1 NSW OTA Career Development Pathway for the perioperative RN and EN Presented by Lilian Blair NSW OTA State Committee member June 2013
2 Developed and published by NSW OTA State Executive - March 2013
3 Structured but flexible approach The pathway offers a structured approach to the professional development of perioperative nurses. The pathway is flexible in that it can be undertaken on a full-time or part-time basis and nurses can step on and off the pathway at various points, and at different facilities.
4 Clinical rotations Each stage of the career pathway has specific clinical rotations built into it. Works towards the nurse achieving their career pathway through planned clinical rotations supported by on site and academic training.
5 Educational and academic outcomes Essentially, the pathway links the nurses clinical experiences with measurable educational and academic outcomes to assist them along their proposed career pathway. It focuses on building flexibility and transferability of skills through the integration of theory and clinical practice.
6 Succession planning For the more senior nurses the emphasis is on academic achievement linked to leadership practice in the workplace. By its very design, the pathway encourages succession planning, as opportunities for 'acting up' and alternative workplace experiences are offered as part of the pathway.
7 The pathway has five distinct sections: STAGE PRACTICE LEVEL TIME FRAME Stage one Induction requirements for the NOVICE or NEW to the unit perioperative nurse 0 to 3 months Stage two Advanced beginner 3 12 months Stage three Intermediate Practice months Stage four Advanced Practice 2 years and above Stage five Specialisation / Extended Practice 5 years and above
8 Let s have a look..eg: RN The Perioperative enrolled nurse is an integral member of the multidisciplinary team and must demonstrate accountability and responsibility for the quality of nursing care delivered during the patient s perioperative experience. Sound knowledge and clinical competence in the provision of complex care ensures safe and effective outcomes for the patient and members of the multidisciplinary team. 1 The NSW OTA Perioperative Nursing Career Development Pathway allows for: ease of identification of key aspects of perioperative nursing practice requiring ongoing development, and; a standardised approach in the achievement of competence and subsequent career progression for the perioperative nurse. NSW OTA recognises that each perioperative facility offers different nursing roles and surgical specialities and is therefore a generic pathway to be tailored for any individual facility as required. Assessment / competency are assessed using the facility s own assessment / competency tools.
11 ADVANCED BEGINNER PRACTICE Participate in relevant professional development activities 3-12 months Anaesthetics & Recovery Room Demonstrate competence, as appropriate, in the following areas: Patient admission and verification Pre and postoperative patient assessment Clinical handover Medication administration Documentation of nursing care provided Infection control practices Patient positioning Management of patient with pain modalities, eg: PCA, epidural Airway assessment and management Anaesthetic machine checking and troubleshooting Set-up and care of vascular access lines and devices Manage patients who have received Initially minor elective surgery and / or anaesthetic E.g. gynae, general, urology, dental Progressing to more complex elective surgery and / or anaesthetic including emergency and on call/out of hours.
12 ADVANCED BEGINNER PRACTICE continued.. Instrument/Circulating Demonstrate competence in the following areas: Pre and postoperative patient assessment Patient assessment and verification Clinical handover Intraoperative medication administration Documentation of nursing care provided Infection control practices Patient positioning Aseptic technique Scrubbing, gowning and gloving Handling of instruments, accountable and other items Instrument care and handling Use of electrosurgery/laser during surgery Rotate through allocated specialist areas: Initially minor elective surgery E.g. gynae, general, urology, dental Progressing to more complex major elective surgery and eventually emergency surgery.
13 INTERMEDIATE PRACTICE Participate in relevant professional development activities Months Manage an cohort of routine elective surgery or routine general anaesthesia patients, with limited supervision Gain further experience caring for patients having complex, emergency or trauma surgery, or requiring more complex anaesthetic/recovery techniques, with supervision Work as a member of the after hours, on-call team RN acts in supervisory role of ENs and novice RNs Attend Preceptor Workshop and begin precepting student and novice perioperative nurses Take on specialty portfolio and act as a resource person for that area
14 INTERMEDIATE PRACTICE continued Identify areas of potential risk and work collaboratively to reduce effects Become a member of professional Perioperative Nursing body (NSW OTA and ACORN) Self initiate professional development opportunities, by attending: - unit based inservice - short courses or study days appropriate to speciality offered by internal or external providers NSW OTA Professional Days and conferences ACORN conferences Commence post graduate studies including Graduate Certificate/Graduate Diploma in Anaesthetic & Recovery Room or Perioperative Nursing courses as addressed in ACORN PS9
15 ADVANCED PRACTICE ROLE 2 Years and above Manage cohort of patients having complex elective and emergency surgery or complex anaesthesia/recovery, with limited supervision Care for the deteriorating patient with limited supervision Act in Team Leader Role with manager supervision Participate in quality improvement, practice development, and/ or research projects Consider working towards CNS status by: Participating in EQUIP and WHS projects Contribute to local policy / guideline development for unit or sub- specialty areas Contribute to working parties Teach learners in the clinical setting on an ongoing basis Inservice presentation Act as resource person for unit and ward areas Complete Post Graduate Studies Attend internal or external specialty practice courses Apply for CNS status
16 SPECIALISATION / EXTENDED PRACTICE ROLE 5 years and above If achieved, perform according to CNS status Comply with ANF Competency Standards for the Advanced RN Lead quality improvement, practice development, and/ or research projects Act as highly skilled clinician and resource person Perform advanced troubleshooting Act in higher grade duties e.g. after hours in charge/ team leader /CNE/ NUM/CNC Involvement in specialty practice meetings and projects at unit and hospital based level Contribute to the development of unit, sub-specialty and hospital based policies and procedures Contribute to effective functioning of workplace environment through inventory control and ordering of specialty equipment
17 SPECIALISATION / EXTENDED PRACTICE ROLE continued Liaise with perioperative and intra hospital senior nursing management Liaise with medical staff, allied health staff, and company representatives Network with inter-hospital perioperative nurses Act as preceptor/ mentor to all levels of staff within unit Deliver informal / formal training sessions Engage in mentorship with superior Self-direct professional development and career progression by attending appropriate courses or tertiary studies (management, education or specialty focus) Involvement in professional body (NSW OTA and ACORN)
18 For Professional Development purposes the pathway can be used by the nurse to? provide allowance for recognition of prior learning provide a structured approach allow flexibility for part time workers show evidence of career / speciality progress supports portfolio supports learning needs use at performance review
19 For Professional Development purposes the pathway can be used by management to? provide allowance for recognition of prior learning provides a structured approach to benchmark an individual s progress show evidence of progress, or lack of supports learning needs performance review performance management
20 Evaluation The pathway has been utilised across CCLHD for 5 years and although formal evaluation has not yet taken place, informal feedback has been positive.
21 Where do I find the career pathways? CAREER PATHWAY Perioperative Nurse Career Pathway Registered nurse Enrolled nurse Awards for perioperative nurses Careers in Perioperative Nursing link Definition of CNS CNS Career Pathway strengthened Clinical Nurse Specialist (CNS) classifications Enrolled Nurse Special Grade NSW OTA ACORN NSW Nurses Association NSW Ministry of Health NOTE: Portfolio help and CPD information also available on this page!!!
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