Declaration of conflict of interest NONE

Transcription

1 Declaration of conflict of interest NONE

2 Advanced nursing practice in cardiology - Feasible for Germany? Daniela Lehwaldt RGN RNT MSc PGDipCHSE BNS (Hons) HDip Intensive Care & Anaesthetic Nursing PhD Student Deutsches Netzwerk APN & ANP (DNAPN) Board member Coordinator International Contacts Leader Development of APN-Critical Care Profile Danela.lehwaldt@dnapn.de Lecturer, School of Nursing and Human Sciences, Dublin City University Daniela.lehwaldt@dcu.ie

3 Agenda Background and driving forces The Copernican Turn Deutsches Netzwerk APN & ANP (DNAPN) DNAPN Position paper 7 Roles Existing structures Currently missing structures APNs in Cardiology

4 Background Internationally, APN is a well established concept USA 1960 s 2005 Nurse Census Survey: ANPs authorised and 6000 ANPs educated annually UK 1980 s Australia 1990 s New Zealand 2000 s Ireland 2000 s (Fry2012, U.S. Census Bureau 2005)

5 continued Today s nurses need to be capable of responding to increasingly complex patient needs. Patient/client recovery from physical illness is often complicated by decreased levels of mobility, nutritional imbalances, decreased levels of cognitive functioning and various levels of pain / discomfort (DNAPN 2011)

6 Driving forces Shortage of medical staff? Complexity of patient needs Advanced levels of technology Patient-centred care Quality agenda Goal is not to bridge gaps in health provision, but to develop advanced roles for nurses that improve patient experience and quality of care (DNAPN 2011)

7 APN Outcomes Improve access to services Reduce waiting times Care outcomes High patient satisfaction rate (Neville and Swift 2012, Fry 2011, OECD 2010, Kleinpell 2008, 2005)

8 The Copernican Turn The Copernican Turn in Germany is characterised by a shift in thinking about the way in which care is provided. The range of activities carried out by an Advanced Practice Nurse are based on patient/client needs; care provided goes beyond the traditional boundaries of nursing. The international model of APN is followed. Some advanced areas for practice include physical assessment, diagnostic and treatment of own patient/client loads. Emphasis on developing APN posts that are multi-dimensional i.e. are not primarily based on cure/medical model, but advance nursing care

9 7 APN Roles: Practitioner Educator Expert Leader Coach Representative Researcher

10 Existing structures German Nurses Association DBfK 2007 First two APN Master s programmes since 2007 Working groups such as the Deutsches Netzwerk APN & ANP since 2008 APN & ANP Position paper 2011 (available from dnapn.de) Projects (ongoing)

11 Currently missing structures Legislation for APN i.e. nurse prescribing Nurse register / nursing board national guidance relating to advanced nursing practice, regulation of APN education national APN register

12 German Networking Group Deutsches Netzwerk APN & ANP Founded 2008 Objectives include to: share information, make recommendations relating to APN roles, activities and educational requirements, create an awareness about the development of Advanced Practice Nursing in Germany, facilitate international collaboration.

13 APNs in Cardiology First Master s prepared APNs in Germany Heart Failure APN Patients on Intensive Care with Heart Failure Ensure consistency and high levels of care Coaching patients and families Life style choices Living with Health Failure (long-term) Assisting patients and families with decision-making in regards to treatment options and management of the condition individual / family meetings Support and advocacy Key person for questions

14 APNs in Cardiology APN Cardiac surgery Improving continuity of care for patients undergoing cardiac surgery Pre-admission clinics Assessment, diagnostic and treatment of patients post-operatively Key person for patients and families Post-discharge follow-up

15 APN-Profiles Working group APN-Critical Care (APN-CC) Guide for practitioners, managers and interested parties regarding the specific activities that can be carried out by an APN-CC in German speaking countries. Germany / Switzerland / Austria Other current APN profiles under development: APN Mental Health APN Family Care Future profiles

16 Advanced nursing practice in cardiology Feasible for Germany? Movement towards APN in Germany evident since at least 2007 Copernican Turn 7 APN Roles First APNs Cardiology Heart failure Cardiac surgery

17 2 nd International Congress: Charité Berlin th September 2013 Call for Abstracts open Everything remains different Activities and Competencies of Advanced Practice Nurses

18 Useful websites: Deutsches Netzwerk APN & ANP German Nurses Association

19 References: American Academy for Nurse Practitioners (AAPN) Why Choose A Nurse Practitioner as your Healthcare Provider? Austin: AAPN. Deutsches Netzwerk fur APN & APN Positionspapier Deutschland Die kopernikanische Wende Advanced Practice Nursing Advanced Nursing Practice Advanced Practice Nurse. Witten: Deutsches Netzwerk APN & APN. Fry, M Literature review of the impact of nurse practitioners in critical care services. Nursing in Critical Care, 16(2), pp Hainsworth, T The development of critical care outreach nursing services. Nursing Times, 102 (32), p25. Kleinpell, R Acute Care Nurse Practitioner Practice: results of a 5-year longitudinal study. American Journal of Critical Care, 14(3), pp Kleinpell, R., Wesley, E. and Grabenkort, R Nurse practitioners and physician assistants in the intensive care unit: an evidence-based review. Critical Care Medicine, 36(10), pp National Council for the Professional Development of Nursing and Midwifery (NCNM) Framework for the Establishment of Advanced Nurse/Midwife Practitioner Posts. 1 st edition. Dublin: NCNM. NCNM Framework for the Establishment of Advanced Nurse/Midwife Practitioner Posts. 4 th edition. Dublin: NCNM. NCNM Service Needs Analysis: Informing Business and Service Plans. Dublin: NCNM. NCNM Profiles of Advanced Nurse/Midwife Practitioners and Clinical Nurse/Midwife Specialists in Ireland. Dublin: NCNM. OECD Nurses in advanced roles: a description and evaluation of experiences in 12 developed countries. Paris: OECD. Por, J A critical engagement with the concept of advancing nursing practice. Journal of Nursing Management, 16, pp84-90.