Education, Scope of Practice, Regulation: Issues and Perspectives

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Education, Scope of Practice, Regulation
Issues and Perspectives

• 1545 1620 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/Consultant
• Nurse Consultant Associates

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Education USA

• USA- Certification programs to MS degrees
  1965-2003
• Varied in length
• 75-Competency tested
• 80s-Moved into colleges and universities
• Degrees granted
• National recognition

USA
UK
NP/APN Education
International Role
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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
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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
• 1990s
• Changes 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

• Dilemma
• Division between cure and care
• Cure-----------------Care
• Nursing often seen as an extension of the
  doctors role

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Education UK

• Nursing Roles
• Nurse Specialist Nurse Practitioner
• Condition Specific General Practice
• Area Specific Client group specific
• Client Group Area specific
• Community/Clinical
• Public Health Nursing

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Education UK

• Four Essentials
• Adoption of a systematic means of determining and
  designating nursing specialties
• Setting of minimum standards
• Establishment of regulatory mechanisms for nurse
  practitioners
• Resource 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 Geyer
• Deputy Director Professional Matters
• DENOSA
• 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

Draft 1 2001 Draft 2 2002 Draft 3 2003
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New Zealand Model

• Marion Clark BA MPP RGON FCNA
• Chief Executive/Registrar
• Nursing 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