The Challenges of Capturing the Impact of Advanced Practice Roles in Nursing Ann McDonnell, Kate Gerrish, Fiona Kennedy

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The Challenges of Capturing the Impact of
Advanced Practice Roles inNursingAnn
McDonnell, Kate Gerrish, Fiona Kennedy
Faculty of Health and Wellbeing
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Plan

• Background
• Why capture impact?
• What are the challenges?
• What would help?

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Background

• Exploring new roles in practice (ENRiP) (Read et
  al 2001)
• Empowering frontline staff to deliver evidence
  based care the contribution of nurses in APN
  roles (Gerrish et al 2007)
• 'Empowering nurse consultants to improve patient
  outcomes and the patient experience the
  development of a toolkit for enhancing the
  quality of care' Ongoing study funded by Burdett
  Trust for Nursing

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Why capture impact?

• Service development
• Benchmarking
• Current climate
• 'If we look at it from a cost effectiveness
  perspective, there are conflicting priorities
  .... who gives best value for money. With
  practice-based commissioning we need to look at
  this in more detail. GPs will want to know, why
  do we have this person?. There is a need for
  them to understand the role and also for some
  demonstration of effectiveness. We need some
  measures that show that they offer benefits and
  value.' Director of Nursing
• from Gerrish et al 2007

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Challenges

• Diversity in terms of clinical speciality, scope,
  boundaries, ways of working
• Who are the stakeholders?
• Which areas of impact do they value the most?

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Whose perspective needs to be captured?

• Impact on patients
• Impact on staff
• Impact on the organisation
• Impact at national level

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What indicators should be used?

• Patients
• Staff
• Organisation
• National level

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Dimensions of impact
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What about lung cancer nurses?

• Where they felt an impact had been made was up
  to and at the point of diagnosis in terms of
  providing advice, emotional support and
  information to patients at this difficult time.
• Patients valued both the emotional and practical
  support from the CNS at diagnosis, and support
  given to their families.
• Patients valued continuity and co-ordinated care,
  and the way the CNS facilitated care by which
  they could re-access the health care system.
• Patients valued the prompt and easy access to the
  nurse specialist provided in order to gain
  information, advice and support. This often
  provided over the telephone rather than
  face-to-face.
• They felt it was difficult to assess their
  clinical effectiveness, especially in terms of
  patient outcome, as there were few systems in
  place to audit this.

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More challenges

• Do APNs have the skills to go it alone?

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What would help?

• A framework
• A toolkit
• Watch this space!
• 'Empowering nurse consultants to improve patient
  outcomes and the patient experience the
  development of a toolkit for enhancing the
  quality of care' Ongoing study funded by Burdett
  Trust for Nurisng

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References
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Any questions?a.mcdonnell_at_shu.ac.uk
Faculty of Health and Wellbeing