How To Get A Job At Anc

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April Alexander
5 years ago
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1 ICU Nurse Practitioners Audrey Jackson Advanced Nurse Practitioner Critical Care NHS Lanarkshire

2 Wishaw Hairmyres Monklands

3 Advanced Nurse Practitioners Critical Care (ANPCC) Why ANPCCs? Who are the ANPCCs? What do ANPCCS do? Added value - our experiences

4 Why ANPCCs? Workforce Modernisation.. Because: EWTD MMC - reduction in anaesthetic trainees - already ^ anaesthetic trainee time in ICU - Deanery potential removal of trainees - ICU - three Theatres case cancellations Nurse Career progression

5 Post Requirements Who are They? Selection & Recruitment RGN - 5 yrs ICU experience Degree essential Post grad qualification in critical care Selection Process OSCEs - scenario based Day psychometric testing Critical Reasoning Skills (Watson Glaser) Numerical (RANRA) Personality testing (16 PF) Formal interview

qualification in critical care Selection Process OSCEs - scenario based Day

6 The Team (1 st cohort)

7 3 year programme: Who are They? Education and Training Post graduate cert in Advanced Practice (1 st yr) MSc Clinical Competency framework & log book Intensivist mentor & consultant nurse coaching Extensive weekly tutorial programme Non Medical Prescribing Assessment - DOPs,, CBD, MiniCex,, MSF,

MSc Clinical Competency framework & log book Intensivist mentor &

8 Post Grad certificates!

9 ANPCCs : What do they do? Work in three ICUs / Hybrid HDUs - Support medical team - Patient assessment - Admissions & clerk in - Treatment planning - Discharge - Audit & Research

10 ANPCCs : What else do they do? Skills & Procedures - central venous access - arterial access - advanced airway management - Non Medical Prescribing - Blood and blood products - X-ray requestors - Cardiac arrest page (airway trial)

11 Value - Experiences in NHSL Anaesthetic Rota compliance measurements Medical Deanery MMC stipulations - anaesthetic trainee ICU time v Theatre time - future trainee provision Future ICU service provision secured Theatre activity - avoidance of cancellations ANPCC pilot evaluation - test the theory Cardiac arrest pilot Research study (2011) NMP audit just completed

Future ICU service provision secured Theatre activity - avoidance of cancellations ANPCC

12 ANPCC Pilot Evaluation 2010 Method - Three ICUs junior medical rotas suspended - Eight week audit period - ANPCC formally on medical rota (no trainees in ICU) - Mon to Friday One ANPCC work load data collected - Incidents, near misses, unplanned medical support etc recorded - Questionnaire & interview medical staff / ICU staff follow up Findings - Coped well without medical trainee - No adverse / critical incidents reported - Education gaps and challenges indentified - Workload graphs / NMP breakdown

unplanned medical support etc recorded - Questionnaire & interview medical staff / ICU staff follow up Findings - Coped well

13 Consultant Anaesthetists Grounded Theory Study Couldn t t imagine life without them. Invaluable... Already been sole person on rota ICU Nurse Things are done a lot quicker now that they are here and it makes s our jobs a bit easier because they re here and part of the team Junior Doctor It s s maybe short-sighted sighted but I m I m there to achieve specific skills and increase my knowledge about critically ill patients. The ANPCCs are there permanently and have a lot more time to get what they need. Fleming E & Carberry M (2011)

easier because they re here and part of the team Junior Doctor It s s maybe short-sighted sighted but I m I m there to achieve

14 NMP Audit - Outcomes Full analysis awaited Provisional data analysis suggest - Low error rate - No major errors - No harm - Comparison NMP v Medical?

15 The Team (except me!)

16 The Challenges! Then & Now Resistance & acceptance Role actualisation for new ANPCC Local competition for experience with trainees Prescribing - IVI opiates / anaesthetics Future Measuring impact on mortality / morbidity Measuring patient experience (ethical challenge) National transferability Succession planning National role out ( Royal College Anaesthetists GB)

experience with trainees Prescribing - IVI opiates / anaesthetics Future Measuring impact

17 Summary - Value Measurements to consider Quantitative ANPs on medical rota (% of time) Patient Safety - compliance / service improvements (processes)( - incidents / adverse events / infection rates / Meds (outcomes) omes) Service provision - Theatre targets - HEAT targets - Local targets (Audit of work load / activity) MMC & EWTD rota compliance Qualitative ANPCC perceived value of role Cross site ANP cover (evidence) (new to NHSL ICUs)

(outcomes) omes) Service provision - Theatre targets - HEAT targets - Local targets (Audit of work load /

18 Acknowledgements Martin Carberry (nurse consultant) Dr Rory MacKenzie Consultant Mentors Dr. Jim Ruddy Dr. Sanjiv Chohan Dr. Ian Lang Dr. Veronica Watson Dr. Tina Maclennan Dr. Alan Morrison Dr. Grant Haldane

Core Module 2: Teaching, Appraisal and Assessment

Core Module 2: Teaching, Appraisal and Assessment Learning outcomes: To understand and demonstrate the knowledge, skills and attitudes to provide appropriate teaching, learning opportunities, appraisal,