A lesson from the UK?

Davidson, Jennifer; Rogers, Tessa

doi:10.1016/j.aenj.2005.04.001

Cited by 4 publications

(7 citation statements)

References 20 publications

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“…2009). Appointments of NP have also been created to more effectively use the existing skilled human resources (Chakravarthy 2008), to relieve emergency department (ED) overcrowding (Davidson & Rogers 2005, Cashin et al. 2007, Keane et al.…”

Section: Discussionmentioning

confidence: 99%

Time to clarify – the value of advanced practice nursing roles in health care

Lowe

Plummer

O’Brien

et al. 2011

Journal of Advanced Nursing

151

130

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Lowe G., Plummer V., O’Brien A.P. & Boyd L. (2012) Time to clarify – the value of advanced practice nursing roles in health care. Journal of Advanced Nursing68(3), 677–685. Abstract Aim. This article presents a discussion of the importance of providing meaningful advanced practice nursing role definition and clarity to improve international standards of nursing titles and scopes of practice. Background. A plethora of international literature exists discussing advanced practice nursing roles and their contribution to healthcare delivery in various countries. However, lack of consistency around title, role definition and scope of practice remains. Data sources. CINAHL and Medline databases were searched using ‘nurse practitioner’, ‘nurse practitioner role’, ‘nurse practitioner practice’, ‘nurse practitioner in public health’, ‘advanced practice nursing roles’ and ‘development of new nursing roles’ with articles limited to years 1995–2010. Citations used in those articles were also explored. All cited articles were in the English language. Discussion. This article supports the need to strengthen the Nurse Practitioner role in health care and professional clarity is identified as a strategy to enhance this. Themes around role clarity, professional identity, ability to enhance healthcare provision and inter‐professional issues are examined. The need to more clearly articulate advanced nursing roles in light of the evolution of the Nurse Practitioner role is highlighted. Much work has already occurred in this domain and a means of adapting and broadening these developments for a wider, more global audience whilst maintaining local context is discussed. Conclusion. Although evidence exists that advanced practice nursing roles are increasing internationally, uncertainty around role clarity remains. This is problematic because the valuable contribution of nursing roles is lost, if the ability to clearly express their function does not exist.

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Section: Discussionmentioning

confidence: 99%

Time to clarify – the value of advanced practice nursing roles in health care

Lowe

Plummer

O’Brien

et al. 2011

Journal of Advanced Nursing

151

130

View full text Add to dashboard Cite

show abstract

“…84 The low-acuity environment has, therefore, become a focus for innovative care solutions that can reduce wait times for all patients, not just those with minor presentations. 98 A systematic search of the English and French literature included 66 papers on the use of physician assistants in EDs and studied several outcomes, including changes in patient flow and patient satisfaction, during the period of physician assistant utilization. The papers, which discussed the effects on patient length of stay during the period of physician assistant utilization, reported that length of stay was reduced when physician assistants were introduced, although the short time period of 1 study limited its generalizability.…”

Section: Innovative Staffing Modelsmentioning

confidence: 99%

Best Practices for Improving Flow and Care of Pediatric Patients in the Emergency Department

Barata¹,

Brown²,

Fitzmaurice³

et al. 2015

Pediatrics

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This report provides a summary of best practices for improving flow, reducing waiting times, and improving the quality of care of pediatric patients in the emergency department. CURRENT STATUS AND NEEDS ED Use and ED Crowding in the United StatesApproximately 800 000 children seek care in the emergency department (ED) each day in the United States. Additionally, it is estimated that 3.4% of US children use EDs as their source for sick care. The vast majority (92%) of these children are seen in community EDs, with a smaller percentage seen in pediatric EDs. The increase in ED utilization has saturated the capacity of EDs and emergency medical services in many communities. Increases in patient volume and decreases in resources, including fragmentation of resources and shortage of critical subspecialists, have resulted in EDs facing crowding and ambulance diversion.The need for emergency medical services outstrips the available resources on a daily basis. This mismatch is reflected by the considerable increase in the number of patients visiting EDs. In 1993, 90.3 million patients visited EDs; in 2003 that number increased to 113.9 million patients. Approximately 21% of these patients were younger than 15 years. Despite the increase in ED visits, the number of hospitals decreased by 703, the number of hospital beds decreased by 198 000, and the number of EDs decreased by 425.

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“…The nurses utilised in this position have shown to be as clinically effective as their junior medical colleges. 9,17,18 Davidson and Rogers 30 argued that ENPs in the UK perform equivalently to senior house offi-cers with over five months experience. They believed that this trend would be transferable to the Australian context where Resident Medical Officers (RMOs) and interns rotate through the ED every 10 to 14 weeks and consequently have limited exposure to patients with minor injuries.…”

Section: The United Kingdom (Uk)mentioning

confidence: 99%

“…They believed that this trend would be transferable to the Australian context where Resident Medical Officers (RMOs) and interns rotate through the ED every 10 to 14 weeks and consequently have limited exposure to patients with minor injuries. 30 The ENP was seen as a complementary practitioner who work autonomously and collaboratively as situations demanded. The work practice undertaken by the ENP allowed medical officers to see and treat the more critically ill patients.…”

Section: The United Kingdom (Uk)mentioning

confidence: 99%

“…11 (p. 1) Various states in Australia have trialled different models of advanced practice nursing and enacted legislation regarding the implementation and accreditation of the role. 30 Some argue that the Australian nursing governing bodies are taking an over cautious and more complex course in implementing NPs. 30 Maurice and Byrnes 39 report that there is also substantial resistance to the NP role by the medical profession who fear nurses subsuming the medical role.…”

Section: The Australian Nursing and Midwifery Council And Advanced Prmentioning

confidence: 99%

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Extending the nursing role in Emergency Departments: Challenges for Australia

Hudson

Marshall

2008

Australasian Emergency Nursing Journal

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As nursing has developed as a profession there has been a continual evolution of the scope of practice in which nurses work. Emergency nursing practice is an example where recently there has been a rapid expansion in the nature and scope of practice. This change in practice has largely resulted from increasing public demand on emergency departments, medical and nursing shortages and governmental pressure to reduced emergency department waiting times and patient length of stay. There have been a number of models worldwide in which the expansion of the Emergency Nurses role has occurred. Recently in New South Wales the Clinical Initiative Nurse role has been developed as an advanced practice role with the objective of initiating treatment based on advanced clinical assessment and to assist emergency departments to meet benchmarks and key performance indicators (KPIs). The scope of practice of this new role did not extend to that of a Nurse Practitioner who is able to discharge patients, prescribe medication and provide medical referral. The variation in advance practice nursing roles in Australia and worldwide has contributed to confusion and uncertainty. The aim of this paper is to explore the various advanced practice roles that may be encountered in emergency nursing practice and examine some of the advantages and limitations to the implementation of these roles.

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A lesson from the UK?

Cited by 4 publications

References 20 publications

Time to clarify – the value of advanced practice nursing roles in health care

Time to clarify – the value of advanced practice nursing roles in health care

Best Practices for Improving Flow and Care of Pediatric Patients in the Emergency Department

Extending the nursing role in Emergency Departments: Challenges for Australia

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