Nurse 1 Advanced Practice Application Form by qvg16642

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									 Nurse 1: Advanced Practice Application Form
Applicant’s Details

Name …………………….....................................................................................………………….

Work Unit/Location …………………...............................................................…………………….

Home Postal Address ……………........................................................…………………….……



Complete the following Checklist prior to submitting the Nurse 1: Advanced Practice Application
and make reference to the DHF Nurse 1: Advanced Practice Policy.


              Nurse 1: Advanced Practice Application Form

              Evidence of Qualifications:

              (a) Diploma of Nursing (Certificate V);
              (b) Advanced Diploma in Nursing (Certificate VI); or
              (c) equivalent nursing qualification.

              Evidence of Clinical Experience:

              (a) completed minimum of six (6) years full time post enrolment experience; and
              (b) completed three (3) year full time equivalent experience in the relevant clinical
                   area

              Medication Administration: authorised by Department of Health and Families

              Evidence of Advanced Practice in:


              (a) care delivery/clinical responsibilities;

              (b) learning and inquiry;

              (c) leadership responsibilities; and

              (d) networks, partnership and team responsibilities.



             (refer Nurse 1: Advanced Practice Domains, following)


              Curriculum Vitae or Professional Portfolio

              Name of two Referees, one being your current Clinical Nurse Manager

              Other Supporting Documentation




Send Completed Applications to your EDON, ND or Community Health Manager.

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NURSE 1: ADVANCED PRACTICE DOMAINS, STATEMENTS OF EVIDENCE


     1. Care Delivery/Clinical Responsibilities
        The Nurse 1: Advanced Practice will demonstrate high levels of knowledge (higher effective
        integration of theory to practice) and experience within scope of practice, including:
             providing care at an advanced level under the supervision of a Registered Nurse;
             practising more autonomously with indirect supervision by the Registered Nurse; and
             collaborating with the Registered Nurse in the development of care plans and the
                 provision of nursing care.

     2. Learning and Inquiry
        The Nurse 1: Advanced Practice will undertake professional development opportunities for self
        and be involved in the professional development of others, including:
            implementing own professional development plan related to their WPP;
            participating in peer development and review; and
            participating in activities related to the enhancement of context specific practice. This
                may include contributing to clinical research and supporting the implementation of
                evidence based practice, within scope of practice.

     3. Leadership Responsibilities
        In the demonstration of leadership responsibilities, the Nurse 1: Advanced Practice will act as a
        role model within the health care team. This will include:
              contributing to the development, implementation and review of the ward/service business
                 plans;
              providing support and direction within their level of competence; and
              taking responsibility for unit activities other than direct patient care; for example,
                 Workplace Health and Safety Officer or manual handling coordinator.

     4. Networks, Partnerships and Team Responsibilities
        This role requires the Nurse 1: Advanced Practice demonstrating sound and effective
        communication skills with members of the health care team, patients, families, visitors and staff
        from other agencies. This would include:
             initiating, maintaining and using team networks in a mature, confident manner to achieve
                positive patient outcomes.




I, ........................................................certify that the information contained in the
Statements of Evidence are an honest and accurate appraisal / reflection of the way in
which I work at a Nurse 1: Advanced Practice within my designated scope of practice.

Applicants Signature .............................................................................Date:....../ ....... / .............




                                                                                     Effective:                        13/03/2009

Developed by the Office of the Principal Nursing Advisor                             Review Date:                      13/03/2012




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