anp oncology masterclass presentation - dr j richmond

Letterkenny General Hospital, Letterkenny General Hospital, Co.DonegalCo.Donegal

The development of an The development of an Advanced Nurse Advanced Nurse

Practitioner Post OncologyPractitioner Post Oncology

Dr Janice RichmondDr Janice Richmond

[email protected]@mailb.hse.ie

[email protected]@st-vincents.ie

mailto:[email protected]

StructureStructure1.1. Local context and pre-site facilitation workLocal context and pre-site facilitation work

2.2. Site preparation-working to site Site preparation-working to site accreditationaccreditation

• Working as an ANP site-facilitator Working as an ANP site-facilitator

3.3. Job componentsJob components

4.4. ANP accreditation working to submit ANP accreditation working to submit portfolioportfolio

• Working as an ANP candidateWorking as an ANP candidate

5.5. ConclusionConclusion

Local context and pre-Local context and pre-site facilitation worksite facilitation work

LGH context 2006LGH context 2006

• Regional GeneralRegional General

• 300 nurses300 nurses

• 300 beds300 beds

• 1 Haem/Onc DSU1 Haem/Onc DSU

• 1 Haem/Onc ward1 Haem/Onc ward

• 1 Cons Onc1 Cons Onc

• 1 Cons Haem1 Cons Haem

Service history up to 2006Service history up to 2006

• 1990s-Staff nurses in oncology commenced service1990s-Staff nurses in oncology commenced service• 2001/2002-Consultant Oncologist and Haematologist 2001/2002-Consultant Oncologist and Haematologist

appointedappointed• 2002 CNM2 Haem/Onc DSU appointed2002 CNM2 Haem/Onc DSU appointed• 2002 CNS Haematology appointed2002 CNS Haematology appointed• 2002 CNS Oncology appointed2002 CNS Oncology appointed• 2002 OPD clinics commenced2002 OPD clinics commenced• 2003 CNS Oncology Liaison appointed2003 CNS Oncology Liaison appointed• 2005 ANP Site-facilitator Oncology appointed2005 ANP Site-facilitator Oncology appointed• 2005 CNM1 Oncology DSU appointed2005 CNM1 Oncology DSU appointed• 2005 CNM2 Haem/Onc In-patient ward appointed2005 CNM2 Haem/Onc In-patient ward appointed• 2006 ANP appointed and nurse-led clinics commenced2006 ANP appointed and nurse-led clinics commenced

Oncology/Haematology Oncology/Haematology Service up to 2006Service up to 2006

• 1 Day services Unit1 Day services Unit

• I In-patient ward (11 beds) opened 03/2006I In-patient ward (11 beds) opened 03/2006

• 1 OPD Oncology Clinic Monday pm1 OPD Oncology Clinic Monday pm

• 1 OPD Haematology Clinic Monday am1 OPD Haematology Clinic Monday am

• 3 satellite St Luke's clinics/month3 satellite St Luke's clinics/month– Visiting radiation oncologistVisiting radiation oncologist

• 2 nurse-led Oncology Clinics/week & 1 walk-2 nurse-led Oncology Clinics/week & 1 walk-in clinic per weekin clinic per week

Pre-site facilitation Pre-site facilitation work work

• DoN had a vision for ANP Oncology in DoN had a vision for ANP Oncology in 2002 2002

• ANP posts must be service-ledANP posts must be service-led– Behind in review clinicsBehind in review clinics– Psychological support at clinics minimalPsychological support at clinics minimal– Delay in reviewing consultsDelay in reviewing consults– Delays in Haem/Onc Day Services for Delays in Haem/Onc Day Services for

review patientsreview patients

The route takenThe route taken

• CNS Oncology given the job of leading CNS Oncology given the job of leading out on development of ANP job out on development of ANP job descriptiondescription

• Key stakeholders group set up to Key stakeholders group set up to lead/develop this rolelead/develop this role– CNS oncology, CNS haematology, CNM2 CNS oncology, CNS haematology, CNM2

oncology, DoN, A/DoN, CNM3, PD person.oncology, DoN, A/DoN, CNM3, PD person.– Medical staff & NCNM not included at this Medical staff & NCNM not included at this

stagestage

The route taken-4 The route taken-4 meetingsmeetings

• Brainstorming sessions surrounding job Brainstorming sessions surrounding job components of ANP role components of ANP role

• Analyse National Council requirements for ANPAnalyse National Council requirements for ANP• Analyse existing ANP roles/job descriptions and Analyse existing ANP roles/job descriptions and

other job descriptionsother job descriptions• Analyse job components documented by nursing Analyse job components documented by nursing

literatureliterature• Advantages/disadvantages of ANP roleAdvantages/disadvantages of ANP role• Vision for ANP role within LGHVision for ANP role within LGH• Developed complex job descriptionDeveloped complex job description

– Needed reduced and redefinedNeeded reduced and redefined

Job purpose ANP OncologyJob Purpose

The ANP is a senior member of nursing staff able to function as an autonomous practitioner responsible for leading a comprehensive oncology nursing service for cancer patients and their families in Letterkenny General Hospital.

The ANP, as an expert practitioner, is an integral member of the multidisciplinary team, linking hospital care with the community, and is a recognised leader within oncology nursing practice and research .

Autonomy in Clinical Practice Advanced case load management & embracing the expanding nurses’ role•Autonomous and holistic assessment St-Luke's Clinic Out-patients Clinic In-patients Day Centre care •Planning of care for oncology patients Liasing with other professionals•Implementing care complementary to the effective management and treatment of patients•Evaluating care Replanning care if necessary Discharge planning & follow-up care

Researcher•Perform nursing research to examine practice•Initiate & develop research strategies within the Hosp/Board•Participate in audit of own practice•Use an evidence-based practice approach review and update nursing policies/practice within the Hosp.•Disseminate research through journal publications/conference presentations•Maintain an up-to-date knowledge of Clinical Trials

Professional/Clinical Leadership•Education and training of oncology professionals and other non-oncology nurses who encounter cancer patients in their work•Participate in hosp.wide educational programmes•Develop policies & protocols •Develop educational role with patients & families•Produce educational information for patients•Develop and foster links with professionals in Ireland, UK & abroad•Own personal development•Develop nursing documentation •Involvement in clinical supervision

Expert Practitioner•Reflect expert clinical knowledge•Work in collaboration with other staff within the Hosp. & Community•Role model best nursing care through daily working with patients•Mentorship of staff/students•Develop patient led care and involve patients in the care they receive•Encourage patient decision making•Empower nursing staff to improve nursing care•Increase the profile of nursing at local, regional international level

Partnership with patients

MDT working

Practice development

Patient advocate

Community

Community

Change agent

Develop/review & implement a Service plan

Consultancy

Vision for service growth

Evaluated through annual report

Patient focused

Consultant support & guidance

Taking this forwardTaking this forward

• Consult wider group (medical board)Consult wider group (medical board)

• NCNM involvedNCNM involved

• Funding sought (? NCNM, ? Health board)Funding sought (? NCNM, ? Health board)

• Funding obtainedFunding obtained (NCNM) (NCNM)

• Job advertised Summer 2004Job advertised Summer 2004

• Interviews 16.07.04Interviews 16.07.04

• Successful applicant informed 23.07.04Successful applicant informed 23.07.04

• Site-prep commenced 21.02.05Site-prep commenced 21.02.05

Site preparation-working Site preparation-working to site accreditationto site accreditation

Working as an ANP site-Working as an ANP site-facilitatorfacilitator

Successful applicantSuccessful applicant

• RN, BSc(Hons) RN, BSc(Hons) 19961996

• PGDip Advanced PGDip Advanced Nursing-1998Nursing-1998

• Doctorate in Doctorate in Nursing Science-Nursing Science-20022002

• N.IrelandN.Ireland

• KenyaKenya

• IrelandIreland

Successful applicantSuccessful applicant

Oncology experienceOncology experience

• Radiation-inpatients Radiation-inpatients and hostel settingand hostel setting

• Chemotherapy-in-Chemotherapy-in-patient and day patient and day services careservices care

• Palliative carePalliative care

• Teaching at QUB/UUCTeaching at QUB/UUC

• Research-clinical trials Research-clinical trials and nursing researchand nursing research

Oncology mainly Oncology mainly since 1997since 1997

• Staff NurseStaff Nurse

• Nurse ManagerNurse Manager

• Practice Practice Development NurseDevelopment Nurse

• Clinical Nurse Clinical Nurse SpecialistSpecialist

Site preparation stageSite preparation stage

• Site document Site document preparedprepared

Also undertook:Also undertook:

1.1. Physical Physical examination examination module (UCD)module (UCD)

2.2. Psycho-Oncology Psycho-Oncology Module (DCU)Module (DCU)

Site-preparationSite-preparation

• Job description already writtenJob description already written

• Site-preparation had unofficially been Site-preparation had unofficially been ongoing in ideas and conversations ongoing in ideas and conversations onlyonly

• Nothing had been documentedNothing had been documented

• Released full-time for site prepReleased full-time for site prep

The site-preparation fileThe site-preparation file

1.1. Part 1: Application form (download)Part 1: Application form (download)

2.2. Part 2: Job descriptionPart 2: Job description

3.3. Part 3: ANP preparationPart 3: ANP preparation

4.4. Part 4: Financial approval form Part 4: Financial approval form (download)(download)

5.5. AppendicesAppendices

6.6. Reference listReference list

The site-preparation fileThe site-preparation filePart 2: Part 2: • Job description (pg 30 NCNM 2004)Job description (pg 30 NCNM 2004)

• Job titleJob title• GradeGrade• WTE hoursWTE hours• Reporting relationshipsReporting relationships• LocationLocation

• Background to postBackground to post• Includes historical documentsIncludes historical documents• Oncology Department informationOncology Department information• National DevelopmentsNational Developments• Service NeedService Need

• Purpose of the postPurpose of the post


Part 2: Part 2: • Role responsibilities (pg 31 NCNM 2004)Role responsibilities (pg 31 NCNM 2004)

• Clinical practiceClinical practice– Autonomy Autonomy – Expert clinical practiceExpert clinical practice

• Pioneering professional and clinical leadershipPioneering professional and clinical leadership• Researcher (Identify priorities for nursing research)Researcher (Identify priorities for nursing research)

DescriptiveDescriptiveTalk through job descriptionTalk through job description


Part 2: Part 2: • Person specification (pg 32 NCNM 2004)Person specification (pg 32 NCNM 2004)

• Qualifications outlinedQualifications outlined• Experience specifiedExperience specified• CompetenciesCompetencies

– Autonomy in clinical practiceAutonomy in clinical practice– Expert practitionerExpert practitioner– Professional and clinical leadershipProfessional and clinical leadership– ResearcherResearcher

Make description in previous section (role Make description in previous section (role responsibilities) into competenciesresponsibilities) into competencies


Part 3: ANP Oncology Site Prep (pg 33 Part 3: ANP Oncology Site Prep (pg 33 NCNM 2004)NCNM 2004)

Took the 11 criteria and made them Took the 11 criteria and made them into 11 sections & 1 conclusioninto 11 sections & 1 conclusion


Part 3: Part 3: 1.1. Health service need (pg 33)Health service need (pg 33)

1.1. Background to post (description of route taken)Background to post (description of route taken)2.2. Results of auditsResults of audits3.3. Service review, evaluation and case load analysis Service review, evaluation and case load analysis

(service plan)(service plan)4.4. Review of relevant literature and documentsReview of relevant literature and documents5.5. Epidemiological and demographical data (HSE and Epidemiological and demographical data (HSE and

NWHB documents)NWHB documents)6.6. National and international developmentsNational and international developments7.7. ConclusionConclusion


Part 3: Part 3:

2.2. Relevant legislation, rules, regulations Relevant legislation, rules, regulations and guidelinesand guidelines1.1. Relevant documents (ABA)Relevant documents (ABA)

2.2. Areas of expansion in relation to ANP Areas of expansion in relation to ANP OncologyOncology• Laws, rules, regulations and guidelinesLaws, rules, regulations and guidelines

3.3. ConclusionConclusion


Part 3: Part 3:

• Service insurance arrangementsService insurance arrangements– Liaise with Clinical risk managerLiaise with Clinical risk manager– Vicarious liabilityVicarious liability


Part 3: Part 3:

4. 4. Guideline developmentGuideline development

• Outlined generic processOutlined generic process

• Identify caseloadsIdentify caseloads

• Consider scope of practiceConsider scope of practice

• Write guidelines (#19)Write guidelines (#19)


Part 3: Part 3:

5.5. Patient/client benefits (pg 34 NCNM 2004)Patient/client benefits (pg 34 NCNM 2004)1.1. IntroductionIntroduction

2.2. Projected level of service to be providedProjected level of service to be provided

3.3. Current service provisionCurrent service provision

4.4. Identification of key projected outcomes in Identification of key projected outcomes in serviceservice

5.5. Audit of service providedAudit of service provided

6.6. Potential value of ANP to pt/clientPotential value of ANP to pt/client


Part 3: Part 3:

6.6. Consistency with service philosophy Consistency with service philosophy1.1. Statement of serviceStatement of service

2.2. Philosophy of carePhilosophy of care

3.3. Role of ANPRole of ANP

4.4. ANP links with philosophy of careANP links with philosophy of care


Part 3: Part 3:

7.7. Facilitation of service plan Facilitation of service plan

Described how ANP would Described how ANP would complement and expand current complement and expand current service provisionservice provision


Part 3: Part 3:

88. Location of service. Location of service

1 paragraph outlining where the ANP 1 paragraph outlining where the ANP should functionshould function


Part 3: Part 3:

9. 9. Integration of the role to the MDTIntegration of the role to the MDT1.1. Identified key stakeholders and methods of Identified key stakeholders and methods of

communicationcommunication

2.2. Relationship of the role to other MDT Relationship of the role to other MDT membersmembers

3.3. Areas of role development that required Areas of role development that required negotiationnegotiation

4.4. Effect of the role upon other health Effect of the role upon other health professionalsprofessionals


Part 3: Part 3:

10. 10. Role context within nursing Role context within nursing frameworkframework

1.1. Areas of responsibilityAreas of responsibility

2.2. Levels of authorityLevels of authority

3.3. Channels of accountabilityChannels of accountability


Part 3: Part 3:

11. 11. Resource implicationsResource implications1.1. RosteringRostering

2.2. StaffStaff

3.3. Equipment and facilitiesEquipment and facilities

4.4. Research facilitiesResearch facilities

5.5. CPDCPD

6.6. Audit facilitiesAudit facilities

7.7. Liaison arrangement with 3Liaison arrangement with 3rdrd level institutions level institutions


Part 3: Part 3:

12. 12. ConclusionConclusion

Reiterated job purposeReiterated job purpose


Part 4:Part 4:

Financial approval form (download)Financial approval form (download)


AppendicesAppendices

• Audit tables/diagramsAudit tables/diagrams

• Guidelines #19Guidelines #19

• Audit form(s) & documentsAudit form(s) & documents

ReferencesReferences

Site preparationSite preparation

• Commenced 21.02.05 to 04.04.05Commenced 21.02.05 to 04.04.05

• Site visit by NCNM June 2006Site visit by NCNM June 2006

• Site accredited August 2006 by NCNMSite accredited August 2006 by NCNM

• ANP candidate job advertised Feb ANP candidate job advertised Feb 20062006

• ANP candidate appointed May 2006ANP candidate appointed May 2006– Only when achieved ‘candidate’ status Only when achieved ‘candidate’ status

can ANP portfolio be submittedcan ANP portfolio be submitted

ANP job componentsANP job components

Clinical work of ANP Clinical work of ANP OncologyOncology

• Caseload management of all patients with a Caseload management of all patients with a breast cancer and colorectal diagnoses following breast cancer and colorectal diagnoses following an 18 month disease free period.an 18 month disease free period.

• Caseload management of all patients with a Caseload management of all patients with a testicular cancer diagnosis not on active testicular cancer diagnosis not on active treatment.treatment.

• Shared caseload management of review patients Shared caseload management of review patients attending the multi-disciplinary oncology clinics.attending the multi-disciplinary oncology clinics.

• Initial assessment and examination of ‘new’ Initial assessment and examination of ‘new’ patients referred to the Oncology team.patients referred to the Oncology team.

• Shared caseload management of in-patients Shared caseload management of in-patients where the skills of ANP specifically requested where the skills of ANP specifically requested

Clinical job componentsClinical job components

• Advanced holistic psychosocial and Advanced holistic psychosocial and physical assessmentphysical assessment– To include family members/significant othersTo include family members/significant others

• Plan Oncology care and communicate this Plan Oncology care and communicate this to patient/familyto patient/family– EducationEducation– AdvocateAdvocate

• Initiate care/work-up/investigations and Initiate care/work-up/investigations and treatment modalitiestreatment modalities

Clinical job componentsClinical job components

• Identify and implement health Identify and implement health promotion strategiespromotion strategies

• Refer to to other health professionalsRefer to to other health professionals

• Plan for and state when discharge Plan for and state when discharge appropriateappropriate – Initiate follow-upInitiate follow-up

• Provide contact detailsProvide contact details

In-patient work

Outpatient work

Geographic location

In-patient wards Outpatient multidisciplinary

team clinics

ANP-led clinics

‘New’ referrals to the Oncology team

All patients with a breast cancer diagnosis following an 18-month

disease free period.

All patients with a colorectal cancer diagnosis following an 18-month

disease free period.

All patients with a testicular cancer diagnosis not on cancer treatment.

‘Review’ of patients attending for follow-

up

‘Review’ of in-patients

Key: Yellow: Anticipated main clinical work of ANP OncologyRed: Weekly clinic for the ANP OncologyGreen: Input from ANP Oncology is dependent on patient needs and other workload (i.e. ‘red’ areas)

EducationEducation• LYIT Undergraduate programmeLYIT Undergraduate programme• LYIT Postgraduate Oncology DiplomaLYIT Postgraduate Oncology Diploma• UUC Undergraduate programmeUUC Undergraduate programme• CNME Study days & short coursesCNME Study days & short courses• CNME Foundations in Oncology & Haematology CNME Foundations in Oncology & Haematology

NursingNursing• LGH workshopsLGH workshops• LGH study daysLGH study days• 1 annual Haem/Onc study day1 annual Haem/Onc study day• 2 Conferences per annum2 Conferences per annum• 2 publications per annum2 publications per annum

Research and AuditResearch and Audit

• Neutropenia researchNeutropenia research

• ? Study on Port-a-Caths in 2007? Study on Port-a-Caths in 2007

• Continually record/audit ANP Continually record/audit ANP workloadworkload

Other workOther work

• Initiate and lead Haem/Onc nurses Initiate and lead Haem/Onc nurses meetingsmeetings

• Haem/Onc Board memberHaem/Onc Board member

• Policy Review committee memberPolicy Review committee member

• Chairperson for accreditation processChairperson for accreditation process

• Support groupSupport group

Other work contd…Other work contd…

• Senior nurse-pulled into Senior nurse-pulled into managementmanagement

• Mid-line cathetersMid-line catheters

• Clinical TrialClinical Trial

• PICC servicePICC service

External to LGHExternal to LGH

• Cancer Nursing Practice Editorial BoardCancer Nursing Practice Editorial Board

• IANO committee memberIANO committee member

• NW IANO chairpersonNW IANO chairperson

• NCI All-Ireland Nurses Working GroupNCI All-Ireland Nurses Working Group

• External reviewer to RCN publishingExternal reviewer to RCN publishing

• External reviewer to UCF External reviewer to UCF

• Editorial board memberEditorial board member

ANP Oncology OverviewANP Oncology OverviewMorningMorning AfternoonAfternoon

MondayMonday OfficeOffice OPD clinicOPD clinic

TuesdayTuesday OfficeOffice

WardsWardsNursing clinicNursing clinic AccreditatioAccreditatio

nn

WednesdaWednesdayy

Radiology Radiology ConferenceConference

Walk-in Walk-in clinicclinic

TeachingTeaching

Team meetingTeam meeting

Haem/Onc Haem/Onc BoardBoard

ThursdayThursday OfficeOffice

WardsWardsNursing clinicNursing clinic Senior Senior

nurses nurses meetingmeeting

FridayFriday OfficeOffice Research timeResearch time

ANP audits (per annum)ANP audits (per annum)

– ANP clinics (n=251)ANP clinics (n=251)– Walk-in clinics (commenced July 2006, n=23)Walk-in clinics (commenced July 2006, n=23)– OPD clinics (n=319 or 46% of review workload)OPD clinics (n=319 or 46% of review workload)– RIP letters (n=50 approx)RIP letters (n=50 approx)– Thank you’s (n=52)Thank you’s (n=52)– Education (53.5 hours and 94.5 hours mentor)Education (53.5 hours and 94.5 hours mentor)– Staff support (Commenced July 2006, n=10.5 Staff support (Commenced July 2006, n=10.5

hours)hours)– Consults (n=50)Consults (n=50)– Ward work (n=42)Ward work (n=42)– Mid-line catheters (Commenced June 2006, n=15) Mid-line catheters (Commenced June 2006, n=15)

ANP accreditationANP accreditation

Re-accredited every 5 yearsRe-accredited every 5 years

Portfolio. Page 37, NCNM Portfolio. Page 37, NCNM 20042004

1.1. Application form (download)Application form (download)

2.2. Job description (as per site-prep Job description (as per site-prep document)document)

3.3. Detailed PortfolioDetailed Portfolio

4.4. Competencies required and attainedCompetencies required and attained

5.5. Evidence and certificatesEvidence and certificates

ReferencesReferences

Portfolio, part 3Portfolio, part 3

1.1. Personal detailsPersonal details

2.2. General EducationGeneral Education

3.3. Professional educationProfessional education• Registerable qualificationsRegisterable qualifications

• Other professional qualificationsOther professional qualifications

• Meaningful achievementsMeaningful achievements

4.4. Professional nursing posts heldProfessional nursing posts held


5. CPD5. CPD• Study activities (small courses)Study activities (small courses)• Research audit and project workResearch audit and project work• Documents produced/developedDocuments produced/developed• Publications (list)Publications (list)• Professional awards obtained (list & date)Professional awards obtained (list & date)• Lectures &seminars presentedLectures &seminars presented• Courses organisedCourses organised• Study days organisedStudy days organised• Papers presentedPapers presented• Posters presentedPosters presented• Clinical supervision involvementClinical supervision involvement• In service training obtainedIn service training obtained


•Conferences and seminars attendedConferences and seminars attended

•Study days attendedStudy days attended

•Professional and work-based activitiesProfessional and work-based activities

PortfolioPortfolio

Part 4: competencies required and Part 4: competencies required and obtainedobtained

• Table formatTable formatSpecific Specific

competency as per competency as per part 1part 1

How achievedHow achieved Reference to evidence Reference to evidence that competency that competency

achievedachieved

Accept Accept responsibility for responsibility for clinical decision clinical decision making at making at advanced practice advanced practice levellevel

Formal education (list)Formal education (list)

CPD (list)CPD (list)

ANP guidelinesANP guidelines

ExperienceExperience

Supervised practiceSupervised practice

3.33.3

3.43.4

See ….See ….

LGH site-prep LGH site-prep documentdocument

NoneNone

PortfolioPortfolio

• Reference listReference list

• Evidence in order as to which it was Evidence in order as to which it was referred to in the list of referred to in the list of competenciescompetencies

ConclusionConclusion

Value of ANP OncologyValue of ANP Oncology

• Initial assessment by ANP provides Initial assessment by ANP provides patient/family with immediate plan for patient/family with immediate plan for Oncology Tx and/or palliative careOncology Tx and/or palliative care– Reduces patient/family anxietiesReduces patient/family anxieties– Can have graded approach to breaking bad Can have graded approach to breaking bad

newsnews– Ensures faster & appropriate work-upEnsures faster & appropriate work-up– Improved referral mechanismsImproved referral mechanisms– Enables speedier and more seamless discharge Enables speedier and more seamless discharge

for in-patientsfor in-patients– Reduces in-patient bed requirementsReduces in-patient bed requirements


• Continuous link in patient’s care (at Continuous link in patient’s care (at diagnosis, as in-patient, review diagnosis, as in-patient, review clinics etc)clinics etc)

• Available by telephone and have Available by telephone and have admission rightsadmission rights

• Have referral mechanisms in place Have referral mechanisms in place for community staff to have ANP for community staff to have ANP review patientsreview patients


• ANP-led clincs ANP-led clincs eenablenabless more time to be spent more time to be spent with patientswith patients– Focus on quality of life issuesFocus on quality of life issues & health promotion & health promotion

• ANP clinics reduce pressure on multi-disciplinary ANP clinics reduce pressure on multi-disciplinary clinic timesclinic times– Can bring sicker patients back to this clinicCan bring sicker patients back to this clinic

• ANP at OPD clinics increases numbers of patients ANP at OPD clinics increases numbers of patients reviewedreviewed– Zeroed waiting times for review patientsZeroed waiting times for review patients

Achievements to dateAchievements to date

• Reduced review patient Reduced review patient waitingwaiting times to be times to be scheduled for review-now on targetscheduled for review-now on target

• Release consultant time to deal with complex Release consultant time to deal with complex cases at clinic-no additional ‘new patient clinics’ cases at clinic-no additional ‘new patient clinics’ have been needed prior to commencing service have been needed prior to commencing service

• All consults reviewed within 24 hoursAll consults reviewed within 24 hours• Senior nurses meetingSenior nurses meeting• No complaints to dateNo complaints to date• Better able to lead/develop serviceBetter able to lead/develop service• Launch patient support group November 2006Launch patient support group November 2006

Improvements requiredImprovements required

• Prescribing rightsPrescribing rights

• Radiology rightsRadiology rights

• Need good nursing leaderNeed good nursing leader

• Hand over clinical trialHand over clinical trial

• Set up but then hand over PICC Set up but then hand over PICC placementplacement

Lessons to be learntLessons to be learnt

• Get site-prep done Get site-prep done ASAP!ASAP!

• Go to all meetings Go to all meetings relevant to the job. relevant to the job. Don’t let others Don’t let others describe it for youdescribe it for you

• Don’t be too ambitiousDon’t be too ambitious• Consider impact on Consider impact on

porters, secretaries, porters, secretaries, medical records, medical records, phlebotomy etcphlebotomy etc

• Contact cardsContact cards

Am I doing it right?Am I doing it right?

Am I doing enough?Am I doing enough?

Encouragement:Encouragement:

• New South WalesNew South Wales

• UKUK

• MSKCC-USAMSKCC-USA


• Specialised team memberSpecialised team member• Professional and clinical leaderProfessional and clinical leader• Initiates/leads/participates in educational Initiates/leads/participates in educational

programmes (internal/external to hospital)programmes (internal/external to hospital)• ResearcherResearcher• Participates in audit and uses results to Participates in audit and uses results to

change practicechange practice• Have national/international linksHave national/international links• Promotes hospital/nursing through journal Promotes hospital/nursing through journal

publications/conference presentationspublications/conference presentations

The ANP is a senior member of nursing staff able to The ANP is a senior member of nursing staff able to function as an autonomous practitioner function as an autonomous practitioner

responsible for leading aresponsible for leading acomprehensive oncology nursing service for cancer comprehensive oncology nursing service for cancer

patients and their families in Letterkenny General patients and their families in Letterkenny General Hospital. Hospital.

The ANP, as an expert practitioner, is an integral The ANP, as an expert practitioner, is an integral member of the multidisciplinary team, linking member of the multidisciplinary team, linking

hospital care with the community,hospital care with the community, and is a recognised leader within oncology nursing and is a recognised leader within oncology nursing

practice and research .practice and research .

anp oncology masterclass presentation - dr j richmond

Documents

oncology nursing practice

anp sitefacilitator

job purpose anp oncology

role cns oncology

cnm2 oncology

oncology patients liasing

job components of anp

anp posts