GOLD COAST PRIMARY HEALTH NETWORK

Student Nurse Online Orientation General Practice Placement 2020

ACKNOWLEDGEMENT

Gold Coast Primary Health Network would like to acknowledge the traditional custodians of the Gold Coast and surrounding

areas, the Yugambeh, Yuggera and Bundajalung peoples

Objectives

• Overview of general practice within the context of Australian Healthcare System

• Overview of the role of nurses in General Practice

• Overview of student nurse placements in General Practice

GENERAL PRACTICE

General practices provides person centred, continuing, comprehensive and coordinated whole person health care to individuals and families in their communities.

General practice is largely seen as the cornerstone of an effective primary health care system

https://www.racgp.org.au/becomingagp/what-is-a-gp/

GENERAL PRACTICE

• In Australia, the GP:– Is most likely the first point of contact in matters of personal

health– Coordinates the care of patients and refers patients to other

specialists– Cares for patients in a whole of person approach and in the

context of their work, family and community– Cares for patients of all ages, any gender, children and adults

across all disease categories– Cares for patients over a period of their lifetime– Provides advice and education on health care– Performs legal processes such as certification of documents

or provision of reports in relation to motor transport or work accidents

https://www.racgp.org.au/becomingagp/what-is-a-gp/

GENERAL PRACTICE FUNDING

• Funding is provided primarily on an activity based, one-to-one basis through Medicare

• There are three principal ways to bill patients for services:

bulk billing accepts the Medicare benefit as full payment for the consultation and there are no out-of-pocket expenses for the patient.

private billing the patient is billed an out-of-pocket fee determined by the practice. If the patient is a Medicare card holder, they may be eligible to claim a rebate from Medicare. For those not eligible for Medicare, they may be billed privately.

mixed billing both bulk billing and private billing is used in the practice.

GENERAL PRACTICE FUNDING

• Additional limited non activity-based funding can be accessed through the Commonwealth including

• https://www.humanservices.gov.au/organisations/health-professionals/services/medicare/practice-incentives-program

Practice Incentives Program Quality improvement focused:• Quality care• Enhanced capacity• Improved access• Improved health outcomes for patients

Workforce Incentive Program Supports an expanded and enhanced role for nurses employed in general practice:• Funding to assist with engaging eligible health

workers• Promotes activities including preventative

health care, education programs, chronic disease management and supported self management

GENERAL PRACTICE ACCREDITATION

• In the early 1990s, government and professional organisations proposed that an independent and voluntary system of practice accreditation be established to promote quality care in general practices.

• In response, the RACGP undertook the development of the Standards for general practices, against which practices would be assessed for accreditation

• The standards support general practices in identifying and addressing gaps in their systems and processes

• As a student you are only placed with Accredited Practice’s or those practice’s Registered for Accreditation

GENERAL PRACTICE NURSING

• Nursing in general practice is a dynamic and vibrant area of the nursing profession. It offers a diverse range of experiences and provides the opportunity to be part of a clinical team caring for the varied primary care needs of the community

• Nursing in general practice represents a shift from a hospital-based environment to a small business environment located in the local community

• Practice Nurses work collaboratively with GPs providing a range of services

GENERAL PRACTICE NURSING

Nurses working in general practice are guided in theirclinical practice by:

• National Practice Standards for Nurses in General Practice

• Professional Practice Framework

Nurses in general practice use these Standards to guide and ensure they are working to the full scope of their

practice.

EXERCISE

• What do you think a General Practice Nurse’s role entails?

• What do you think you will see and do during your placement in general practice?

GENERAL PRACTICE NURSING

Nursing in General Practice: watch these 2 videos, featuring local preceptors and previous students, to

give you more insight into nursing in general practice and to assist with setting your placement goals

Introduction to nursing in general practice

What is the role of the Nurse in general practice

Activity: Placement goal setting

• Take to practice and discuss with Preceptor/s

• Discuss your learning needs with your Preceptor early in your placement preferably on day 1

Key Nurse Activity in General Practice

Chronic Disease Management in General Practice • Chronic Disease Management is a core component

of health care provision in general practice

• There are several rebatable Medicare item numbers to support GPs coordinate the care of people with chronic conditions

• Nurses play a key role in supporting GPs coordinating care for people with chronic conditions including:– Assisting GPs to prepare or review a GP Management

Plan (GPMP) or Team Care Arrangement

– Assisting GPs to support and monitor the care of patients managed through a GPMP

Key Nurse Activity in General Practice

Prevention and Health Promotion • To assess a person's health status and their risk of developing

a chronic disease GPs supported by nurses can complete Health Assessments rebatable through Medicare in the following target populations:– People aged 45-49 years who are at risk of developing chronic

disease (once off)

– A type 2 diabetes risk evaluation for people aged 40 – 49 years with a high risk of developing type 2 diabetes (once every 3 years during target age range)

– An annual health assessment for people aged 75 years and older

– An annual comprehensive medical assessment for permanent residents of residential aged care facilities

– A health assessment for people with an intellectual disability

– A health assessment for refugees and other humanitarian entrants

Key Nurse Activity in General Practice

Health Assessments for Aboriginal and Torres Strait Islander People

• To assess an Aboriginal or Torres Strait Islander person's health status and their risk of developing a chronic disease GPs supported by nurses can complete an annual Health Assessment for the following age groups rebatable through Medicare:– Aboriginal and Torres Strait Islander children who are less than

15 years old

– Aboriginal and Torres Strait Islander adults who are aged 15 years and over but under the age of 55 years

– Aboriginal and Torres Strait Islander older people who are aged 55 years and over

Key Nurse Activity in General Practice

For further information refer to HealthyGC:

Chronic Disease

Health Assessments

Population Health Management

Aboriginal and Torres Strait Islander Peoples Health

Professional Behaviour

• Review the student pre-brief provided on SONIA

• Once you have completed this orientation module you must call your

allocated practices’ primary contact to confirm your placement and

receive your roster

• Once you have confirmed your placement and received your roster

complete the Orientation to General Practice Questionnaire which

can be accessed at the end of this presentation

• When you have completed your placement please return to this

presentation and complete the Post General Practice Placement

Feedback Questionnaire

Professional Behaviour

• Required to follow University policy for professional placement dress code including jewelry

• Hand Hygiene (http://www.hha.org.au/) you can complete the online student module as a refresher

• Must wear an identification badge

• Must have your Blue Card with you to present if requested

• Arrive 10 minutes prior to placement and complete required placement hours each day

• If you are going to be late or can not attend your placement, please contact your preceptor and follow University procedure for absenteeism

• Do not take personal calls, texts or use social media while in the clinical environment

Refer to Bachelor of Nursing Professional Practice Policy & Contract

Professional behaviour

• Be aware of your current scope of practice and work within this scope at all times

• Review Griffith University Undergraduate student nurses' scope of practice document

• Confidentiality is an important component of clinical placements. You must work within the University as well as practice confidentiality policy

• Covered as part of 2805NRS course (legal and ethical principles in healthcare)

• Informed consent is required from patients or their carers for all consultations you are involved in. Consent can be withdrawn at anytime

• Covered as part of 2805NRS course (legal and ethical principles in healthcare)

NURSING STUDENT RESPONSBILITIES

• Some RN’s working in general practice have an extended scope of practice – you can only observe these activities i.e. PAP Smear accreditation; Immunisation certified nurses

• You must always be directly supervised by a Registered Nurse

• Observational learning only when not directly supervised by a Registered Nurse. Can include time with EEN, reception staff, practice manager or GP.

NURSING STUDENT RESPONSBILITIES

• Safe medication administration involves the entire team- Doctor, pharmacist, nurse and the patient. • Safe and quality use of medicines is covered under Criterion Q12.2 – Safe and quality use of

medicines as part of general practice accreditation page 101.

• It is the responsibility of each student nurse to know and understand their own scope of practice and follow the University policy on medication administration.

• Students can NOT prepare or administer any type of medication without supervision.

• Students can NOT administer medication under the supervision of EEN staff members.

• Remember the 6 ‘Rights’– Right patient– Right drug– Right dose– Right route– Right time– Right documentation

GOLD COAST PRIMARY HEALTHNETWORK

Further information and resources related to Primary Healthcare can be accessed from the

Gold Coast Primary Health Network website

www.gcphn.org.au

Placement Experience

We hope your clinical placement in general practice is an enjoyable and rewarding experience that enables you to further develop your nursing skills

Your RN preceptor will orientate you to the general practice environment on your first day and introduce you to other members of the general practice team

Who to contact whilst in placement:For questions regarding your allocated general practice or documentation associated with the placement• GCPHN Clinical Placement Team: email clinicalplacements@gcphn.com.au phone:

07 5635 2455

For questions regarding placement objectives, assessment, concerns, absence or incidents• Primary contact: Course Convener • Secondary contact: Danny Sidwell Professional Practice Coordinator

Orientation Confirmation

To progress to commencing your clinical placement in your allocated general practice you must now complete the linked questionnaire

Orientation to General Practice Questionnaire

Post General Practice Placement

On completing your placement in general practice you will receive a reminder to complete a post placement feedback questionnaire.

Completing this questionnaire is an important component of your placement. It informs a review of the placement program each year and provides important feedback to the nurses supervising students undertaking placements in general practice. This assists in supporting quality placements in general practice for student nurses.

Post General Practice Placement Feedback Questionnaire