APN in Korea

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APN in Korea

• DongOak Debbie Kim, RN, PhD
• Assistant Professor,
• Daejeon University, Korea
• Geneva
• 2003. 6. 28

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COTENTS

• Emerging Background
• History Features
• KNAs Approaches Efforts
• Current Issues
• Future

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Emerging Background
Changing Clients Needs

• Improving Socio-economic status/ Tech.
• New highlights for Elders
• Changes in Dis. pattern
• Chronic Degenerative Dis.
• Trauma T.A. and Industrial A.
• Easily access to Med. Inform.
• Complexity of Nsg. Care
• Clients Responsibilities
• Clients Participation

Qualified Specialized Nursing
Need for Development of APN
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History features

• 1950s Emerging the APN roles Nurse midwifery
  Nurse Anesthetist
• Nurse midwifery under the nurse midwifery law,
  license
• Nurse Anesthetist under the health care law,
  certification.
• Educational Preparation 1-year program in the
  accredited hospital by the Ministry of Health
  Welfare(MOHW).
• Professional social recognition advanced
  practicing role

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History features contd-

• 1973 Specified the title of the community
  health nurse, nurse anesthetist, mental health
  nurse in the health care law as the special
  field nurses.
• CHN MHN only the title.
• 1990 Home care nurse included in the special
  field nurses.
• Under the health care law, certification
• Educational Preparation 1-year program in the
  accredited university by MOHW.
• Professional social recognition advanced
  practicing role

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History features contd-

• 1980 Community Health Nurse Practitioners
• Not included in the special field nurses.
• Under the provisional law of health care for the
  residents of fishing and agrarian villages
• Educational Prep 6-month program in the
  accredited university by the MOHW.
• Professional social recognition advanced
  practicing role.

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History features contd-

• 1995 Community Mental Health Nurse
  Practitioner
• Not included in the special field nurses.
• Under the community mental health law.
• Certification (1st. 2nd. Grade
• Educational Preparation 1-year program in the
  accredited university hospital by the MOHW.
• Professional social recognition capable of
  advanced practicing role, but not playing an
  active role.
• 2000 changed the title of the CHN, NA, MHN,
  HCN in the health care law
• Advanced Practice Nurse

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KNAs Aproaches

• Purpose to improve the national health status
  through providing the Advanced Nursing Services
  with high quality low cost.

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KNAs Aproaches

• Take Initiatives and Active Participation in the
  Legislation and the Policy Making
• Recognize and monitor the clients needs and
  professional needs for APN.
• Prepare the draft negotiate with the policy
  maker and legislator
• Role and Responsibilities
• Scope and Standards of Practice
• Education Reimbursement
• Prescriptive Authority
• Credentialing

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KNAs Approaches contd-

• Making the united nursing voices to increase the
  solidarity and decrease the conflicts within the
  nursing profession.
• Establish a mechanism to encourage the nurses
  participation survey, committee, open forum,
  workshops of interested groupsetc.
• Support the affiliated institutes to facilitate
  researches.
• Make continuous efforts for the legislating the
  Nursing Acts.

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KNAs Approaches contd-

• Collaborate with other health care
  disciplines(esp. medical) and the clients
• Utilize the political power.
• Utilize the International Resources INPAPNN,
  AAPN, NONPFetc.

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The KNAs Efforts(1990)

• Recognized the social and professional needs
• To expand the types and roles of APN
• To establish the integrated regulatory system of
  APN from the existing fragmented and confused
  one.
• To coordinate the different opinions within the
  nursing profession.
• To play an pivotal role in policy making and
  legislation.
• 1991 Organized an ad hoc committee for APN
• Develop and submit the draft for the APN
  regulation to KNA (1998)

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The KNAs Efforts contd-

• 1999 CNR meeting of KNA
• Add the 7 types of APN
• Determine the basic conditions to drive the
  strategies for policy making and legislation
• 1999 Submit the draft for the APN regulation
  and curriculum to MOHW
• 2000. 1 Revised the health care law (title -
  APN)
• 2000. 3 discuss with the officer of MOHW - need
  the contents to be inserted to the detailed
  enforcement regulations for APN.

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The KNAs Efforts contd-

• Consistent systematic approaches of KNA ad
  hoc committee, workshops of interested groups,
  open forum, reference and consult to experts,
  tight contacts cooperation with MOH,
  collaboration with other health prof.,
• clients,
• lobbies
• etc.
• 2003 The agenda for APN is under deliberation
  on the general assembly of National Assembly
  through carriage in the standing committee of
  health care under NA.

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Definition (KNA, 1998)

• Advanced Practice Nurse means a certified nurse
  who has legal authorization after acquiring
  advanced knowledge and skills through a training
  program specific for APNs in specialty area, and
  performs advanced nursing practices

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Role of the APN (KNA, 1998)

• Overall role APN is a certified practitioner
  who has advanced knowledge as well as performs
  expert clinical practice on a specific nursing
  field to provide safe, effective high-quality
  nursing care for the clients

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Role of the APN-contd

• Detailed roles of APN are as follows

• Expert practitioner in direct nursing care
• Educator and counselor
• Consultant, collaborator, and coordinator
• Researcher
• Leader
• Change agent
• Ethical decision maker with high morality
• Role model for general nurses

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10 types of APN

• APN for Community Health Nursing Service
• APN for Nursing Anesthesia Service
• APN for Mental Health Nursing Service
• APN for Home Care Nursing Service
• APN for Infection Prevention/Control Nursing
  Service
• APN for Industrial Health Nursing Service
• APN for Emergency and First-Aid Nursing Service
• APN for Gerontological Nursing Service
• APN for Critical Care Nursing Service
• APN for Palliative and Hospice Nursing Service

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Qualification of APN

• Authorizing agency The Minister of Health
  Welfare.
• Pass from Certification exam
• 3 or more years recent practice experiences
  within last 10years in the corresponded specialty
  area.
• Certified APN in foreign countries approved by
  the Minister of Health Welfare
• Details required to educational program
  approval areas for practice experiences as each
  APN The Minister of Health Welfare.
• The Minister of Health Welfare.
• Is able to delegate his supervision authority for
  certification exam to professional organization.

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Education of APN

• Accredited Institution
• The Institution has nursing graduate programs
  with affiliated tertiary health care facilities.
• Facilities labs for Advanced Health Assessment
• Faculties
• 1 or more exclusive professor per each APN
  program
• 3 or more preceptors(clinical adjunct professor)
  for Clinical Practicum Master degree, 3 or more
  years recent practice experiences within last
  10years in the corresponded specialty area.
• Facilities for Clinical Practicum
• Types of Facilities for each APN are stated on
  the the detailed enforcement regulations.

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Curriculum

• Minimum 33 units or more 1 unit (16 classroom
  hours
• APN Core 10 units or more
• Nursing theory 2 units
• Nursing Research Methodology 2 units
• Roles and Policies of APN 2 units
• Advanced Health Assessment 3 units
• Advanced Pharmacology 2 units
• Advanced Pathophysiology 2 units
• Elective(Specialty area) 20 units or more
• Theory(Class) 10 units or more
• Clinical Practicum 13 units or more

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Certification Examination

• Supervising Agency KNA or Credentialing Center
  for Nursing Education
• 1st examination written form exam. Corresponded
  to each APN
• 2nd examination
• practice or oral test

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Qualification Renewal for APN

• APN certification should be renewed every 5 years
  with the completion of 10 or more hour continuing
  education per each year.
• If not, she/he should retake the certification
  exam.

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Current Challenging Issues

• Absence of Consistent Comprehensive Conceptual
  Framework for APN.
• Reimbursement from 3rd. Parties.
• Reward for APN
• Resistance of physicians.
• Conflicts in the nursing profession.

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Future

• Promising!
• Collaboration is the Key!
• With Clients, Government Legislator, Other
  health care professionals
• Within the Nursing Professionals Synergy
• Clinical fields - Academy
• Practice Education Research
• Interested Groups
• Global Network

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21st. Century is the Nursing Era.
?????! Thank you.