Framework for the Nurse Practitioner Candidacy Program Clinical and Professional Practice Expert Panel Interview

Transcription

1 Framewrk fr the Nurse Practitiner Candidacy Prgram Clinical and Prfessinal Practice Expert Panel Interview

2 This dcument was prepared by: Irene Murphy September 2014 Gippsland Regin Palliative Care Cnsrtium c/- West Gippsland Healthcare Grup 41 Landsbrugh St, Warragul 3820 Tel:

3 Table f Cntents Intrductin... 3 Purpse... 3 Interview prcedure... 4 Interview structure... 5 Steering cmmittee 6 NMBA NP Clinical Dmain Standards diagram..7 Appendix 1 Expert Panel membership. 8 Appendix 2 Expert Panel Cmpetency recrd Appendix 3 Bndy Scale Standard Standard Standard Standard Expert Panel summary and recmmendatins.. 21 References 22, 23

4 1. Intrductin Case study presentatins t an expert panel The Gippsland Regin Palliative Care Cnsrtium (GRPCC) requires the Nurse Practitiner Candidate (NPC), twards the end f the candidature, t present tw case studies t an expert panel 1. These case studies draw tgether the NPC s preparatin and learning frm the Framewrk fr the Nurse Practitiner Candidacy Prgram. The case studies fcus n advanced and extended practice elements as well as utlining clinical leadership, prfessinal efficacy and prfessinal effectiveness cmpnents. This prcess intends t ffer the candidate a supprtive framewrk t exhibit her/his prfessinal attributes, skills and clinical knwledge as stipulated by the NMBA standards. The prcess prvides an pprtunity fr celebratin f the NPC s achievements and shwcasing f the individual s rle and impact. It als prmtes cnsistency f practice in the NPCs supprted by the GRPCC Purpse The purpse f the Expert Panel Interview is t: make a judgement n the clinical cmpetency, prfessinal safety, and apprpriateness f the applicant in the nminated categry f practice; ensure the NPC demnstrates readiness fr endrsement as a Nurse Practitiner; and ensure the NPC exhibits the clinical knwledge, attributes and skills required t perfrm in an advanced nursing practice rle Framewrk fr the Nurse Practitiner Candidacy Prgram May 2014, page 19 2 Ibid 3 Begbie, J. and Wheelhuse, A. The Nurse Practitiner Panel: A Crucial Step In The Endrsement Prcess? Retrieved 2 September 2014 frm 4 Nurses Bard f Victria: Wrk Instructin Nurse Practitiner Applicatin Oral Examinatin. Plicy, Research and Practice Standards June

5 3. The interview prcedure The expert panel interview is cnducted prir t the NPC s submissin f prtfli fr endrsement as a Nurse Practitiner. The Nursing and Midwifery Bard f Australia (NMBA) Standards f Practice guide the interview prcess fr the NPC. The Nurse Practitiner Mentr (NPM) in assciatin with the NPC and in cnsultatin with the NPC clinical supervisr and steering cmmittee membership assess the NPC s readiness fr the interview as part f the preparatin twards endrsement as a Nurse Practitiner. In preparatin fr this prcess the NPM: cnvenes pssible expert panel members; schedules the expert panel interview; advises the nminated panel members and the NPC three weeks in advance f the: scheduled time; and date and venue f the interview. The NPC then cnfirms his/her availability fr the interview The expert panel membership must be endrsed by the Steering Cmmittee (see pint 5) Panel members include (see appendix1): Manager f a palliative care service within the Gippsland Regin; Palliative Care Medical Specialist; Nurse Practitiner- Palliative Care; Senir Pharmacist; and Nursing academic. The NPM will act as the scribe 4

6 In preparatin fr the expert panel interview the NPC will: ensure that he/she has a clear understanding f hw his/her rle demnstrates advanced and extended practices in line with the NMBA Nurse Practitiner Standards f Practice and identified scpe f practice; prepare tw case studies t reflect the cntext, cntent and cmplexity f his/her clinical practice; and frward the case studies t the NPM and panel members ne-week prir t the expert panel interview The Interview structure: 1. The NPC presents ne case study at the time; 2. The infrmatin is delivered in a cncise and clear manner; 3. Each case study presentatin shuld last apprximately 15 minutes each in duratin; 4. At the cmpletin f each case study the panel ask questins guided by the NMBA NP Standards f Practice (see appendix 4); 5. Questins will incrprate cmpnents directly related t the case studies presented. These include: a. advanced and extended practice clinical elements within the NPC s palliative care specialty, critical thinking and analysis within the cntext and scpe f practice; and b. medicatins and prescribing factrs relevant t the case studies and challenges the NPC is expected t encunter in the nminated categry f his/her clinical practice. 6. Questins will als incrprate educatin, research and leadership dmains t enable the NPC t utline: a. her/his rle and clinical leadership and prfessinal develpment during her/his candidacy perid; b. mdel f care; c. quality and research activities; d. cllabrative relatinships; and e. NP clinical practice develpment and sustainability f the rle. 5 Gippsland Regin Palliative Care Cnsrtium Framewrk fr the Nurse Practitiner Candidacy Prgram May 2014 Page 19 5

7 7. T prmte bjective evaluatin f the NPC s clinical cmpetence the Bndy Scale may be applied t rate the NPC verall perfrmance during the expert panel interview (see appendix 3); 8. The scribe clearly and succinctly dcuments the questins, respnses and cmments frm the interview; 9. At cmpletin f the expert panel interview, the panel cnfers t determine whether the NPC has been successful r unsuccessful; 10. Outcmes and feedback cmments are relayed t the NPC; 11. Panel member s frmal letters utlining the interview findings fllws successful interview cmpletin. This letter will be included in the NPC s applicatin prtfli t AHPRA; and 12. If the applicant is unsuccessful the NPM will write a letter t the applicant. This letter must clearly dcument the clinical, prfessinal and/r leadership gaps/deficiencies identified by the expert panel during the interview. The letter is signed by the panel and frwarded t the NPC. The candidate can then apprpriately prepare fr a repeat expert panel interview. 5. Steering Cmmittee The Steering Cmmittee s rle is t versee, advise, guide and supprt the planning, develpment, implementatin and evaluatin f the NPC Prgram in inpatient and cmmunity settings acrss Gippsland 6. Its bjectives include: T versee, advise, guide and supprt the NPC Prgram t meet the NMBA Nurse practitiner standards fr practice; T versee, advise, guide and supprt the prgress f NPCs in the areas f clinical practice, research, educatin and leadership, bth within their specific settings and in palliative care practice in general, t the achievement f endrsement; and T review the Prgram s prgress against key milestnes. 6 Gippsland Regin Palliative Care Cnsrtium Framewrk fr the Nurse Practitiner Candidacy Prgram May 2014 Page 17 6

8 Figure1. Representatin f hw the educatin, research and leadership dmains are cuched within the clinically fcused standards 7. 7 Nursing and Midwifery Bard f Australia (2014) Nurse practitiner standards fr practice Retrieved 31 March 2014 frm 7

9 Appendix 1 Expert Panel The evaluatin f clinical apprpriateness required judgements based n established and recgnised clinical, prescribing, leadership and managerial expertise in a field f practice 8, 9. Ptential expert were initially identified using Gippsland Regin Palliative Care Cnsrtium s prfessinal and academic netwrk within the regin and frm the metr and state wide palliative care cmmunity. The five expert representatives cmprise: 1. Palliative care service manager within the Gippsland Regin. This member will have knwledge and understanding f: palliative care as an apprach that imprves the quality f life f patients and their families facing the challenges assciated with life-threatening illness; the Department f Health Strengthening Palliative Care: Plicy and strategic directins , particularly strategic directins 4. Prviding specialist care when and where is needed and 6. Prviding quality care supprted by evidence; and is cmmitted t a strng and sustainable nurse practitiner mdel f care in the Gippsland regin. 2. Palliative care medical specialist. This member will have extensive knwledge and expertise in: palliative care clinical practice and leadership acrss the inpatient and cmmunity settings; the NP prfessinal mvement and NP rle thrugh, prven cmmitment, cllabratin and supprt; supervising and mentring nurse practitiner candidates; and wrking cllabratively with all health prfessinals within a multidisciplinary palliative care philsphy and values. 8 Evaluating the clinical apprpriateness f nurses prescribing practice: methd develpment and findings frm an expert panel analysis: Qual Saf Health Care 2007;16: di: /qshc Retrieved August End-f-Life Decisin-Making in Canada: The Reprt by the Ryal Sciety f Canada Expert Panel n End-f-Life Decisin-Making: SCHÜKLENK, JOHANNES & etal. Biethics ISSN (print); (nline) i: /j x Vlume 25 Number S pp

10 3. Nurse Practitiner Palliative Care. This member will have knwledge, attributes and expertise in: cmmunity palliative care practice and (preferably) in the inpatient setting; cllabratively wrking in an NP rle utilising advanced and extended practice elements; safe prescribing, quality use f medicines and rdering f diagnstics; and clinical leadership and prfessinal efficacy. 4. Pharmacist. This member will have extensive knwledge and expertise in: cmmunity and inpatient pharmactherapy structures and mst cmmnly prescribed medicines in palliative care practice; the establishment and prgressin f the NP rle within the Gippsland regin; and wrking and cllabrating with NP/NPCs candidates within the NP/NPC individual sub-regin. 5. Nursing academic. This member will have knwledge and understanding f: the capabilities and scpe f practice f the NP rle; the educatin, research and leadership dmains within the clinically fcused standards f practice; the NMBA and AHPRA requirements t achieve endrsement as a nurse practitiner; and the NMBA/AHPRA guide fr submitting a prtfli: Pathway 1 and Pathway Endrsement as a nurse practitiner Nursing and Midwifery Bard f Australia and Australian Health Practitiner Regulatin Agency January

11 Appendix 2 Expert Panel Cmpetency Recrd 11 Applicant s Name Categry fr endrsement Organisatin Expert Panel Interview Date Time Start Case studies available Time End Yes N Panel Members Qualificatins Signature Recmmended fr submissin f prtfli fr endrsement Yes N If nt recmmended Actin/recmmendatins Next Interview 11 Nurses Bard f Victria: Wrk Instructin Nurse Practitiner Applicatin Oral Examinatin. Plicy, Research and Practice Standards June

12 Appendix 3 Bndy Scale Grade Perfrmance criteria Quality f perfrmance Assistance required Independent (I) Level f clinical practice is f a high and safe standard sund level f theretical knwledge applied effectively in clinical practice crdinated and adaptable when perfrming skills achieves intended purpse prficient and perfrms within expected time frame initiates actins independently and in cperatin with thers t ensure safe delivery f patient care Withut supprting cues Supervised (S) Level f clinical practice is f a safe standard but with sme areas f imprvement required crrelates theretical knwledge t clinical practice mst f the time crdinated and adaptable when perfrming skills achieves intended purpse perfrms within a reasnable time frame initiates actins independently mst f the time and in cperatin with thers t ensure a safe delivery f patient care Requires ccasinal supprtive cues Assisted (A) Level f clinical practice is f a safe standard but with many areas f imprvement required demnstrates limited crrelatin f theretical knwledge t clinical practice at times lacks crdinatin when perfrming skills achieves intended purpse mst times perfrms within a delayed time perid lacks initiative and fresight Requires frequent supprtive cues and directin Dependent (D) Level f clinical practice is unsafe if left unsupervised unable t crrelate theretical knwledge t clinical practice lacks crdinatin when perfrming skills unable t achieve intended purpse unable t perfrm within a delayed time perid n initiative r fresight Requires cntinuus supervisin and directin Bndy, K. N., (1983). Criterin-referenced definitins fr rating scales in clinical evaluatin. Jurnal f Nursing Educatin, 22(9),

13 Appendix 4 Standard 1 Assesses using diagnstic capability Outcme Cmpetency Perfrmance Indicatrs Cmpetency evidenced 1.1 Cnducts cmprehensive, relevant and hlistic health assessment a) Demnstrates extensive knwledge f human sciences and health assessment b) Demnstrates cmprehensive and systematic skills in btaining relevant, apprpriate and accurate data that infrm differential diagnses c) Assesses the cmplex and/r unstable health care needs f the persn receiving care thrugh synthesis and priritisatin f histrical and available data d) Assesses the impact f c mrbidities, including the effects f c-existing, multiple pathlgies and prir treatments in the assessment f the persn receiving care e) Demnstrates cmprehensive skill in clinical examinatin including physical, mental health, scial, ethnic and cultural dimensins f) Cnsistently and accurately synthesises and interprets assessment infrmatin specifically histry, including prir treatment utcmes, physical findings and diagnstic data t identify nrmal, at risk and abnrmal states f health g) Critically evaluates the impact f scial determinants n the persn and ppulatin Independent: Supervised: Assisted: Dependent: Cmments 12

14 Cmpetency Perfrmance Indicatrs Cmpetency evidenced 1.2 Demnstrates timely and cnsidered use f diagnstic investigatins t infrm clinical decisin making a) Makes decisins abut the use f persn-fcused diagnstic investigatins that are infrmed by clinical findings and research evidence b) Demnstrates accuntability in cnsidering access, cst, clinical efficacy and the infrmed decisin f the persn receiving care when rdering diagnstic investigatins c) Orders and/r perfrms selected screening and diagnstic investigatins d) Is respnsible and accuntable fr the interpretatin f results and fr fllwing-up the apprpriate curse f actin Independent: Supervised: Assisted: Dependent: Cmments e) Uses effective cmmunicatin strategies t infrm the persn receiving care and relevant health prfessinals f the health assessment findings and diagnses. Cmpetency Perfrmance Indicatrs Cmpetency evidenced 1.3 Applies diagnstic reasning t frmulate diagnses a) Synthesises knwledge f develpmental and life stages, epidemilgy, pathphysilgy, behaviural sciences, psychpathlgy, envirnmental risks, demgraphics and scietal prcesses when making a diagnsis Independent: Supervised: Assisted: Dependent: 13

15 b) Cnsiders the persn s expectatins f assessment, diagnsis and cst f health care Cmments c) Acts t prevent and/r diagnse urgent and emergent and life threatening situatins d) Determines clinical significance in the frmulatin f an accurate diagnsis frm an infrmed set f differential diagnses thrugh the integratin f the persn s histry and best available evidence. Standard 2 Plans care and engages thers Outcme Cmpetency Perfrmance Indicatrs Cmpetency evidenced 2.1 Translates and integrates evidence int planning care a) Takes persnal respnsibility t critically evaluate and integrate relevant research findings int decisin making abut health care management and interventins b) Ethically explres therapeutic ptins cnsidering implicatins fr care thrugh the integratin f assessment infrmatin, the persn s infrmed decisin and best available evidence c) Is practive and analytical in acquiring new knwledge related t nurse practitiner practice. Independent: Supervised: Assisted: Dependent: Cmments 14

16 Cmpetency Perfrmance Indicatrs Cmpetency evidenced 2.2 Educates and supprts thers t enable their active participatin in care a) Respects the rights f the persn t make infrmed decisins thrughut their health/illness experience r episde, whilst ensuring access t accurate and apprpriately interpreted infrmatin Independent: Supervised: Assisted: Dependent: b) Uses apprpriate teaching/learning strategies t prvide diagnstic infrmatin that is relevant, thery-based and evidence-infrmed Cmments c) Cmmunicates abut health assessment findings and/r diagnses, including utcmes and prgnsis d) Wrks t meet identified needs fr educating thers regarding clinical and nging care. Cmpetency Perfrmance Indicatrs Cmpetency evidenced 2.3 Cnsiders quality use f medicines and therapeutic interventins in planning care a) Develps an individual plan f care and cmmunicates this t apprpriate members f the healthcare team and relevant agencies b) Exhibits a cmprehensive knwledge f pharmaclgy Independent: Supervised: Assisted: Dependent: 15

17 and pharmackinetics related t nurse practitiner scpe f practice Cmments c) Wrks in partnership with the persn receiving care t determine therapeutic gals and ptins d) Verifies the suitability f evidence-based treatment ptins including medicines, in regard t cmmencing, maintaining/titrating r ceasing interventins e) Demnstrates accuntability in cnsidering access, cst and clinical efficacy when planning treatment. Cmpetency Perfrmance Indicatrs Cmpetency evidenced 2.4 Independent: Refers and cnsults fr care a) Cllabrates with ther health prfessinals t make and Supervised: decisins t btain ptimal accept referrals as apprpriate utcmes fr the persn receiving Assisted: care b) Cnsults with and/r refers t ther health services, Dependent: disability services, aged-care prviders and cmmunity agencies at any pint in the care cntinuum. Cmments 16

18 Standard 3 Prescribes and implements therapeutic interventins Cmpetency Perfrmance Indicatrs Cmpetency evidenced (yes/n) 3.1 Prescribes indicated nnpharmaclgical and pharmaclgical interventins a) Cntributes t health literacy by sharing knwledge with the persn receiving care t achieve evidence-infrmed management plan b) Safely prescribes therapeutic interventins based n accurate knwledge f the characteristics and cncurrent therapies f the persn receiving care c) Demnstrates prfessinal integrity and ethical cnduct in relatin t therapeutic prduct manufacturers and pharmaceutical rganisatins d) Safely and effectively perfrms evidence-infrmed invasive/nn-invasive interventins fr the clinical management and/r preventin f illness, disease, injuries, disrders r cnditins e) Interprets and fllws-up the findings f screening and diagnstic investigatins in an apprpriate time frame during the implementatin f care. Independent: Supervised: Assisted: Dependent: Cmments 17

19 Cmpetency Perfrmance Indicatrs Cmpetency evidenced (yes/n) 3.2 Maintains relatinships with peple at the centre f care a) Supprts, educates, caches and cunsels the persn receiving care regarding diagnses, prgnses and selfmanagement, including their persnal respnses t illness, injuries, risk factrs and therapeutic interventins Independent: Supervised: Assisted: Dependent:. b) Advises the persn receiving care n therapeutic interventins including benefits, ptential side effects, unexpected effects, interactins, imprtance f cmpliance and recmmended fllw-up Cmments c) Shares infrmatin with thers in cnsultatin with the persn receiving care d) Crdinates care with ther health, disability and agedcare prviders, agencies and cmmunity resurces f) Disclses the facts f adverse events t the persn receiving care and ther health prfessinals; mitigates harm, and reprts adverse events t apprpriate authrities in keeping with relevant legislatin and rganisatinal plicy g) Advcates fr imprved access t health care, the health care system and plicy decisins that affect health and quality f life. Cmpetency Perfrmance Indicatrs Cmpetency evidenced (yes/n) 3.3 Practises in accrdance with federal, state and territrial legislatin and prfessinal regulatin gverning nurse practitiner practice a) Defines duty f care in accrdance with relevant legislatin and regulatin b) Remains infrmed f changes t legislatin and prfessinal regulatins, and implements apprpriate alteratins t practice in respnse t such changes Independent: Supervised: Assisted: Dependent: Cmments 18

20 c) Cntributes t the develpment f plicy and prcedures apprpriate t cntext and specialty. Standard 4 Evaluates utcmes and imprves practice Cmpetency Perfrmance Indicatrs Cmpetency evidenced (yes/n) 4.1 Evaluates the utcmes f wn practice a) Mnitrs, evaluates and dcuments treatments/interventins in accrdance with persndetermined gals and health care system utcmes b) Cnsiders a plan fr apprpriately ceasing and/r mdifying treatment in cnsultatin with the persn receiving care and ther members f the health care team c) Applies the best available evidence t identify and select apprpriate utcmes measures f practice d) Uses indicatrs t mnitr and measure the effectiveness f strategies, services and interventins t prmte safe practice Independent: Supervised: Assisted: Dependent: Cmments 19

21 e) Participates in clinical supervisin and review f) Implements research-based innvatins fr imprving care g) Cntributes t research that addresses identified gaps in the prvisin f care and/r services. Cmpetency Perfrmance Indicatrs Cmpetency evidenced (yes/n) 4.2 Advcates fr, participates in, r leads systems that supprt safe care, partnership and prfessinal grwth a) Advcates and prvides evidence fr expansin t nurse practitiner service where it is believed that such an expansin will imprve access t quality and csteffective health care fr specific ppulatins Independent: Supervised: Assisted: Dependent: b) Demnstrates clinical leadership in the design and evaluatin f services fr health prmtin, health prtectin r the preventin f injury and/r illness Cmments c) Articulates and prmtes the nurse practitiner rle in clinical, plitical and prfessinal cntexts d) Acts as an educatr and/r mentr t nursing clleagues and thers in the healthcare team e) Critiques health care plicies fr their implicatins n the nurse practitiner rle and the ppulatins fr whm they care f) Influences health, disability and aged-care plicy and practice thrugh leadership and active participatin in wrkplace and prfessinal rganisatins. 20

22 Expert Panel Summary and Recmmendatins. Expert Panel Chair Name Signature Date 21

23 References Australian Cmmissin n Safety and Quality in Health Care Safety and Quality Imprvement Guide Standard 1: Gvernance fr Safety and Quality in Health Service Organisatins (Octber 2012) Sydney Begbie, J. and Wheelhuse, A. The Nurse Practitiner Panel: A Crucial Step In The Endrsement Prcess? Retrieved 2 September 2014 frm Bndy, K.N. (1983). Criterin-referenced definitins fr rating scales in clinical evaluatin. Jurnal f Nursing Educatin, 22 (9), End-f-Life Decisin-Making in Canada: The Reprt by the Ryal Sciety f Canada Expert Panel n End-f-Life Decisin- Making: SCHÜKLENK, JOHANNES & etal. Biethics ISSN (print); (nline) i: /j x Vlume 25 Number S pp 1 73 Evaluating the clinical apprpriateness f nurses prescribing practice: methd develpment and findings frm an expert panel analysis: Qual Saf Health Care 2007;16: di: /qshc Retrieved August 2014 Department f Health. Nursing in Victria. NP Candidate Supprt Packages Retrieved 31 March 2014 frm Gippsland Regin Palliative Care Cnsrtium Framewrk fr the Nurse Practitiner Candidacy Prgram May 2014 Page 19 Gvernment f Western Australia, Department f Health, Nursing and Midwifery Office 2012 Nurse Practitiner Candidacy Prgram Implementing nurse practitiner candidacy pprtunities acrss WA Health Mnash Health Nurse Practitiner Prgram; Nurse Practitiner Clinical and Prfessinal Practice Panel Interviews Prcedure Dc. N: SNH V 1.0, 3.0 AND Nursing and Midwifery Bard f Australia (2013) Explanatry nte and FAQ n title prtectin Retrieved 31 March 2014 frm Nurses Bard f Victria: Wrk Instructin Nurse Practitiner Applicatin Oral Examinatin. Plicy, Research and Practice 22

24 Standards June 2008 Nursing and Midwifery Bard f Australia Nursing and Midwifery Bard Newsletter March 2014 Retrieved 31 March 2014 frm Nursing and Midwifery Bard f Australia (2013) Nursing and Midwifery Endrsement nurse practitiners Registratin Standard Retrieved 31 March 2014 frm Nursing and Midwifery Bard f Australia (2014) Nurse practitiner standards fr practice Retrieved 31 March 2014 frm 23