cora o connor m.sc, rnp, ranp. chairperson irish association of advanced nurse and midwife...

Cora O Connor M.Sc, RNP, RANP.

Chairperson Irish Association of Advanced Nurse and Midwife Practitioners

IAANMP

Background Advanced Nurse Practitioners: the Irish Experience.

1996 Valerie Small St James’ Hospital

1998 Commission on Nursing ( A Blue Print For The Future)

2000 National Council for the Professional Development of Nursing and Midwifery in Ireland

2000 Mater Hospital 1 ANP candidate, 2013 4RANPs/1 ANP candidate

2001 Valerie Small First ANP (emergency)

2013 Nationally (100 RANPs in various specialities)

ContextEmergency Department Mater Hospital48 ,000 Patients Annually20% present with a minor injury/illnessChallengesANP Service Within the Department (5,000

pts)Innovation FundingHealth Service ExecutativeLocation

The Journey1st Meeting Jan 2010

Participants (16 attendees)

IT/telephones/housekeeping/pharmacy/security/lab x-ray/transportation/stores/clinical indemnity/data protection

Pilot study for 6 months

ProsDesignated Location for the Care of Patients

Presenting with Minor InjuriesRecognition of the Benefits of ANP ServiceAlleviating the Numbers Presenting to the

Main EDEnsures Appropriate Use of the Emergency

DepartmentOff Site Direct Access to the Mater Hospital

ConsLogistics of New InitiativeTime consumingMinor Stakeholders with large Input to Consultation

ProcessWorking Outside of the Emergency Department TeamLoss of Contact Between ANPs Provision of Care Across to Sites Without Increase in

Staff.Available to a Wider Catchment AreaNo Access to Other Hospitals in Patients Catchment

Area

LogisticsCommunication/EducationPublic (Information Leaflets)Staff Members of ED Team and Allied

Disciplines and SpecialitiesHospital (telephone. Internet)Merging of Information and Transfer of

Information Between Two Separate Systems (Private and Public)

ChallengesED AttitudeSelf Triage (information sheet)Emergency ProceduresClient GroupIsolation Work Ethos (8am to 6pm)Education of Public and GPs to Prevent

Unsuitable Presentations

SuccessPatient SatisfactionPatients Seen Since OpeningAppropriate location for Treatment of

Specific Cohort of PatientsGP/ANP CollaborationGP Training SchemeValue for Money

Case Presentation38 year old male self referral- thumb injuryUsing I phone the night before and felt a pop to

the thumb as he was scrolling the thumb across the screen

Noticed loss of extension to the distal phalanx of the thumb and wrist swelling

History of a punching injury x 3/52 previous Past history/meds/allergiesAssessment Impression /Differential DiagnosisPlanOutcome /DiagnosisTreatment/Follow up care.

Present DayNumbers IncreasingInformation Spreading by Word of MouthRANPS/RNPSEvaluate the Role of the RANP/RNP in the

Prescription of AntibioticsEvaluation of the Service

The FutureThe role of the Registered Advanced Nurse

Practitioner in a Minor Injuries Clinic

Evolution of the Role and Scope of Practice to Facilitate and Increase the Service to the Public