Education, Scope of Practice, Regulation: Issues and Perspectives 15:45 – 16:20 6/28/03

Panel Members Moderator: Rosemary Goodyear - United States Sue Cross – United Kingdom Nelouise Geyer – South Africa Marion Clark – New Zealand

NP Education USA Rosemary Goodyear EdD, RNC, FAANP Director/Consultant Nurse Consultant Associates

Education: USA USA- Certification programs to MS degrees –Varied in length –75-Competency tested –80s-Moved into colleges and universities –Degrees granted –National recognition NP/APN Education USA UK International Role

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

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

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

Nurse Practitioner Strengths Care CareCareCare Care Care QualityQualityQuality Quality Cost EffectiveEffectiveCost Effective Cost

Education UK Sue Cross RN, BSc (Honors) PGCE, FANNP International Project Manager Respiratory Education Resource Centers

Education UK The role and education of the UK Nurse Practitioner

Education UK Nurses taking on the roles of doctors Who makes clinical and management decisions? Prescribing Status of nurses

Education UK Effects of health sector changes on nursing practice Effects of tight health budgets on nursing practice

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)

Education UK Publication Guidelines Framework (1993) Specialised education available (1989)

Education UK Partnership - health & social services Performance - clinical & productivity Professions - flexibility Patient care - access, empowerment & information Prevention - inequalities

Education UK Dilemma Division between cure and care Cure Care

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

Education UK Nursing Roles Nurse SpecialistNurse Practitioner Condition SpecificGeneral Practice Area SpecificClient group specific Client GroupArea specific Community/Clinical Public Health Nursing

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

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

Education UK Nurse Practitioner Expert practice Professional leadership and consultancy Education and training Service development Research and evaluation

Scope and Standards Nelouise Geyer Deputy Director Professional Matters DENOSA Pretoria, South Africa

Scope and Standards The Policy Subgroup was initiated in Consisted of 8 members from 7 different countries Three persons withdrew due to work constrains Liaison with Core Steering Group was Rosemary Goodyear

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

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

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

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

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

Scope and Standards Subgroup will meet in Geneva Evolving scope and standards

New Zealand Model Marion Clark BA; MPP; RGON; FCNA Chief Executive/Registrar Nursing Council of New Zealand

Regulation in NZ An Overview

Regulation in NZ A Regulatory Framework Protection of title(s) Appropriate legislative authority Development of scope, standards and competencies Educational qualifications Who regulates?

Regulation in NZ Process for assessment Examination Graduates of approved programmes Individual competence-based assessment

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

Summary NP Education in USA NP Education in UK Scope and Standards for International NP/APN Network The New Zealand Model