Leonie Burdack, Australian College of Nursing: Trialled And Proven; Time To Move On: How Health...

transforming health care.

australian college of nurse practitioners

Trialed and Proven: Time to Move on

Getting the most out of the NP role

Leonie Burdack NP, FFACNP MNP; Grad Dip Ed, A&E Cert, Grad Cert BA, BApSc

Vice President ACNP

March 2013



Overview

• Background

• Role implementation

- NP role and leadership

- NP role in practice

• Future direction and challenges



Potted History https://www.acnp.org.au/australian-college-of-nurse-practitioners-potted-history.html

• 1990 First Nurse Practitioner authorised in NSW

(2002-SA; 2003-WA; 2004 - ACT, VIC; 2006-QLD; 2008-NT)

• 2005 ANMC NP Competency Standards

• 2005 Inaugural National Conference ANPA

• 2007 3 yr funded ARCS: Australian NP Research Project

• 2008 Primary Health Care Round Table

• 2009 ACNP registered

• 2010 MBS & PBS reforms announced



The journey so far.......

• Safety and efficacy

• Patient satisfaction

• Improved quality and access

• Comparative analysis

• Cost

• “Outcomes”



Specialists raise doubts about the quality of nurse referrals

Dumbing down the Australian health system.

Beware the ‘gift’ of nurse practitioners “I think there is a Trojan horse lurking in the weeds trying to pull a fast

one on the American people.” George W Bush

Debate rages over push for more nurse practitioners

Push to restrict rights of solo nurse practitioners

Nurse prescribing: a risky proposition

Nurse practitioners: insurance status warning

Inferior health care

A dangerous and irresponsible path to follow

IN THE NEWS


australian college of nurse practitioners Practice reality.......

• Effective partnerships – patient-centred

• Diverse models of care –good patient outcomes

Aged care, Chronic disease, Acute care , Mental Health,

Palliative Care, Community, Primary Health Care

• Public + Private

• Metropolitan, urban, rural + remote



Distribution

Source:ACNP Survey 2012



Practice areas


Employment settings



Getting the most from the role

• Empowering and enhancing leadership

• Communicating benefits and considerations for establishing NP role

• Changes in healthcare : future implications for NP models of care



Leadership • NP leadership role is multi-faceted

• Learned or innate

• May “manage” clinics but focus is advanced clinical practice

• Not necessarily leading group/people - NPs work alongside

• Integral to establishment of role (Source: Watson, ANMC Competency standards)



Qualities? • Advocate quality care

• Collaborator

• Communication

• Mentor

• Risk taker

• Role model

• Visionary

(Source: Carter et al 2010)



Leadership in practice......... • Clinical nursing role - setting standards, resource, expertise

• Change – policy, professional, patient level

• Mentoring or facilitating; Education and teaching

• Promoting and contributing to evidence based practice

• Maintaining an ethical practice;

• Promoting or developing the nursing profession;

• Developing new initiatives

• Inspiring or motivating others;

(Source: Watson, ANMC Competency standards)

• (Watson, ANMC Competency standards



Enabling factors

• Infrastructure + resource

• Policies and systems

• Clinical and professional governance

• Clarification around the role

• Integration + utilisation of the role dimensions

• Role design



Benefits and other considerations

• Complementary role that provides expert nursing knowledge and skills

• Grounded in nursing theory and not a substitute medical role

• NP, RN, PN not mutually exclusive

• Role differentiation + scope

• Individually liable + accountable

• Constant



Benefits and other considerations

Optimization + full utilization of the role benefits:

• Patient

• Organization

• Professional/clinician



Benefits of NP role and practice

• Improved access

• Early intervention prevents deterioration/exacerbation

• Longer appointments with patients

• Improved coordination of care

• Expert case management

• Provision of new services

• Enhanced team work

• Constant


australian college of nurse practitioners Responsibilities include ................





Discharge process



Other considerations • Identify need/benefits

• Determine scope and profile

– Experience and qualifications

– Clinical services, procedures, interventions -competency +skills

• Verify quality of health services to be provided

• Capability of employer or health service provider

• Stakeholders

Source: 2011 Queensland Health Office of the Chief Nursing Officer Clinical Governance for Nurse Practitioners in Queensland: A Guide



Future : where to from here?

• Dynamic and evolving

• NPs as part of the solution?

Aged care and Community

Acute and sub-acute

Primary healthcare

Outreach models

• Decisive implementation

• Purposeful planning models of care, workforce



Future : where to from here?

• Cyclical funding/economic factors

• Health service factors

• Professional

• NP specific outcome measures

• Educational preparation

• Policy framework

•



Critical Success Factors Source: 2011 Queensland Health Office of the Chief Nursing Officer Clinical Governance for Nurse Practitioners in Queensland: A Guide

• Safety + quality

• Collaboration

• Autonomy

• Role clarity

• Innovation

• Respect + recognition

Patient- C

en

tred

Supportive environment

Full Potential



Questions?

Leonie Burdack, Australian College of Nursing: Trialled And Proven; Time To Move On: How Health...

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