PILOT STUDY OF FACULTY MENTORING IN A NEWLY-DEVELOPED ADVANCED PRACTICE PROGRAMME

Transcription

1 PILOT STUDY OF FACULTY MENTORING IN A NEWLY-DEVELOPED ADVANCED PRACTICE PROGRAMME MARY K. STEINKE, RN, DNP, APRN-BC, FNP-C; LORI A. SPIES, PHD, RN, NP-C; DEBBIE LEACH, NP; DR. MÁTÉ ORSOLYA PHD, MEDU; HELEN FOX-MCCLOY DNP MSN CPNP; MICHAL NOONAN RCOMPN, M NURSING, NZ NP; ANNABELLA S. GLOSTER, RN, MSC; CHRISTINE MCDERMOTT REGISTERED ANP; MARY ELLEN ANDREWS RN(NP) MN-ANP PHD

2 GLOBAL CONCERNS OF SHORTAGES CONCERNS ABOUT THE FUTURE OF HEALTHCARE HAVE BECOME INCREASINGLY URGENT IN RECENT YEARS ACROSS THE GLOBE. PREDICTIONS OF SHORTAGES OF HEALTHCARE WORKERS BY 2025 INCLUDE SOME OR ALL OF THE FOLLOWING REASONS CITED BY THE 2013 WORLD HEALTH ORGANISATION (WHO) REPORT

3 NO HEALTH WITHOUT A WORKFORCE WHO REPORT 2013 INCREASING SHORTAGES OF HEALTH WORKERS. THE HEALTH WORKFORCE IS AGEING, AND REPLACEMENT IS A CHALLENGE. SKILLS-MIX IMBALANCES PERSIST ADVANCED PRACTITIONERS, MIDWIVES, NURSES AND AUXILIARIES ARE STILL INSUFFICIENTLY USED IN MANY SETTINGS. AVAILABILITY AND ACCESSIBILITY CONTINUE TO VARY WIDELY DIFFICULTY IN ATTRACTING AND RETAINING WORKERS. ADAPTING EDUCATION STRATEGIES AND THE CONTENT OF PRE-SERVICE EDUCATION IS A MAJOR CHALLENGE. (CAMPBELL ET AL, 2013)

4 ADVANCED PRACTICE NURSE ROLE DEVELOPED TO INCREASE ACCESS TO HIGH QUALITY CARE RURAL AND REMOTE COMMUNITIES AT-RISK POPULATION (BRYANT-LUKOSIUS, D. & MARTIN-MISENER, R. 2015) THERE ARE CURRENTLY APPROXIMATELY 70 COUNTRIES THAT HAVE ESTABLISHED NP/APN ROLES OR ARE EXPLORING THE POSSIBILITY OF INTRODUCING THESE ROLES (INTERNATIONAL COUNCIL OF NURSES 2018).

5 FACULTY OF HEALTH SCIENCES OF UNIVERSITY OF PÉCS GAP ANALYSIS THE FACULTY OF HEALTH SCIENCES OF THE UNIVERSITY OF PÉCS IN HUNGARY HAD ALSO RECOGNISED THIS GAP IN THEIR NATION S HEALTHCARE SYSTEM IN TERMS OF AVAILABILITY AND ACCESSIBILITY OF HEALTHCARE WORKERS AS MENTIONED IN THE WHO REPORT AMONG THE REASONS FOR INITIATING THE IMPLEMENTATION OF THE NEW NURSING ROLE IN HUNGARY, SIMILAR TO OTHER COUNTRIES WORLDWIDE, CAN BE MENTIONED IN THE FOLLOWING POINTS: TO PROMOTE HIGHER QUALITY OF CARE TO PROVIDE MORE INTENSIVE FOLLOW-UP AND COUNSELING FOR PATIENTS WITH CHRONIC ILLNESS IN PRIMARY CARE TO PROVIDE OVERSIGHT OF QUALITY IMPROVEMENTS IN HOSPITALS

6 REASONS FOR IMPLEMENTING THE APRN ROLE IN HUNGARY IMPROVE ACCESS TO CARE BY DELEGATING CERTAIN TASKS TO NURSES IMPROVE QUALITY OF CARE (BY AVOIDING UNNECESSARY HOSPITALISATIONS) INCREASE THE ATTRACTIVENESS OF THE NURSING PROFESSION IN HUNGARY AGAIN DECREASE THE MIGRATION OF NURSES TO OTHER COUNTRIES FOR BETTER SALARIES REDUCE HEALTH SPENDING IN THE LONGER TERM BY AVOIDING COMPLICATIONS AND UNNECESSARY HOSPITALISATIONS

7 OBJECTIVES OF THE PRACTICE SUBGROUP OF THE INP/ANPP THE OBJECTIVES OF THE PRACTICE SUBGROUP INCLUDE TO: IDENTIFY COUNTRIES WITH ADVANCED NURSING PRACTICE DESIGNATION AND REGISTRATION IDENTIFY AND SUPPORT THE GLOBAL DEVELOPMENT OF ADVANCED NURSING PRACTICE ROLES PROMOTE EVIDENCE-BASED ADVANCED NURSING PRACTICE WORLDWIDE ENCOURAGE THE WORLDWIDE DEVELOPMENT OF ADVANCED NURSING PRACTICE THROUGH COLLABORATION AND SHARING OF DEVELOPMENTS IN MEMBER COUNTRIES

8 PILOT STUDY THE MEMBERS OF THE PRACTICE COMMITTEE OF THE INTERNATIONAL COUNCIL OF NURSING NURSE PRACTITIONER/ADVANCED PRACTICE NETWORK (INP/APNN) WERE APPROACHED IN AUGUST OF 2017 BY A FACULTY MEMBER OF THE DIVISION OF HEALTH SCIENCES AT THE UNIVERSITY OF PÉCS WITH THE REQUEST TO HELP GUIDE THE CURRICULA DEVELOPMENT FOR THIS PROGRAMME BY PROVIDING MENTORSHIP AND SUPPORT TO THE FACULTY MEMBER

9 GOAL OF THE STUDY THE GOAL OF THE STUDY WAS TO EXAMINE WHETHER THE MENTORING PROCESS, USING THE RECIPROCAL MODEL OF DISTANCE MENTORING AS A GUIDELINE IS EFFECTIVE (LACH, ET AL., 2013). A RECIPROCAL RELATIONSHIP MENTOR AND MENTEE MODEL COMMUNICATION OF EXPECTATIONS A MUTUALLY AGREED UPON PLAN DEVELOPMENT OF A STRATEGY FOR MODES AND FREQUENCY OF COMMUNICATION.

10 EXPLANATION OF MENTORING MENTORING IN ITS SIMPLEST FORM MEANS A RECIPROCAL RELATIONSHIP MENTOR ADVISES OR CONSULTS WITH MENTEE GIVES ADVICE IN RESPONSE THERE ARE NO DUTIES, IT IS JUST A RELATIONSHIP THE MENTOR FILLS GAPS THE PRACTICE SUBCOMMITTEE HAD INFORMATION ON HOW OTHER NURSE PRACTITIONER PROGRAMS FUNCTION THE EXPERIENCE FROM PRACTICING NURSE PRACTITIONERS AS EDUCATORS WE WANTED TO PROCEED IN A LOGICAL WAY AND DETERMINE NEEDS GOALS

11 EXPLANATION OF MENTORING, CONTINUED THE PRACTICE SUB-GROUP IS IDEALLY POSITIONED TO HELP OTHERS WHO MAY BE JUST STARTING A PROGRAMME. THE SUB-GROUP MEMBERS AGREED THAT THIS FRAMEWORK MIGHT BE ABLE TO BE USED AS A TEMPLATE FOR PROGRAMS IN OTHER COUNTRIES. THE MENTORING PROCESS GUIDES US NO FINANCIAL OBLIGATIONS RESPECTFUL OF THE PHILOSOPHY OR CURRICULUM THAT HAS ALREADY BEEN CREATED

12 INFORMATION NEEDED FOR PILOT STUDY RN BACKGROUND: HOW ARE THE STUDENTS PREPARED? WHAT ARE THE ADMISSION REQUIREMENTS? IS THERE AN ESTABLISHED INTERVIEW AND APPLICATION PROCESS? WILL ALL STUDENTS HAVE A BSN/BSC EQUIVALENT? ANY CLINICAL EXPERIENCE? HOW LONG IS THE POST-GRADUATE PROGRAMME? HOW MANY STUDENTS WILL BE ENROLLED?

13 SPECIFIC QUESTIONS ADDRESSED IN PILOT STUDY, CONTINUED IS THERE BACKING OF THE GOVERNMENT OR MINISTRY OF HEALTH SUPPORT? IS THERE REGULATORY SUPPORT IN PLACE? WILL THE SCOPE OF PRACTICE BE LEGALLY DEFINED AND PROTECTED? WHAT TYPE OF ADVANCED PRACTICE NURSE TRACKS ARE THERE? NURSE ANESTHETISTS PRIMARY CARE NURSE PRACTITIONER EMERGENCY CARE NURSE PRACTITIONER ACUTE CARE NURSE PRACTITIONER GERIATRIC NURSE PRACTITIONER FIRST ASSISTANT OF THE SURGEON

14 SPECIFIC QUESTIONS ADDRESSED IN PILOT STUDY, CONTINUED WHO WILL TEACH THE COURSES? HOW WILL FACULTY BE PREPARED? PHYSICIAN TAUGHT VERSUS VISITING PROFESSOR?

15 SPECIFIC QUESTIONS ADDRESSED IN PILOT STUDY, CONTINUED WHAT IS THE VISION OF THE PROGRAMME DEVELOPERS? TO IMPROVE ACCESS TO CARE IN A CONTEXT OF A LIMITED SUPPLY OF DOCTORS. ANOTHER REASON FOR THE DEVELOPMENT OF APN ROLES IS TO PROMOTE HIGHER QUALITY OF CARE, FOR INSTANCE BY CREATING NEW POSTS TO PROVIDE MORE INTENSIVE FOLLOW-UP AND COUNSELING FOR PATIENTS WITH CHRONIC ILLNESS IN PRIMARY CARE OR THE CREATION OF ADVANCED NURSING POSTS IN HOSPITALS TO OVERSEE QUALITY IMPROVEMENT INITIATIVES. THE DEVELOPMENT OF THE APN ROLE IS ALSO SEEN AS A WAY TO CONTAIN COST. HOW LONG WILL THE PROGRAM RUN? WHAT ARE THE 5 YEAR AND 10 YEAR PLAN / GOALS? TO HAVE MORE APRNS, TO ENSURE PROPER PRACTICE FIELDS IN THE HEALTH SYSTEM AND HELP TO ENSURE THE PATIENTS A BETTER QUALITY OF CARE NOT ONLY IN THE FIELD OF CHRONIC CONDITIONS.

16 METHODOLOGY A DESCRIPTIVE SURVEY USING A SELF-REPORT QUESTIONNAIRE MENTORS AND MENTEES WILL BE SURVEYED USING THE LACH TOOL ADMINISTRATION OF SURVEY AT BEGINNING OF MENTORING RELATIONSHIP, 1 MONTH, AND ONE YEAR OR AT COMPLETION OF MENTORSHIP (THE TIME TO BE DETERMINED MUTUALLY) SAMPLE QUESTIONS: WHAT ARE YOUR GOALS FOR THIS MENTORING RELATIONSHIP? HOW ARE YOU WORKING TO ACHIEVE THESE GOALS?

17 STEPS / PROCESS STEP 1: DETERMINE NEEDS ASSESSMENT STEP 2: IDENTIFY STRENGTHS AND RESOURCES STEP 3: IDENTIFY REALISTIC GOALS STEP 4: DEVELOP DETAILED PLAN TO MEET GOALS THAT INCLUDE.ESTABLISHING A PREDICTABLE MEETING SCHEDULE AND RELIABLE MEANS OF COMMUNICATION STEP 5: DETERMINE OUTCOMES STEP 6: DETERMINE STEPS FOR COMPLETION

18 RESULTS GOAL OF PILOT STUDY WAS TO DETERMINE WHETHER A MENTORING ROLE FOR FACULTY IN OTHER COUNTRIES WHO HAVE DEVELOPED OR ARE DEVELOPING AN ADVANCED PRACTICE ROLE WOULD BE DOABLE FUTURE DIRECTIONS REFINE A MENTORING PLAN THAT COULD BE ADAPTED AND IMPLEMENTED TO ASSIST IN THE DEVELOPMENT OF ADVANCED NURSE PROGRAMS IN OTHER COUNTRIES TEST THE SURVEY TOOL FOR ROBUSTNESS GET ETHICS APPROVAL TO DO SO DETERMINE THE TYPES OF NEEDS THAT THE MENTEE FACULTY MAY HAVE HELP WITH ASPECTS OF CURRICULUM, LECTURES, COMPETENCIES, LEGISLATION, CNS OR NP REGULATION, ETC.

19 RESULTS, CONTINUED DETERMINE THE STRENGTHS THE MENTOR FACULTY HAVE SUCH AS CURRICULUM DEVELOPMENT, LECTURER, COMPETENCIES IN SPECIALTY AREAS, LEGISLATIVE OR REGULATORY BACKGROUND EITHER AS A CNS OR NP MATCH THE COMMITTEE MEMBERS WITH THE NEEDS ANTICIPATE A NEED FOR ONGOING CLARIFICATION AND OPEN COMMUNICATION AGREEMENT FROM MENTOR AND MENTEE THAT ON PLAN AND RESULTS TO BE POSITIVE FOR BOTH AND THE RELATIONSHIP CAN BE TERMINATED AT ANY TIME WITHOUT CONSEQUENCE SPREAD THE WORD PROVIDE INFORMATION ON THE PRACTICE SUBGROUP SITE TO MEMBERS ABOUT THE AVAILABILITY OF THE MENTORSHIP PROGRAM

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