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Education, Scope of Practice, Regulation:
Issues and Perspectives15:45 – 16:20 6/28/03
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Panel Members
• Moderator: Rosemary Goodyear - United States
• Sue Cross – United Kingdom• Nelouise Geyer – South Africa• Marion Clark – New Zealand
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NP Education USA
Rosemary Goodyear EdD, RNC, FAANP
Director/ConsultantNurse Consultant Associates
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Education: USA
• USA- Certification programs to MS degrees 1965-2003– Varied in length– ’75-Competency
tested– 80’s-Moved into
colleges and universities
– Degrees granted– National
recognition
NP/APNEducation
USAUK
InternationalRole
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Education USA
• Scope and Standards were developed by Professional Organizations
• Regulation began on a state by state basis
• Federal Government recognized and funded educational programs
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Education USA
• Payment for services by NPs began with governmental programs
• Prescribing regulations were instituted on a state by state basis and continue in 2003
• Change in the delivery of health care increased the demand for NPs
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Education USA
• Increase in demand for NPs• Accreditation of educational
programs by professional organizations
• Continued public relations for recognition of NPs in health care systems– Private Health Care Systems– Managed Care Systems– Public Health Care Systems
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Nurse Practitioner Strengths
CareCare
Care
Care
CareCare
Care
Care
CareCare
CareCare
QualityQuality
Quality
Quality
Quality
Quality
Quality
Quality
Cost Effective
Effective
Effective
Cost
Cost
Effective
Effective
Cost
Cost
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Education UK
Sue Cross RN, BSc (Honors) PGCE, FANNP
International Project Manager
Respiratory Education Resource Centers
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Education UK
The role and education of the
UK Nurse Practitioner
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Education UK
•Nurses taking on the roles of doctors
•Who makes clinical and management decisions?
•Prescribing•Status of nurses
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Education UK
•Effects of health sector changes on nursing practice
•Effects of tight health budgets on nursing practice
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Education UK
Changing and developing role of nurse involvement
1990’sChanges in NHS drive towards
more involvement- New GP Contract Number
PNs (1990)- CDM programme
reimbursement (1992)
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Education UK
• Publication Guidelines Framework (1993)
• Specialised education available (1989)
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Education UK
• Partnership - health & social services
• Performance - clinical & productivity
• Professions - flexibility• Patient care - access,
empowerment & information• Prevention - inequalities
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Education UK
Dilemma
Division between cure and care
Cure--------------------Care
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Education UK
DilemmaDivision between cure and care
Cure-----------------Care
Nursing often seen as an extension of the doctor’s role
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Education UK
Nursing RolesNurse Specialist Nurse Practitioner
Condition Specific General PracticeArea Specific Client group specificClient Group Area specific
Community/ClinicalPublic Health Nursing
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Education UK
Four EssentialsAdoption of a systematic means of
determining and designating nursing specialties
Setting of minimum standardsEstablishment of regulatory
mechanisms for nurse practitionersResource planning
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Education UK
The Nurse Practitioner Role
• Agree role is needed• Decide on role parameters and
scope• Support for appropriate
education• Agreement on intr and intra
professional issues
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Education UK
Nurse Practitioner
• Expert practice• Professional leadership and
consultancy• Education and training• Service development• Research and evaluation
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Scope and Standards
Nelouise GeyerDeputy Director Professional
MattersDENOSA
Pretoria, South Africa
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Scope and Standards
• The Policy Subgroup was initiated in 2000-2001
• Consisted of 8 members from 7 different countries
• Three persons withdrew due to work constrains
• Liaison with Core Steering Group was Rosemary Goodyear
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Scope and Standards
•Project initiated in 2001•All members were requested
to submit their information on Scope and Standards
•The first draft documents were prepared from this information
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Scope and Standards
•The documents were circulated to all Subgroup members for comment
•A few amendments were made to this draft
•The second draft was prepared and presented in Adelaide, AU 2002
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Scope and Standards
•Adelaide, Australia October 2002
•Second Draft discussed•Meeting of Subgroup of
members in attendance• Identified need to develop
a glossary to accompany the documents
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Scope and Standards
•Valuable discussion with both Subgroup and Core Steering Group members
•Amendment of draft documents December 2002
•Work on third draft during early part of 2003
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Scope and Standards
• 30 March Conference call with subgroup members (Canada, New Zealand, South Africa, USA)
• Work divided among Subgroup members
• Third draft of scope and standards and a glossary are available for comment
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Scope and Standards
• Subgroup will meet in Geneva• Evolving scope and standards
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New Zealand Model
Marion Clark BA; MPP; RGON; FCNA
Chief Executive/RegistrarNursing Council of New
Zealand
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Regulation in NZ
An Overview
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Regulation in NZ
A Regulatory Framework
• Protection of title(s)• Appropriate legislative
authority• Development of scope,
standards and competencies• Educational qualifications• Who regulates?
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Regulation in NZ
Process for assessment
• Examination• Graduates of approved
programmes• Individual competence-based
assessment
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Regulation in NZ
New Zealand Model• Brief overview• Profile of Nurse Practitioners• Roles of regulatory authorities
and professional organizations• Regulatory framework• Assessment of applicants• Issues
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Summary
• NP Education in USA• NP Education in UK• Scope and Standards for
International NP/APN Network• The New Zealand Model
http://www.icn.ch