2nd Nursing Conference on Advanced Practice 21 to 22

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2nd Nursing Conference on Advanced Practice

21st

to 22nd

November, 2008

Dr. Susie LumChairperson, Hong Kong Academy of Nursing Preparatory Committee

Moving a Step Moving a Step Forward in Forward in Advanced Nursing Advanced Nursing PracticePractice––Preparation for the Preparation for the Formation of the Formation of the Hong Kong Hong Kong Academy of Academy of NursingNursing向前迈进了一步

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+ Hong Kong Nurses Wish, Want, & Will to move forward in Advanced Practice 香港护士许愿，希望，意志和推进

+ HK Nurses want recognition & legitimate power for specialization

要承认和合法的专科化

+讓激情來燃燒激情

Change can happen

他讓激情來燃燒激情，

讓希望來推动希望，

喚醒冬眠巳久的理想主義，

展現巨大的穿透力。

+太空一小步創新一大步

+Background

Expanded scope of nursing practice

Rapid proliferation of nursing specialties

International development in advanced practice nursing

Hospital Authority career progression model

190 nurse specialists (38 specialties)

530 advanced practice nurses

+ Hong Kong Academy of Nursing Preparatory Committee Hong Kong Academy of Nursing Preparatory Committee established 2006 under established 2006 under (Societies Ordinance Section 5A[1], Chapter 151)(Societies Ordinance Section 5A[1], Chapter 151)

MembershipMembership

Nursing & Midwifery Councils chairmenNursing & Midwifery Councils chairmen

Department of HealthDepartment of Health

Hospital AuthorityHospital Authority

19 Professional Associations / Colleges / Societies19 Professional Associations / Colleges / Societies

4 Universities4 Universities

website:website: http://www.hkan.hk http://www.hkan.hk P.O. Box 91601 Tsim Sha Tsui Post OfficeP.O. Box 91601 Tsim Sha Tsui Post Office

+ Nurse leaders coming together to create our own preferred future 护士的领导人走到一起创造

我们自己的未来

+Advisors

Mr. Anthony WU, Chairman, Hospital Authority

Dr Hon CH LEONG, Executive Council member, Chairman, Elderly Commission, and Former President of the Hong Kong Academy of Medicine

Prof Grace TANG, President, Hong Kong Academy of Medicine

Dr The Hon Joseph LEE, Legislative Council Member (Health Services)

Dr PY LAM, Director of Health, Department of Health

Prof Thomas KS WONG, Health and Medical Development Advisory Committee member

Dr William HO, Chief Executive, Tung Wah Group of Hospitals

+Oversea Advisors

Prof Frances HUGHES, Former Chief Advisor Nursing, Ministry of Health, currently Professor of Faculty of Medical and Health Sciences and Director of Centre for Mental Health Research, Policy and Service Development, University of Auckland

Dr Karen MACDONALD, Chair, American Nurses Credentialing Center Commission on Certification, USA.

Dr Angela MCBRIDE, Distinguished Professor and University Dean Emeritus of the School of Indiana University and former Scholar-in-Residence of the Institute of Medicine of the National Academies, USA

Dr Mary SMOLENSKI, Director, American Nurses Credentialing Center Certification Program, USA

+Honorary Legal Advisors

Mr Lester HUANG

Mr Mark LAM

Honorary Auditor

Mr William Wai Hei CHAN

+The Hong Kong Academy of Nursing

Key functions

Regulating the practice and promoting the professional development of advanced practicing nurses in specialty areas.

+Advanced Practice Nurses

Nurses who work both independently and in collaboration with other health care professionals to provide a wide range of advanced assessment and specialized interventions in response to the actual and potential health needs of the individual, group or family.

Their practice encompasses the continuum of health promotion and maintenance, disease prevention and management.

+The Hong Kong Academy of Nursing

An independent institution with the statutory power to organize, monitor, assess and accredit all nursing specialist training and to oversee the provision of continuing nursing specialist education.

Explore the feasibility to establish a Specialty Register under the amended Nurses Registration Ordinance Chapter 164

+The objectives of the HKAN are: (1)The objectives of the HKAN are: (1)

For the publicFor the public

to protect the public by regulating standards of to protect the public by regulating standards of advanced nursing practice;advanced nursing practice;

to educate the public regarding the value of to educate the public regarding the value of professional nursing specialization; andprofessional nursing specialization; and

to promote the improvement of health care for to promote the improvement of health care for Hong Kong citizensHong Kong citizens..

+ The objectives of the HKAN are: (2)The objectives of the HKAN are: (2)

For nursing professional developmentFor nursing professional development

toto promotepromote the advancement of the art and science of nursing;the advancement of the art and science of nursing;

to promote integrity, ethical conduct and standards in the to promote integrity, ethical conduct and standards in the practice of advanced nursing and its specialties;practice of advanced nursing and its specialties;

to foster the development of advanced practice nursing to foster the development of advanced practice nursing education in specialty areas; andeducation in specialty areas; and

to facilitate the exchange of information and ideas in nursing to facilitate the exchange of information and ideas in nursing and matters concerning the nursing profession. and matters concerning the nursing profession.

+ Major functions of HKAN

set, monitor and enforce the standards of study and practice of specialty nursing in Hong Kong;

accredit advanced-practice programmes and education institutions in reference to the set standards;

certify and re-certify individuals who have graduated from the accredited programmes (and comparable others) for advanced practice;

sponsor and conduct educational activities that enable advanced practice nurses to maintain currency in areas of expertise;

support and foster development of advanced nursing practice e.g. through recognition of excellence, through analyses of future needs; and

educate the public regarding the roles and benefits of specialization in nursing.

+Proposed structure of the HKAN (1)

CouncilPresident

2 Vice-presidents

Secretary

Treasurer

Representatives from nursing specialties

Six elected members

Two co-opted members

+Proposed structure of the HKAN (2)

CommitteesRegistration Committee

Education and Accreditation Committee

Professional Development Committee

Secretariat

+Education and accreditation of advanced nursing practice

+Term of Reference

To derive a generic competence framework for advanced practice nurses (APN)*通用能力框架

To specify key elements that need to be present in curriculum that prepares APNs

To propose strategies for accreditation of APNs for new comers and those who are already in practicing APN positions.

*APN is used here as an umbrella term to include nurses who practice at advanced / specialty level. It is not used here to present a title for position nor a title of membership that will be granted by the Hong Kong Academy of Nursing.

+Key questions to ask

Are our APNs fit for practice?

How do we know?

How do we let others know?

What is fit for practice?

What are the measures indicating ‘fit for practice’?

What is the purpose of making the measuresexplicit?

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Hong Kong

International

+APN Curriculum

At postgraduate level 研究生

Theoretical component

Practical component

+Theoretical curriculum

Converging (common core, generic to postgraduate students and all APNs)

会聚（共同的核心，一般以研究生和所有APNs ）

Diverging (subjects addressing specific specialty content)

发散（科目处理具体的专业内容）

+ Reference to American Association of Colleges of Nursing

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Graduate Nursing Core(All master’s degree nursing students)

APN Clinical Core(All master’s degree nursing students prepared to provide direct client care)

Community Health(All master’s degree nursing students prepared to provide population-based care)

Administration

Speciality CurriculaCNM CRNA NP CNS

Primary Care NP Acute Care NP

Model of MasterModel of Master’’s Nursing Curriculums Nursing Curriculum

+ American Association of Colleges of Nurse (1996) The essentials of master education for advanced practice nursing. Washington, DC: AACN.

Graduate core

(e.g. research, health policy, leadership, ethical / legal issues and heath care delivery system)

Advanced practice core

(e.g. advanced assessment, pharmacology, pathophysiology, decision making, advanced nursing therapeutics and health promotion)

Specialty core

(content not been specified in the AACN documents)

+ Specialty core

National Association of Clinical Nurse Specialist (NACNS)

3 key spheres of influence

patient/client

nurse/nursing

system/organization

Gouldreau K.A., Clark A., Lyon B. & Rust J.E. (2007)

+ NACNS Essential core content areas for developing CNS competencies

1.

Theoretical

foundation for CNS practice

2.

Phenomenon of concern 现象的关注

3.

Design and development

of innovative nursing

interventions

4.

Clinical inquiry/critical thinking

using

advanced knowledge 临床调查/批判性思维



5.

Technology, products and devices

6.

Teaching and coaching

7.

Influencing change

8.

Systems

thinking

9.

Leadership for transprofessional collaboration



10.

Consultation

theory

11.

Measurement

12.

Outcome evaluation

methods

13.

Evidence-based

practice and translation of

research

14.

Developing content

areas


+Basic Requirement

A mean number of 416.2

clinical hours

A range of 41.4 to 52.2 theoretical

credit hours

57 clinical nurse specialist programmes in 139 different schools surveyed in the United States by Walker et al. (2003)

+Mechanism of approval to practice 审批机制的实践

Nursing practice acts护理实践行为

professional regulations专业法规

certification认证

institutional guidelines (approval)体制准则

（批准）

standards标准

+ http://www.nursingworld.org/ancc/cert/index.html

+APN –

local and global trend

A generic competence framework

for advanced practice nurses

+ Six domains

of the competence framework for

advanced practice nurses (A total of 54 statements) 六个领域

Domain 1

Managing clients with complex health conditions

Domain 2

Enhancing therapeutic nurse-client relationship

Domain 3

Demonstrating effective leadership and team

work

Domain 4

Enhancing quality assurance

and improvement

Domain 5

Managing and negotiating innovative and effective approaches

to care delivery

Domain 6

Enhancing professional attributes

of general and advanced practice

Domain 7

Enhancing personal attributes

+ Accreditation 认证

For New comersFulfills requirements set by the Academy to be considered as a member

Has graduated from a Master program recognized by the Academy

Passes an exit assessment for qualifying APNs recognized by the Academy

For Existing APNsGrandfathering those who are currently appointed as APNs

The applicant needs to meet the requirements that are equivalentto the exit assessment for qualifying APNs recognized by the Academy

For re-certificationProvides evidence of continued education as specified by the Academy

+Academy Colleges

+Academy College

Each nursing specialty will form its own Academy College.

The Academy Colleges will be contained within the Academy, all of which run their own structured training programs.

+Suggested Academy Colleges

Medical/surgical care

Men/women’s health

Child and adolescent health

Mental health

Public/community health

Critical care

Gerontological health

Nursing Management

Complementary/alternative Medicine

+Admission of members into the College (1)Admission of members into the College (1)

Individual College will set its own Individual College will set its own requirement for admission as fellows requirement for admission as fellows and members. Individual College will and members. Individual College will set its standards of specialist training, set its standards of specialist training, including level, duration, content, and including level, duration, content, and methods of assessment. methods of assessment.

+ Admission of members into the College (2)

Trainees have to complete a nurse specialist education from an accredited nursing specialty programme;

have at least a master level education;

have at least five years of structured specialist training in the specialty area.

The Academy Board will hold certified assessment for their trainees. Passing the final assessment is a prerequisite to Fellowship and members of the Academy.

To apply for re-certification and maintain the name on the specialist registry, members have to fulfill mandatory continuing professional development requirement as stipulated by individual College.

+Membership of the HKAN

Fellow

Member

Associate

Honorary Fellow

+Membership of the Hong Kong Academy of Nursing

The members of the HKAN are members of an Academy College who recommended by that Academy College for admission to the membership of the Academy and approved by the Registration Committee.

+Associate member

if a registered nurse is engaged in postgraduate nursing education or in any study or other activity which is in the nature of continuing nursing education or if the HKAN is satisfied that he/she is interested in such study or activity.

+Member

if a registered nurse has successfully completed such courses or periods of training and passed such examinations held, conducted or recognized by such Academy College in relation to the admission of members.

+Fellow

if a registered nurse has successfully completed such courses or periods of training and passed such examinations held, conducted or recognized by such Academy College in relation to the admission of Fellows;

or if a registered nurse has specialised and practised in a branch of nursing for 15 years or more as at the commencement of the Amended Nurses Registration Ordinance, has significant contributions to specialty services development, and in the opinion of the Council, the conduct of his/her practice was consistently good throughout such years.

+Honorary Fellow

Person of eminence or any person who has rendered outstanding service to the art or science of nursing or to the HKAN, may be admitted to the membership of the Academy as an Honorary Fellow.

+Publicity & Communication

宣传和交流

+Strategies

Stakeholders Identification

Promotion & Publicity

Communication

+Stakeholders Identified

1. Political Personnel (Leg Co / Ex

Co / DC members / patient groups)

2. Nursing Groups

3. Target Populations in the Community:

3.1 Professional Bodies

3.2 Prestigious Groups

4. Mass Media

5. Patient groups

6. General Public

+Promotion & Publicity

Mass Media

Newsletter

Pamphlets, poster

Website: http://www.hkan.hk

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+Communication

Meeting with stakeholders.

Discussion & explanation through talks, open forum and e-mails (Website: http://www.hkan.hk).

+Funding model 筹资模式

Self-financed in the long run.

membership fees

friends of nurses

Sources of funding: fund raising activities, membership fees, examination fees and course fees.

+ Support needed from the Government of the Hong Kong Special Administrative Region

需要政府支持

Facilitate the establishment of the Academy of Nursing Ordinance

Explore appropriateness of the adaptation of the extant Nurses Registration Ordinance or its subsidiary legislation to embody a specialist nurse accreditation and registration mechanism.

A venue

A start-up fund

+What have we done so far?

Discussions with the Secretary and Deputy Secretary for Food and Health

Business Plan presented in March 2008 商业计划

Temporary office in former School of Nursing, Princess Margaret Hospital

+ Preparatory Committee for Hong Kong Academy Preparatory Committee for Hong Kong Academy of Nursing meeting with SF&H on 13/6/07of Nursing meeting with SF&H on 13/6/07

+ 2nd Meeting with FHB in April 082nd Meeting with FHB in April 08

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+ Kick-off Ceremony of HKANPC Office on 21 June 2008

+ Kick-off Ceremony of HKANPC Office

+ Kick-off Ceremony of HKANPC Office

Opening of the Hong Kong Academy of Nursing Office in June 2008

We need YOUR SUPPORT!!

+Meeting with Nurses’

Union/Association Leaders, November 2008

+ The next steps

Seek consensus and future links with the Nursing Council

Ｓeek further support from government on legislation and funding

Grant or conferment of specialistdetermine the qualifications and experience to be acquired, training to be undergone or research requirements to be undertaken or fulfilledSeek assistance from overseas expert consultantAssess, evaluate or examine the standards of specialist education

Step up communication with specialty groups

Set up Foundation to raise fund

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THANK YOU

Documents

2nd Nursing Conference on Advanced Practice 21 to 22