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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