Transcript Developing the Nurse Practitioner Role in Community Palliative Care

Developing the Nurse Practitioner
Role in Community Palliative Care
Leanne Davey
Nurse Practitioner, Palliative Care
Royal District Nursing Service
Northern Region
Collaborative Project
• Royal District Nursing Service &
• Melbourne CityMission Palliative Care
Service
• Development of Clinical Practice
Guidelines (CPG’s) & Medication
Formulary
Implementing the NP role in the
Community setting
• Appointment of Project Manager
• Key areas of work undertaken:
– Gaining an in-depth understanding of the Drugs, Poisons
and Controlled Substances Regulations 2006 (Vic) in order
to identify areas to be addressed
– Writing a Policy and Procedure to support the NP prescribing
& authorising rights
– Developing a Position Description
– Identifying equipment needed for the role
– Developing a specific set of codes
– Developing a comprehensive Communication Strategy
Policy and Procedure-Nurse Practitioner
role in medication and diagnostic tests
Policy and Procedure was derived from the
Drugs, Poisons and Controlled Substances
Regulations 2006 (Vic) and includes:
• Definitions of terms used in the policy
• General policy statement
• Processes in relation to:
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Prescribing medicines
Seeking consent to the NP prescribing
Disclosure of drug use
Oral instructions in an emergency
Schedule 8 permit and notification requirements
Policy and Procedure-Nurse Practitioner role
in medication and diagnostic tests (cont’d)
– Confirming prescriptions
– Authorising medicines
– Disposing of unused schedule 8 medicine
ampoules
– Transporting client medicines
– Authorising diagnostic investigations
– Communicating with doctors or hospital
Policy and Procedure-Nurse Practitioner
role in medication and diagnostic tests (cont’d)
– Referring to community based
service/inpatient for admission
– Giving advice to a Doctor
– Giving notification of a drug dependent
person
– Giving notification of fraudulent obtaining of
drugs and poisons
– Process where GP writes script and NP
writes authorisation in the home
Position Description
• Job purpose
• Key Position functions
- Clinical Practice
- Quality Management
- Research and Continuous Improvement
- Collaboration and Partnership Approach
- Professional Development
• Skills/knowledge/attributes
• Qualifications
Equipment to support NP role
• Private prescription pad
• Electronic access to copy of:
– Therapeutic Guidelines
– MIMS online, and
– Australian Medicines Handbook
• Nurse Practitioner stamp
• Prompt card
Activity Codes
• Activity codes developed to reflect
practice
• Codes exclusive to NP role
• Data terms and definitions for codes
developed to reflect and capture the
extended practices
• Supporting evidence for the NP role
Communication with internal &
external Stakeholders
Communication strategy included:
• Developing letters to introduce the role
• Arranging visits to Pharmacies and
GP’s
• Writing articles for newsletters
• Developing a road show presentation
• Producing Business cards
Issues to address
• Carrying of drugs by NP
• Inability to access PBS
• Expense of private scripts
Strategies to address the challenge
• Decision not to carry drugs
• Costing of medications on private script
• Forging relationships with Pharmacies,
the Pharmacy Board and Guild
• Development of private prescription pad
• Authorising medications in collaboration
with the GP or specialist
Demonstrating Continuing Competency
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Professional portfolio
Development of new activity codes
Clinical Supervision
Review/update CPG’s every 2-3 years
Conclusion
• Sharing of information/experience
• Consult/contact
• Process for using RDNS forms &
documentation
-Written request to Sharon McNeil,
RDNS Policy Officer
-Need to acknowledge RDNS on
form/documentation