Professional Documents
Culture Documents
nursing practice
To determine the characteristics of nurse led clinics
services
Practicing autonomously
Making decisions and being accountable
Admitting and discharging patients
Ability to take a clinical history
Ability to physically examine patient
Ability to determine diagnosis
Ability to determine when onward referral is
required
Ability to prescribe
Do you need to be an expert to run a clinic?
The continuum of advanced nursing practice
Practicing autonomously
Making decisions and being accountable
Admitting and discharging patients
Ability to take a clinical history
Ability to physically examine patient
Ability to determine diagnosis
Ability to determine when onward referral is required
Ability to prescribe
Specific clinical competencies
14
Rationale for nurse led services
Increased efficiency and effectiveness
Increased patient access
An educative role
Psychological support
Monitoring the patient's condition
Empowerment of the patient
15
Types nurse led clinics and services
“Cost cutting”
“Practicing
medicine without
a license”
“Depriving people
of proper medical
care”
Evidence
In heart failure people receiving nurse led care “experienced
fewer hospital admissions for any cause and an increase in
survival and number of participants reaching target dose within
a shorter time period” (Driscol et al, 2015)
In diabetes patients receiving nurse led care demonstrated
better outcomes and costs were reduced (Cook-Johnson et al
2012).
In monitoring people with prostatic cancer nurse led was
acceptable to patients and good coutcomes were demonstated
(Wade et al, 2015)
In caring for people with hypertension nurse led care led to
improved outcomes and reduced costs (Sanders & Guse,
2016).
The value of advanced nursing practice
Driscoll A, Currey J, Tonkin A, Krum H (2015). Nurse-led titration of angiotensin converting enzyme
inhibitors, beta-adrenergic blocking agents, and angiotensin receptor blockers for people with heart failure
with reduced ejection fraction. Cochrane Database Syst Rev. 2015 Dec 21;(12):CD009889. doi:
10.1002/14651858.CD009889.pub2.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009889.pub2/abstract
Sanders J, Guse CE (2016). Reaching Urban Poor Hypertensive Patients: A Novel Model of Chronic
Disease Care Versus a Traditional Fee-for-Service Approach. J Prim Care Community Health. 2016 Aug 9.
pii: 2150131916662465. [Epub ahead of print]
Julia Wade, Peter N Holding, Susan Bonnington, Leila Rooshenas, J Athene Lane, C Elizabeth Salter,
Kate Tilling, Mark J Speakman, Simon F Brewster, Simon Evans, David E Neal, Freddie C Hamdy, Jenny L
Donovan , for the ProtecT Study Group (2015). Urology - Research: Establishing nurse-led active
surveillance for men with localised prostate cancer: development and formative evaluation of a model of
care in the ProtecT trial. BMJ Open 5:9:
http://bmjopen.bmj.com/content/5/9/e008953.full
Advanced nursing practice
Contributes to
developing nursing
Enables us to nurse
with the hands, the
heart and the head
Enriches the lives of
those we care for
and our lives
Thank you for listening
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