience
Reflection
Peer review
Critical Companion working
  Opportunity for the implementation of theory to
   practice
Action learning sets
Summary

 I started on the pathway with my outcomes steeped
  in academia
 The pathway and critical companion working has
  given me the opportunity to ground learning by
  linking theory to practice and evidence competence
 It has broadened my understanding of advanced
  practice
 I had an idea of the destination, however I my
  expectation of the academic journey has been very
  different and the pathway has helped to enrich and
  focus my practice as a nurse
Conclusion:
                                       Multidisciplinary
                                     approach to planned
                                      And unplanned care Enhancing
                     1st Responder to
                                                         Nursing role
                       Unwell Adults                     development



              Integration                                               Support
          of science and art                                       multi-professional
           Bridging the gap                                              teams
                                       Advance Nurse
                                         Practitioner
                                        H@N/H@D

          Promote evidence                                             Reducing
            based practice                                            clinical Risk




                         Lead audit                      Identification and
                         and quality                    management of the
                         assurance     Ensuring high acutely unwell adult
                                         standards
                                       of clinical care
Thank you!

								
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