APNA 25th Annual Conference October 21, Session 3042

Transcription

1 Psychiatric Nurse Practitioner Residency Mimi Meiselman CNS, NP Hines VA Hospital University of Illinois Chicago No commercial support to disclose. 1 Personal Experience APNA discussion Internships for other disciplines Primary Care NP residency Discussion with NP educators How the Concept Evolved 2 Rationale/Literature Review Pilot Program Goals Partnership Preceptorship Characteristics Challenges and Benefits Objectives 3 Meiselman 1

2 Evidence that the US is short 45,000 psychiatrists. Konrad, TR,Ellis AR,Thomas,KC,Holzer,CE, Morrissey, JP (2009) County level estimates of Mental Health professional shortage in the US. Psychiatric Services 60: Mental health spending is predicted d to drop 8% in Treatment.stateline.org Rationale 4 Health care reform proposes nursing education evolve to meet the new demands of health care Expectations for Psychiatric Mental Health Nursing to grow over next 10 years Rationale 5 Interest in moving towards a competency based approach to NP education via clinical hours Need consistency in role preparation across programs, organizations and agencies Employers can sponsor/permit employees to get advanced degrees and then provide them with preceptorship during residency Rationale 6 Meiselman 2

3 ANCC requires 500 faculty supervised clinical hours (roughly 63 8 hour days) to practice and integrate health assessment, pharmacology and pathophysiology, health promotion, disease prevention/management and at least 2 psychotherapeutic treatment modalities eligibility.aspx Educational Requirements for Psychiatric NP 7 Is this enough time to gain competence? Clinical settings often variable no standardization Psychotherapeutic treatment modalities vary Concerns 8 Pilot Program Goals: Theoretical model Allow time for NP to perfect competencies Transition to practice period Enable feedback, coaching, mentoring, peer evaluation, supervision Offer research opportunities with use of EBP anesthesia.org/showthread.php/12057 Overhauling Nursing Education Selig, P.,Lewanowicz,W. (2008)Translation of Practice: Developing an Evidence Based Practice Nurse Internship Program. Adavanced Critical Care, vol8,#3,pp NP Residency Program 9 Meiselman 3

4 Graduate Educational Institution Comprehensive Mental Health Center which fulfills competency criteria Preceptors on staff at both institutions Common goal of providing expert MH caremission/values must be in agreement Partnership 10 NPs precept NPs Participation, repetition and reinforcement strengthen and enhance learning Immediate use of information and skills enhances retention Variety in learning increases interest, readiness to learn enhances retention Burns C,Beuchesne,Ryan Krause,M,Swain, K (2006)Mastering the Preceptor Role: Challenges of Clinical Teaching Journal ped Health Care 20 (3) Preceptorship 11 Clinical practice and educational expectation standardization is vital. Stanley, J Reaching a Consensus on a Regulatory Model: What does this mean for APRNs? Journal of Nurse Practitioners5(22): Clinical competence influences use of evidence based practice, EBP influences competence/improves outcome Simpson,MR,Stevens, P, Kovahc, C Nurses Experience with the clinical application of a research based protocol in a long term setting. Journal of Clinical Nursing. 16(6) Meiselman 4

5 Theoretical Model Patient Education Treatment t Profession 13 Intake and evaluation Outpatient Services Inpatient Treatment Consultation ti Primary Care Program Characteristics 14 Prioritize patients Financial barriers Preceptor workload Communication between systems Liability Psychiatrist Acceptance Differing states/licensure requirements/credentials Global standardization Employer Needs Concept is evolving Challenges 15 Meiselman 5

6 Patients Students Systems Educational and Hospital Health care system financial, prevention, improved outcomes Refresher clinical experience option may be proposed NP Profession Benefits 16 Aiken, LH Nurses for the Future NEJM health policy and reform.nejm.org/1 6 Altier, MA,Krsek,CA. Effects of a One year Residency Program on Job Satisfaction and Nurse retention of New graduate Nurses 2006 Journal for Nurses in Staff Development. 22(2) Buerhaus, PI, Have Nurse practitioners Reached a Tipping Point?:Interview of a Panel of NP Thought Leaders 2010 Nursing Economics 28(5) Burns, C, Beauchesne, M,Ryan Krause,P, Sawin, K Mastering the Preceptor Role: Challenges of Clinical teaching Journal Pediatric Health care 20 (3) Fairman, J.Rowe, J.Hassmiller,D Shalala, Broadening the Scope of Nursing practice 2010NEJM.org Happell, B. The Importance of Clinical Experience for mental health nursing Part 1: Undergraduate nursing attitudes, preparedness and satisfaction International Journal of mental health Nursing 17, Konrad,TR,Ellis,AR,Thomas,KC,Holzer,CE,Morrisey,JP.(2009) County level estimates of Mental Health professional shortage in the US. Psychiatric Services.60: Lindsey, G and Keiner, B Residency Program: An Effective tool for Recruitment and retention Journal of health Care finance 31(3) Marfell, J. Preceptors the Cornerstone of Clinical Education 2011 The Nurse practitioner 36(6)6 7. Psychiatric Mental health Nurse practitioner Competencies, 2003 National Panel for Psychiatric Mental health NP competencies Scheibmeir, MS, Sechrist, Reports of Nurse practitioner Specialty and Subspecialty Clinical Track Titles, Hours and Credentialing National Organization i of Nurse Practitioner i Faculties, Washing ton DC. Selig, P, Lewanowicz, W. Translation to Practice Developing an Evidence Based practice Nurse Internship Program 2008 Advanced Critical Care 19(3) Stanley, JM. Reaching Consensus on a Regulatory Model: What does this mean for APRNs? 2009,Journal for Nurse Practitioners. Stetka, B US Psychiatric Resources: A Country in Crisis. 2010, Stokowski, la Overhauling Nursing Education Bibliography 17 THANKS 18 Meiselman 6