Adopting a State-Wide Approach to Palliative Care Nurse Practitioner Development in South Australia Karen Glaetzer Palliative Care Nurse Practitioner Heather Broadbent Palliative Care Nurse Practitioner Southern Adelaide Palliative Services Flinders University
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Heather Broadbent & Karen Glaetzer, Southern Adelaide Palliative Service - Adopting a State-Wide Approach to Palliative Care Nurse Practitioner Development in South Australia
Karen Glaetzer and Heather Broadbent, Palliative Care Nurse Practitioner, Southern Adelaide Palliative Services delivered the presentation at the 2014 Developing the Role of the Nurse Practitioner Conference.
The Developing the Role of the Nurse Practitioner Conference 2014 is for organisations and managers looking to better understand, utilise and grow the role of the nurse practitioner in their health service.
For more information about the event, please visit: http://www.healthcareconferences.com.au/npconference14
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Transcript
Adopting a State-Wide Approach to
Palliative Care Nurse Practitioner
Development in South Australia
Karen Glaetzer Palliative Care Nurse Practitioner
Heather Broadbent Palliative Care Nurse Practitioner
Southern Adelaide Palliative Services
Flinders University
SA Health
SA Health Palliative Care Plan
2009-2016
Recognised the need for Nurse
Practitioners as a workforce strategy
Proposed up to 20 Palliative Care NP’s
working across SA by 2016
SA Health
Process
Nurse Practitioner Sub-Committee
established under Palliative Care
Clinical Network
Membership included representation
from SA Health, University Sector,
Specialist Palliative Care Services,
Senior Nursing, Service Directors
SA Health
Terms of Reference
NP Sub-Committee
Ensure consistency
Outcomes link with and contribute to the implementation
of the palliative care service plan and the goals of the
palliative care clinical network
Develop and clearly articulate a training pathway
Integrate the Nurse Practitioner into palliative care
service delivery and outcomes informed by evolving
practice and research
Contribute to health professionals and the communities
understanding of the role of the Nurse Practitioner within
the SA Health system
Develop a nurse practitioner workforce development
program
SA Health
Opportunities
COAG Funding to Sub-Acute Services
SA Health Nursing and Midwifery
Scholarships
State Government commitment to
establishing 100 NP positions with
palliative care recognised as priority area
SA Health
Achievements
Training pathway developed
Advisory panel established
NP Chair
Psychosocial Representative
Palliative Medicine Consultant
Nursing Director
3 initial Candidates appointed in each
Metropolitan Palliative Care Service in
August 2010
Palliative Care NP Pathway
1. ACCEPTED INTO A NURSE PRACITIONER CANDIDACY IN A LEVEL 6 PALLIATIVE CARE
SERVICE.
2. AT ENTRY:
THREE YEARS OF STUDY
ELECTIVE
4. INFRASTRUCTURE
SUPPORT
RESEARCH
PROJECT
5. ADVISORY PANEL ESTABLISHMENT OF A
PLAN
9
COMMUNITY
INPATIENT
CONSULTATION
LIAISON
10. MINIMUM TW O PLACEMENTS IN OTHER THAN ‘HOME’ LEVEL 6 SERVICE
RURAL
SETTING
7.
COMMUNITY
6.
INPATIENT
8.
LIAISON
3. AT ENTRY: TW O
YEARS OF STUDY
SA Health
First Candidates
SA Health
Positives
Provided structure to training programme
Forced State-wide and Multi-D approach
Consistent training across multiple settings
Academic requirements varied so allowed some
consistency
Assisted candidates to identify learning needs
Guided mentors
SA Health
Positives
Resulted in credibility so influenced service
commitment to the roles
Model adopted by other specialties as process
viewed as tangible
Joint fortnightly tutorials with Oncology NPC’s
Resulted in interstate collaboration
Nurse Advisor to Victorian Collaborative
Shared Competencies
SA Health
Pitfalls
Misunderstanding about advisory panel role
Lack of engagement by some candidates
Variable understanding of the expectations
Confusing around governance responsibilities
Panel unable to mandate only recommend
Resignation of one candidate after 18 months
Personal Reasons
Local Health Networks variable supervision and
support to the roles
SA Health
2014
2 endorsed candidates from first cohort
1 has accepted role in renal
4 current candidates
1 has recently moved to country Victoria
1 has submitted for endorsement
3 candidates appointed in Country SA
1 endorsed in Aged Care/Palliative Care
Mentoring extended to 2 Oncology candidates
SA Health
2014
COAG not refunded
Succession planning stalled
Palliative Care Clinical Network Workforce sub-
committee put on mothballs
NP sub-committee reconvened in late 2013
Advisory Panel re-established with State-wide role
Consistent scope of practice and P-list with local
variations allowable
SA Health
Holding on… for dear life
State level
The organization
Mentorship
NPC as an individual
Across the spectrum
The organization:
Southern Adelaide Palliative Service
Metropolitan specialist palliative service
2012-13
1415 referrals, 470 current patients
age: 84% > 61 years, 14% 41-60 years
site of care : 76% in own homes at referral
diagnosis
The organization
> Multi-disciplinary
> Demonstrated commitment
Provide contemporary best practice by
utilising a team that is made up of advance
practice clinicians*
*SAPS Mission statement
The mentorship offered
> Qualities
• Availability
• Preparedness
• Willingness to commit
• Aspirational
• Personal philosophy
The NPC as an individual
> Robust
> Resilient
> Humble
Novice
Advanced beginner
Competent
Proficient
Expert Novice
Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park,
CA: Addison-Wesley.
The importance of a framework
for the NPC experience
> Diversity of settings offered
• Outpatient clinic with Palliative Medicine Consultant