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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Serie: Advanced Clinical Practice
- Sprache: Englisch
The Advanced Practitioner An essential text for Advanced Practitioners In The Advanced Practitioner: A Framework for Practice, a team of distinguished Advanced Practitioners (APs) and academics deliver the go-to text for trainee APs, with a strong focus on the four pillars that underpin advanced practice: clinical practice, education, research, and leadership. The patient is at the core of this essential resource, which offers the knowledge required to care safely for people in a variety of care settings, as well as with a range of common and specialised holistic interventions. Readers will also find: * A thorough introduction to the core principles of advanced practice, including the AP curriculum and the principles of physiology, pharmacology, and pathophysiology * Comprehensive exploration of the clinical pillar, including discussions of clinical history taking and physical examination * Practical discussion of the education and research pillars, including an exploration of research principles and education and learning * Discussion of innovation in practice, the leadership pillar, and how to deal with difficult situations Perfect for trainee advanced practitioners, The Advanced Practitioner: A Framework for Practice will also benefit healthcare students and trainee medical associate professionals.
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Table of Contents
Cover
Title Page
Copyright Page
Contributors
Preface
Acknowledgements
CHAPTER 1: Advanced Clinical Practice
LEARNING OUTCOMES
INTRODUCTION
HOW TO USE THIS BOOK
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 2: The Advanced Clinical Practice Curriculum
LEARNING OUTCOMES
INTRODUCTION
CURRICULUM DEVELOPMENT
THE CLINICAL PRACTICE CURRICULUM
THE LEADERSHIP AND MANAGEMENT CURRICULUM
THE EDUCATION CURRICULUM
THE RESEARCH CURRICULUM
ASSESSMENT FOR ACP
SPECIALIST CURRICULUMS, CREDENTIALS AND CAPABILITY FRAMEWORKS
SUPERVISION AND CPD STRATEGIES
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 3: Scope of Practice and Management of Patient Care
LEARNING OUTCOMES
INTRODUCTION
THE MULTI‐PROFESSIONAL FRAMEWORK (MPFFACP)
MENTAL HEALTH ACT 1983 AND SECTIONS
THE RIGHT TO LIFE AND THE RIGHT TO DIGNITY
DEVELOPMENT AND REGULATION
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 4: Principles of Physiology for Advanced Practice
INTRODUCTION
HOW THE BODY ADAPTS TO DIFFERENT SITUATIONS
KEY CONCEPTS OF THE CELL
CONTROL – HOW THE BODY ALLOWS US TO ACHIEVE ACTION AND PARTICIPATION IN SOCIETY
CHANGES TO PHYSIOLOGY THROUGH THE LIFE COURSE
MICROBIOME/MICROBIOTA AND INTERACTIONS WITH THE MICROBIOLOGICAL ENVIRONMENT
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 5: Principles of Pathophysiology
INTRODUCTION
CANCER
CARDIOVASCULAR DISEASE AND STROKE
DIABETES
RESPIRATORY DISEASE
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 6: Principles of Pharmacology
LEARNING OUTCOMES
INTRODUCTION
PHARMACOTHERAPY
PHARMACOKINETICS (PK)
PHARMACODYNAMICS (PD)
THERAPEUTIC DRUG MONITORING (TDM)
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 7: Supplementary and Independent Prescribing
LEARNING OUTCOMES
INTRODUCTION
EDUCATION
GENERAL PHARMACOLOGICAL PRINCIPLES
LEGAL ASPECTS AND GOVERNANCE
DE‐PRESCRIBING
HEALTH PROMOTION
SOCIAL PRESCRIBING
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 8: Core Procedural Skills
LEARNING OUTCOMES
INTRODUCTION
CONSENT/ASSENT
CLINICAL COMPETENCE FOR PROCEDURES
PREPARATION: POSITIONING
CORE PROCEDURAL SKILLS
LEARNING FROM PATIENT SAFETY EVENTS
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 9: Clinical History Taking and Physical Examination
LEARNING OUTCOMES
INTRODUCTION
THE CONSULTATION AS A DIAGNOSTIC TOOL
CONSULTATION MODELS
ASPECTS OF OBTAINING A MEDICAL HISTORY
CLINICAL ASSESSMENT – ASPECTS OF PHYSICAL EXAMINATION
HANDS AND NAILS
CLOSING THE CONSULTATION
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 10: Clinical Decision Making and Diagnostic Reasoning
LEARNING OUTCOMES
INTRODUCTION
CLINICAL REASONING AND CLINICAL DECISION MAKING
THINKING, GROWING AND EVOLVING
DECISION‐MAKING THEORIES
INTUITION
HYPOTHETICO‐DEDUCTIVE REASONING
THE COGNITIVE PROCESS
BIASES
ASSISTIVE TOOLS AND CONCEPTS: RISK ASSESSMENTS/PROBABILITY SCORES/RISK STRATIFICATION
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 11: Diagnostic Interpretation
LEARNING OUTCOMES
INTRODUCTION
PRINCIPLES TO FOLLOW
THE FULL BLOOD COUNT
DIAGNOSTIC INTERPRETATION: IMAGING
THE ESSENTIALS OF EACH IMAGING MODALITY ARE CONSIDERED BELOW
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 12: Public Health
LEARNING OUTCOMES
INTRODUCTION
CLINICAL EXAMINATION
CLINICAL EXAMINATION
CLINICAL EXAMINATION
MANAGEMENT
REFLECTIONS
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 13: Managing Complexity
LEARNING OUTCOMES
INTRODUCTIONS
MEDICAL COMPLEXITY
SITUATIONAL COMPLEXITY
SYSTEMS COMPLEXITY
NHS LONG TERM PLAN (2019)
ADVANCED CLINICAL PRACTICE
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 14: Frailty
LEARNING OUTCOMES
INTRODUCTION
DISCHARGE PLANNING
INTERMEDIATE CARE
PALLIATIVE OR END‐OF‐LIFE CARE
CLINICAL FRAILTY
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
CHAPTER 15: Mental Health, Learning Disability and Autism
INTRODUCTION
PARITY OF ESTEEM
MENTAL HEALTH AND ETHNICITY
COMMUNICATION
CLINICAL INVESTIGATIONS
PHARMACOLOGICAL PRINCIPLES
RESOURCES
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 16: Education and Learning
LEARNING OUTCOMES
INTRODUCTION
PRINCIPLES OF TEACHING AND LEARNING
SUPPORTING OTHERS TO DEVELOP KNOWLEDGE AND SKILLS
CREATING AN EFFECTIVE LEARNING ENVIRONMENT
SIMULATION AND TECHNOLOGICAL ADVANCES IN HEALTHCARE EDUCATION
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 17: The Advanced Practitioner as Educator
LEARNING OUTCOMES
INTRODUCTION
PROVIDING FEEDBACK
THE ONE‐MINUTE PRECEPTOR
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 18: Research Principles
LEARNING OUTCOMES
WHY RESEARCH IS IMPORTANT
CRITICAL APPRAISAL AND THE HIERARCHY OF EVIDENCE
DESIGNING A RESEARCH PROJECT
QUANTITATIVE VERSUS QUALITATIVE RESEARCH METHODS
HEALTHCARE RESEARCH ETHICS
QUALITY IMPROVEMENT
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 19: Leading Research in Advanced Practice
LEARNING OUTCOMES
INTRODUCTION
ENABLING EVIDENCE‐BASED PRACTICE
DEVELOPING GUIDELINES AT A NATIONAL/INTERNATIONAL LEVEL
DEVELOPING NEW EVIDENCE FOR PRACTICE
DISSEMINATION OF EXISTING AND NEW KNOWLEDGE
DEVELOPING THE ADVANCED PRACTITIONER AS A CLINICAL ACADEMIC
CREATING A RESEARCH CULTURE AT ORGANISATIONAL LEVEL TO IMPROVE PERSON‐CENTRED HEALTHCARE
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 20: Innovations in Practice
LEARNING OUTCOMES
INTRODUCTION
INNOVATION, PRACTICE DEVELOPMENT AND SERVICE IMPROVEMENT
INNOVATION AND ADVANCED‐LEVEL PRACTICE AND THE ADVANCED PRACTITIONER ROLE
CONCLUSION
REFERENCES
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
CHAPTER 21: Professional Development and Transition
INTRODUCTION
PERSONAL PROFESSIONAL DEVELOPMENT
CONTINUING PROFESSIONAL DEVELOPMENT AND ROLE TRANSITION
SUPPORTING PROFESSIONAL DEVELOPMENT WITHIN A TEAM
CONTRIBUTION TO BROADER DEVELOPMENT OF ADVANCED PRACTICE
WHAT NEXT?
CONCLUSION
REFERENCES
FURTHER READING
SELF‐ASSESSMENT QUESTIONS
GLOSSARY
Index
End User License Agreement
List of Tables
Chapter 1
TABLE 1.1 Definition of advanced clinical practice as defined by Health Educ...
TABLE 1.2 An explanation of the pedagogy used within this book (boxed).
Chapter 2
TABLE 2.1 The differences between competence and capability.
Chapter 4
TABLE 4.1 Frameworks and curriculum for ACP which mention physiology as a re...
Chapter 5
TABLE 5.1 Summary of the main disease mechanisms.
TABLE 5.2 Eight hallmarks of cancer.
TABLE 5.3 The main clinical complications of atherosclerosis.
Chapter 6
TABLE 6.1 Common drugs that require therapeutic drug monitoring.
TABLE 6.2 An example of how free form drug plasma concentrations can rise be...
TABLE 6.3 How drug metabolic pathways develop with age.
TABLE 6.4 Common drug–disease interactions with a rationale for contraindica...
TABLE 6.5 Common excipients present in some drugs and potential effects on p...
Chapter 7
TABLE 7.1 Professionals' eligibility to become independent and supplementary...
TABLE 7.2 Pathological changes affecting absorption in critical illness.
TABLE 7.3 Changes of distribution during critical illness.
TABLE 7.4 Changes of metabolism during critical illness.
TABLE 7.5 Changes of excretion during critical illness.
TABLE 7.6 Examples of antibiotic stewardship interventions commonly deployed...
Chapter 8
TABLE 8.1 Indications and contraindications for ICD insertion (Yousuf and Ra...
TABLE 8.2 Indications and contraindications for venepuncture.
TABLE 8.3 Indications and contraindications for peripheral venous cannulatio...
TABLE 8.4 Indications and contraindications for arterial puncture and cannul...
TABLE 8.5 Indications and contraindications for central venous access.
TABLE 8.6 Indications and contraindications for IO insertion.
TABLE 8.7 Indications and contraindications of LP.
TABLE 8.8 Indications and contraindications for nasogastric tube insertion (...
Chapter 9
TABLE 9.1 Components of an adult health history and associated mnemonics.
TABLE 9.2 Specific challenges in taking a history in neurodiverse population...
TABLE 9.3 Clinical findings of the hands and nails and their associated path...
TABLE 9.4 Arterial pulse examination, abnormal findings and common pathologi...
TABLE 9.5 Clinical findings of the head and neck and their associated pathol...
TABLE 9.6 Clinical findings of the thorax and their associated pathological ...
TABLE 9.7 Clinical findings of the abdomen and their associated pathological...
Chapter 11
TABLE 11.1 Pattern recognition.
TABLE 11.2 Imaging request details.
TABLE 11.3 Plain film imaging studies and their applicable clinical situatio...
Chapter 12
TABLE 12.1 Example of an adapted NEWS tool.
TABLE 12.2 Wells score assessment.
TABLE 12.3 Classification of cellulitis.
TABLE 12.4 Abbreviated Mental Test Score questions.
Chapter 13
TABLE 13.1 International organisations' usage of FIC (WHO 2022a).
Chapter 14
TABLE 14.1 The nine conditions included in UCR provision.
TABLE 14.2 Rockwood clinical frailty scale.
TABLE 14.3 PRISMA clinical frailty score.
Chapter 15
TABLE 15.1 ‘Soft signs’ of sepsis – STOP AnD WATCH
TABLE 15.2 Some common symptoms.
Chapter 16
TABLE 16.1 Key educational theories.
TABLE 16.2 Benefits of simulation in healthcare education.
TABLE 16.3 How to incorporate non‐technical skills into simulation.
TABLE 16.4 The do's and don'ts of debrief.
TABLE 16.5 Core models for debrief.
Chapter 18
TABLE 18.1 GRADE rating for quality of evidence from the Cochrane Handbook....
TABLE 18.2 The PICO framework.
TABLE 18.3 The FINER criteria.
TABLE 18.4 Type of research and the question it aims to answer.
TABLE 18.5 Quantitative and qualitative research: a comparison.
TABLE 18.6 Summary of quantitative studies design.
TABLE 18.7 Summary of qualitative research approach.
TABLE 18.8 Type of data collection for qualitative research.
TABLE 18.9 Summary of approaches used to analyse qualitative research.
TABLE 18.10 Ethics throughout the research process.
Chapter 19
TABLE 19.1 Core research skills.
TABLE 19.2 Sources of national/international evidence guidelines for clinic...
TABLE 19.3 Underlying principles of quality improvement.
Chapter 20
TABLE 20.1 Links to Multi
‐
professional Framework for Advanced Clinical...
TABLE 20.2 Examples of area‐specific/specialist accreditation considerations...
TABLE 20.3 Types of innovation and key stakeholders.
TABLE 20.4 Characteristics of advanced‐level practice in England as an examp...
TABLE 20.5 Principles of practice development.
TABLE 20.6 Enacting levels of leadership in advanced practice.
TABLE 20.7 Four elements of cultures for innovation.
TABLE 20.8 Summary of Venus model.
Chapter 21
TABLE 21.1 Multi
‐
professional Framework for Advanced Clinical Practice...
List of Illustrations
Chapter 1
FIGURE 1.1 The four pillar of advanced clinical practice based upon the Heal...
Chapter 2
FIGURE 2.1 Advanced practice spectrum.
FIGURE 2.2 Miller's triangle.
Chapter 4
FIGURE 4.1 Transport routes across cell membranes.
FIGURE 4.2 Physiological fluid compartments.
FIGURE 4.3 Transport of carbon dioxide (a) from cells to blood, (b) from blo...
FIGURE 4.4 DNA and RNA structure.
FIGURE 4.5 Example of folding using cube puzzle, (a) correctly folded, (b) i...
FIGURE 4.6 Cell cycle illustrating the sequence of phases during cell divisi...
FIGURE 4.7 UK predicted deaths in 2019 by age group and major disease or inj...
FIGURE 4.8 UK predicted deaths in 2019 by age group and major disease or inj...
Chapter 5
FIGURE 5.1 (a) Common risk factors for the development of cancer. (b) The pr...
FIGURE 5.2 (a,b) Pathophysiology of atherosclerosis and subsequent plaque ru...
FIGURE 5.3 Stages in the development of type 1 diabetes. The stages are list...
FIGURE 5.4 The pathogenesis of type 2 diabetes.
FIGURE 5.5 Summary of the metabolic disturbances resulting from a deficiency...
FIGURE 5.6 (a) Changes occurring in the airways during an asthma exacerbatio...
FIGURE 5.7 Pathophysiology of chronic bronchitis and emphysema.
FIGURE 5.8 Pathophysiology of pulmonary hypertension.
Chapter 6
FIGURE 6.1 An overview of the four main processes of pharmacotherapy.
FIGURE 6.2 Principles of drug actions.
FIGURE 6.3 The dose–response and dose–toxicity relationships of a drug on a ...
FIGURE 6.4 The therapeutic window of a drug administered with time.
Chapter 7
FIGURE 7.1 Key moments in prescribing – a timeline.
FIGURE 7.2 Critical illness‐induced pharmacokinetic changes. SIRS, systemic ...
FIGURE 7.3 Conceptual framework for assessing the influence of patient facto...
Chapter 8
FIGURE 8.1 Surgical safety checklist (1st edition).
FIGURE 8.2 (a–c) Simple airway manoeuvres and adjuncts.
FIGURE 8.3 Supraglottic airway devices (SADs).
FIGURE 8.4 The ‘triangle of safety’ for inserting an intercoastal drain.
FIGURE 8.5 Examples of different equipment used for conducting venepuncture....
FIGURE 8.6 Veins of the antecubital fossa.
FIGURE 8.7 Ultrasound‐guided peripheral venous cannular insertion.
FIGURE 8.8 Performing the modified Allen test.
FIGURE 8.9 Enzymatic tests of coagulation.
FIGURE 8.10 Essential anatomy of the lumbar spine in relation to performance...
FIGURE 8.11 Common positions for lumbar puncture procedure.
FIGURE 8.12 The palpated intercristal line (a), the imaged intercristal line...
FIGURE 8.13 CSF interpretation (Hersi et al. 2022).
Chapter 9
FIGURE 9.1 A pictorial representation of the open to closed cone described i...
FIGURE 9.2 Consultation models and their differing emphasis on four common d...
FIGURE 9.3 Enhanced Calgary‐Cambridge consultation model.
FIGURE 9.4 The NEWS2 scoring chart.
FIGURE 9.5 Example physical examination content.
Chapter 10
FIGURE 10.1 The Roberts & Francis‐Wenger clinical decision‐making tree 2022....
FIGURE 10.2 Schematic model for diagnostic decision making.
FIGURE 10.3 The four stages of competence.
FIGURE 10.4 Heading to the ‘sharp end’ of advanced practice.
FIGURE 10.5 Actual and estimated performance percentiles.
Chapter 11
FIGURE 11.1 Calcium and parathyroid feedback loop. a) Cells in the parathyro...
FIGURE 11.2 Thyroid system.
FIGURE 11.3 Chest X‐ray densities and normal anatomy.
FIGURE 11.4 A 79‐year‐old male with history of squamous non‐small cell lung ...
FIGURE 11.5 Chest X‐ray of a 34‐year‐old female showing consolidation in the...
FIGURE 11.6 Axial slice through the head showing left‐sided acute subdural h...
Chapter 12
FIGURE 12.1 A multifactorial risk assessment.
Chapter 13
FIGURE 13.1 International Statistical Classification of Diseases and Related...
FIGURE 13.2 A pictorial representation of the elements included in the Inter...
FIGURE 13.3 Dimension of healthcare and ‘wickedness’ Kuipers et al. (2011)....
FIGURE 13.4 Factors associated with healthcare complexity and ‘wickedness’ K...
Chapter 14
FIGURE 14.1 Discharge pathways.
FIGURE 14.2 Home‐based care.
FIGURE 14.3 Fit for Frailty.
Chapter 16
FIGURE 16.1 Dual coding theory.
FIGURE 16.2 Learner, teacher, process, space.
FIGURE 16.3 Maslow's hierarchy of needs.
FIGURE 16.4 Planning teaching with goal, reality, options, will framework.
FIGURE 16.5 How to create psychological safety.
FIGURE 16.6 Team STEPPS – components of team performance.
FIGURE 16.7 Action learning cycle.
Chapter 17
FIGURE 17.1 Miller's pyramid.
FIGURE 17.2 COM‐B.
FIGURE 17.3 Pendleton's model for feedback.
FIGURE 17.4 ALOBA model for feedback.
Chapter 18
FIGURE 18.1 The research process.
FIGURE 18.2 The evidence hierarchy pyramid.
FIGURE 18.3 PDSA cycle.
Chapter 19
FIGURE 19.1 Research capabilities in the Multi‐Professional Framework for Ad...
FIGURE 19.2 What is a policy, guideline, protocol.
FIGURE 19.3 The audit cycle.
FIGURE 19.4 Steps in PPPG development.
FIGURE 19.5 The PDSA cycle.
Chapter 20
FIGURE 20.1 Participatory Evidence‐informed Patient‐centred Process‐Plus (PE...
Chapter 21
FIGURE 21.1 Layers of professional development and transition in advanced pr...
FIGURE 21.2 The professional development journey.
Guide
Cover Page
Title Page
Copyright Page
Contributors
Preface
Acknowledgements
Table of Contents
Begin Reading
Index
Wiley End User License Agreement
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The Advanced Practitioner
A Framework for Practice
Edited by
Ian Peate,OBE, FRCN
Visiting Professor, St George’s University of London and Kingston University London Visiting Professor, Northumbria University Senior Clinical Fellow, University of Hertfordshire Professorial Fellow, University of Roehampton Editor‐in‐Chief, British Journal of Nursing Consultant Editor for the Journal of Paramedic Practice and the International Journal for Advancing Practice
Sadie Diamond‐Fox,MCP, ACCP, BSc (Hons), RN, PGC AHP, NMP (V300), FHEA
Advanced Critical Care Practitioner (FICM member) and ACCP Programme Co‐Lead at Newcastle upon Tyne NHS Hospitals
Subject Lead for Advanced Practice Programmes and Assistant Professor in Advanced Critical Care Practice (Fellow – HEA) at Northumbria University
Speciality Advisor for Critical Care at Regional Faculty for Advancing Practice NHS England North East & Yorkshire Honorary Assistant Professor in Advanced Clinical Practice at Nottingham University Member (& Past Chair) of the Advanced Practitioners in Critical Care (APCC) Professional Advisory Group (PAG) at the Intensive Care Society (ICS). External Examiner for MSc ACCP Programmes at Southampton University. Editorial Board Member of the International Journal of Advancing Practice
Barry Hill,MSc, AP, PGCAP, BSc (Hons), DipHE/OA, Dip SFHEA, TEFL, NMC, RN, RNT/TCH, V300
Associate Professor of Nursing Science and Critical Care; Director of Nursing Midwifery and Health Employability, Northumbria UniversityConsultant Editor for the International Journal for Advancing Practice Clinical Series Editor for the British Journal of Nursing
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Library of Congress Cataloging‐in‐Publication DataNames: Peate, Ian, editor. | Diamond‐Fox, Sadie, editor. | Hill, Barry (Lecturer in nursing) editor.Title: The advanced practitioner : a framework for clinical practice / [edited by] Ian Peate, Sadie Diamond‐Fox, Barry Hill.Description: Hoboken, NJ : Wiley‐Blackwell, 2024. | Includes bibliographical references and index.Identifiers: LCCN 2022059953 (print) | LCCN 2022059954 (ebook) | ISBN 9781119882039 (paperback) | ISBN 9781119882046 (adobe pdf) | ISBN 9781119882053 (epub)Subjects: MESH: Advanced Practice NursingClassification: LCC RT41 (print) | LCC RT41 (ebook) | NLM WY 128 | DDC 610.73–dc23/eng/20230302LC record available at https://lccn.loc.gov/2022059953LC ebook record available at https://lccn.loc.gov/2022059954
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Contributors
Ihab Ali, MRPharmS, ASTEM, SFHEA, PGDip, IP
Lead Pharmacist for urgent care, Stockport NHS Foundation Trust. Ihab's career began in 2013 as a Community Pharmacist before transferring to a clinical role in an NHS hospital in 2014. He has experience in many different clinical areas but decided to specialise in acute medicine when completing his independent prescribing qualification. He side‐stepped into becoming a teacher practitioner in 2019 before returning to work as Lead Pharmacist for urgent care in 2020. He has worked as unit lead for both undergraduate and postgraduate pharmacy courses, at the University of Manchester and Aston University. He is now working purely in the emergency department as a Clinical Pharmacist with the intention of becoming an advanced clinical practitioner and then eventually a Consultant Pharmacist.
Clare Allabyrne
Associate Professor and professional lead for advanced clinical practice mental health at London Southbank University and a fellow of the Higher Education Academy. A dual qualified nurse (Adult and Mental Health) by profession, her areas of expertise include advanced clinical practice in mental health, child and adolescent mental health services (CAMHS), forensic psychiatry, liaison psychiatry; mental health in adult and child physical health services, substance use, physical health care in mental health, service user involvement/people participation, multi‐agency/partnership working, leadership and service creation and innovation. Clare worked for 35 years in the NHS across physical and mental healthcare services in clinical, therapeutic, senior operational, clinical academic and corporate/strategic leadership roles.
Sarah Ashelford, BSc (Hons), PhD
Sarah started her career as a researcher at Edinburgh University, Centre for HIV Research. This was followed by a move into teaching secondary level science in schools in Wakefield and Leeds. Sarah moved back into teaching biosciences on various healthcare professional courses at Bradford University and the University of Lincoln, and now works at the University of York. Sarah specialises in teaching physiology and pathophysiology relating to healthcare, and research in biosciences education.
Jill Bentley, mFICM, ACCP MSc
Lecturer in advanced clinical practice, non‐medical prescribing and nursing, University of Salford, Salford, UK. Jill is an experienced practitioner with a demonstrated history of working in the hospital and healthcare industry. She is skilled in critical care, clinical research, medical education, medical‐surgical, paediatrics and critical thinking. Jill is a strong healthcare services professional with a MSc focused in advanced practice from the University of Salford, and an MSc in pain management.
Roberta Borg, BSc (Hons), MSc
Roberta obtained a BSc (Hons) in nursing studies from the University of Malta (2008). Shortly afterwards, she moved to the UK and started her career in critical care at Cambridge University Hospitals. Roberta has always enjoyed a side hustle in academia alongside her clinical work, engaging in research, teaching and advancing her own academic studies. She completed a PGCert in critical care and later an MSc in advanced clinical practice. The latter was in parallel with a two‐year clinical training programme, which saw her qualify as an Advanced Critical Care Practitioner (mFICM) in 2015 and she continued to work in this role. She has recently taken a break from clinical work to spend time with her young family and move to the United States. During this time, she continues to contribute to the academic nursing world through various book chapters and has expanded her readership to a younger audience through a book that she wrote for children to understand the value of healthcare workers.
Phil Broadhurst, RN, BSc (Hons) (Nursing Practice), MSc (Advanced Clinical Practice), PGCE (Medical and Health Education)
Phil is a FICM‐registered Advanced Critical Care Practitioner at Stockport NHS Foundation Trust. He started his career as a ward volunteer before working as an auxiliary nurse while completing his nurse training. He has significant experience in intensive care, where he has worked as a staff nurse and team leader, before qualifying in advanced practice. Phil has a special interest in professional education and around his clinical work he is actively involved in training and education of both medical and nursing colleagues, taking a lead on Trust‐wide acute illness management training. Phil spent several years working in the international humanitarian sector co‐ordinating relief and development projects, and he maintains a special interest in this field.
Mark Cannan, MSc, BSc (Hons), Dip HE
Mark is an Advanced Critical Care Practitioner in intensive care, at the North Cumbria University Hospitals Foundation Trust. Mark entered the healthcare profession as an Operating Department Practitioner (ODP) in 2013 with the University of Central Lancashire, having witnessed the work of an ODP first‐hand in the theatres of Camp Bastion, Afghanistan. On qualification, he rotated through anaesthetic and scrub practice, in both elective and emergency surgical procedures in two busy district general hospitals. While qualifying with a diploma, he continued in education by completing an Honours degree in acute and critical care at the University of Cumbria, which is where he discovered the Advanced Critical Care Practitioner (ACCP) role. Having excluded career progression in managerial or educational roles, the ACCP role seemed to best fit his aspirations by being retained at the bedside, performing clinical duties. Mark started his ACCP training with Northumbria University in 2017 and qualified in 2019 with a postgraduate diploma and works across two general intensive care units which increased to four during the COVID‐19 pandemic. Mark has since completed his Master's degree and has specialist interests in advanced airway management, regional anaesthesia and transfer of the critically ill patient. He is also on the national working group for legislation change in allowing ODPs who have progressed into advanced practice the ability to undertake non‐medical prescribing.
Colin Chandler, BSc (Hons) Physiology, PhD, FHEA
Colin is a Lecturer in life science at the School of Health in Social Science (Nursing Studies), Programme Director MSc Advanced Nursing (online) and Programme Director PGCert Neurological Rehabilitation and Care (online) at the University of Edinburgh. Colin has extensive experience in life science education for nurses and allied health professional at both undergraduate and postgraduate levels. He has recently been involved in projects that have defined undergraduate anatomy and physiology curricula for nurses. He has wide experience of designing and delivering Master's and doctoral education and support for health, education and social care professionals to support their advanced practice.
Esther Clift, PhD, BSc (Hons), MSc
Consultant Practitioner – frailty, Chair of the Geriatric Society, National Speciality Advisor for NHSE, visiting lecturer at the University of Winchester, Winchester, UK.
Esther is currently working as a Consultant Practitioner in frailty for the Southern Health NHS Foundation Trust. She undertakes research in physiotherapy, geriatrics and allied health science. Her most recent publication is 'Use of the electronic Frailty Index to identify vulnerable patients: A pilot study in primary care'.
Rebecca Connolly, BA (Hons), BSc, MSc
Consultant ACP in emergency and critical care medicine, United Lincolnshire Hospitals NHS Trust, Associate Lecturer, University of Lincoln, Lincoln, UK, co‐creator of the College of Paramedics national peer support programme, founding member of the College of Paramedics Diversity Steering Group. Rebecca specialises in Emergency and Critical Care Medicine. Before entering healthcare, she gained her undergraduate degrees in Japanese and Marketing, lived in Japan and studied at Kwansei Gakuin University. Returning to the UK, she worked as a police officer where her areas of specialism and interest were in deception and body language. Her passion for social psychology, body language, executive function and the neuropsychological processes that mediate decision making led her to complete her MSc in psychology where she researched psychopathy and success, together with facial microexpressions in psychopaths.
Stuart Cox, RN, BSc (Hons), MSc
Stuart works as an Advanced Critical Care Practitioner (ACCP) at University Hospitals Southampton NHS and Dorset and Somerset Air Ambulance. Prior to this, he was employed as a senior charge nurse ICU at Southampton and senior nurse CEGA Air Ambulance. He graduated with a BSc (Hons) in nursing science and completed his MSc in ACCP in 2018. Stuart is a registered nurse with the Nursing and Midwifery Council and an ACCP with membership with the Faculty of Intensive Care Medicine. Stuart is actively involved in national groups on advanced practice for the Intensive Care Society.
Rachael Daw
Senior Educationalist, Royal College of Physicians, London, UK.
Jo Delrée
Jo is a learning disability nurse with many years' experience as an Associate Professor in mental health and learning disability nurse education. She works as an educator and consultant for the NHS and higher education, including London South Bank University, specialising in issues affecting autistic people and people with learning disabilities.
Joanna De Souza, MSc, PATHE, RNT, AKC
Joanna is a Senior Lecturer at the Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, UK. She has a nursing background in haemato‐oncology and palliative care in the UK and New Zealand and is currently completing her doctorate in end‐of‐life family conversations with Lancaster University. She has taught the merits and skills of using evidence to inform practice since 2000 in the UK, China, Singapore and Somaliland.
Sadie Diamond‐Fox, MCP, ACCP (mFICM), BSc (Hons), RN, PGCAHP, NMP (V300), FHEA
Sadie qualified as an adult nurse in 2008 and has since worked in various critical care departments. She progressed to her current advanced practice roles which include Advanced Critical Care Practitioner (ACCP), Assistant Professor in Advanced Critical Care Practice (FHEA) and Speciality Advisor for Critical Care for the North East and Yorkshire’s Regional Faculty of Advancing Practice, NHS England. Sadie is also currently a second‐year Doctor of Philosophy (PhD) candidate and sits on various national and local advancing practice and critical care committees. She has an extensive teaching portfolio spanning multiple disciplines within postgraduate healthcare education, making a wide range of contributions at local and international levels. Her key areas of interest are postgraduate healthcare education, acute, emergency and critical care, physiology and pharmacology, advanced‐level practice and simulation and virtual reality education modalities.
Leanne Dolman, RN, MSc, PGDip, BSc
Leanne is Lecturer (Adult Nursing), King's College, London, UK.
Christine Eade, MSc, PGCE, PgC, BSc (Hons)
Christine is a Consultant Plain Film Reporting Radiographer who works in the NHS and private healthcare sectors. She has worked at Royal Cornwall Hospitals Trust since qualifying from Bristol in 1999, with a specialist interest in paediatrics. She is also a member of the European Society of Paediatric Radiology AI Taskforce. Other professional activities include forensic radiography, career coaching and guest lecturing on the MSc Reporting and Advanced Practice modules for Plymouth and Exeter Universities.
Brigitta Fazzini, BSc(Hons), PgDiP DTN, MSc (Crit Care and Adv Clin Practice), NMP(V300)
Brigitta is an Advanced Critical Care Practitioner in the Adult Critical Care Unit at the Royal London Hospital. She is an honorary research fellow with Queen Mary University of London. She is a clinical academic passionate about critical care and critical care outreach and applied clinical research. She is the deputy chair of the Intensive Care Society (ICS) Professional Advisory Group for Advanced Practice in Critical Care and part of the chair team of the Advanced Clinical Practitioners Academic Network (ACPAN) in the UK. Her highest hope is to proactively shape the future of intensive care speciality with an inclusive multidisciplinary approach promoting effective quality changes, education and research.
Helen Francis‐Wenger
Helen began her nursing career in Essex and soon focused her work on emergency medicine (EM), holding roles within EM in secondary care. Now, focusing on higher education for postgraduates as a lecturer in advanced clinical practice at the University of Plymouth, she is a fellow of the Higher Education Academy. Helen remains clinically active as an ACP in emergency medicine in Cornwall's Royal Cornwall Hospitals Trust, and is member of the Royal College of Emergency Medicine as well as being a registered independent prescriber. Helen is a credentialled ANP and an active committee member of the Association of Advanced Practice Educators and RCN ANP committee.
Alexandra Gatehouse, BSc (Hons), MSc
Alex graduated from Nottingham University in 2000 with a BSc (Hons) in physiotherapy. Following junior rotations in the Newcastle Trust, she specialised in respiratory physiotherapy in adult critical care, also working in New Zealand. In 2012, she trained as an Advanced Critical Care Practitioner, completing a Master's in clinical practice in critical care and qualifying in 2014. Alex subsequently completed her non‐medical prescribing qualification and continues to rotate within all the critical care units in Newcastle upon Tyne, also enjoying teaching on the regional transfer course. She is a co‐founder of the Advanced Critical Care Practitioner Northern Region Group and a committee member of the North East Intensive Care Society. Alex has presented abstracts at the European Society of Intensive Care Medicine and the North East Intensive Care Society conferences.
Kirstin Geer, Advanced Critical Care Practitioner. North Cumbria Integrated Care.
Kirstin qualified as a nurse in 2005 and worked on an Emergency Admissions Unit before becoming a Critical Care Outreach. She began her Advanced Critical Care Practitioner training in 2014 and qualified in 2016.
Barry Hill, MSc, PGCAP, BSc (Hons,) Dip HE, OA Dip, RN, NMC, RNT/TCH, SFHEA
Barry is Associate Professor and Director of Employability, Northumbria University; Consultant Editor for the International Journal for Advancing Practice; Clinical Editor for the British Journal of Nursing. Barry is an experienced leader, academic, educator, researcher and clinical nurse. His current role is Associate Professor and Director of Employability for nursing, midwifery and health. He has a demonstrated history of working within academia in higher education. Barry is a senior fellow and an HEA mentor, a certified intensive care nurse, with an MSc in advanced practice (clinical); NMC registered nurse, NMC registered teacher and NMC registered independent and supplementary prescriber (V300). He is skilled in clinical research and clinical education, and is passionate about higher education, especially nursing science, advanced clinical practice, critical care, non‐medical prescribing and pharmacology. Barry is a strongly education‐focused professional who has published nine books, 60 book chapters and 100 peer‐reviewed journal articles. He is the Consultant Editor for the International Journal of Advancing Practice and Clinical Editor for the ‘At a glance’ and ‘Advanced clinical practice’ series within the British Journal of Nursing.
Robin Hyde, MSc, BN, RN (Child) RNT, RNMP, PGCert TL, HE, FHEA
Robin is an Assistant Professor in children and young people's nursing at Northumbria University. He is an NMC registered children's nurse, nurse teacher, independent/supplementary prescriber, qualified advanced paediatric nurse practitioner and fellow of the Higher Education Academy. Robin has been a qualified nurse for over 18 years. He is an experienced clinician and academic, having held a range of roles across the NHS and HEI sectors in Scotland and England. Robin is currently in year three of a PhD research project, carrying out a realist evaluation of an advanced practice programme in the context of children and young people's healthcare.
Joanna Lavery, MSc Advanced Practice, NMP, PgDip, SCPDN, PGCert Teaching and Learning In Clinical Practice, BSc (Hons), Dip HE, RN, FHEA, Queen's Nurse
Joanna is a Senior Lecturer in adult nursing and programme lead specialist community practitioner in district nursing at Liverpool John Moores University. She qualified as a registered nurse in 1999. She worked in neurosurgery and critical care before embarking upon a role in the community as a district nurse. She held posts as District Nurse Care Manager and Community Matron. Joanna returned to secondary care to work as an advanced nurse practitioner in acute medicine and ambulatory emergency care in 2013. She has worked in higher education since 2019 teaching both undergraduate and postgraduate students.
Elizabeth Midwinter, RN, MSc, BSc (Hons)
Elizabeth is a Continuous Improvement Clinical Fellow at Lancashire Teaching Hospitals NHS Foundation Trust. She is a registered nurse and advanced clinical practitioner in emergency medicine, arriving here via the scenic route (theatres, ED, urgent care, primary care and ED again), before moving to education as a Lecturer at the University of Bolton and Matron for resuscitation and simulation. Whilst in the role, Elizabeth became involved in a number of projects and completed the Flow Coaching Academy, which sparked her passion for improvement and led her to her current role.
Stevie Park
Stevie is an Advanced Critical Care Practitioner at University Hospital Birmingham, Birmingham, UK.
Ollie Phipps
Ollie is a Course Director for non‐medical prescribing and MSc advanced clinical practice (ACP) at Canterbury Christ Church University. He has a clinical background as a consultant nurse in acute medicine and he continues to work as an advanced clinical practitioner in an emergency department in Kent. Ollie has led the Health Education England and Royal College of Physicians ACP Credential Development for Acute Medicine and Respiratory Medicine. Previously, he was the credential lead for the Centre for Advancing Practice, the chair of the Royal College of Nursing's Advanced Nurse Practitioner (ANP) Forum, and the National Advanced Practice Steering Group. He is a published author on the subject of advanced practice within multiple texts and is an international keynote speaker on the subject. Ollie continues to be a national expert advisor for advanced practice. He also is an expert advisor for the National Institute for Health and Care Excellence (NICE) and the National Confidential Enquiry into Patient Outcome and Death (NCEPOD).
Jaclyn Proctor
Jaclyn is an Advanced Clinical Practitioner at Warrington and Halton Teaching Hospitals NHS Foundation Trust, Warrington, UK.
Sharon Riverol, MSc (dist) Advanced Practice, BSc (Hons), Dip HE Nursing Studies, Adult RN, PGCert, FHEA
Sharon is a Senior Lecturer in adult nursing and deputy programme lead for the Trainee Nursing Associate programme at Liverpool John Moores University. She qualified as a registered nurse in 2005. She started her nursing career in stroke rehabilitation before moving to coronary care and then acute medical care, and then moving into general practice. As a general practice nurse, Sharon was able to complete her V300, her nursing degree and then her Master's in advanced practice. Sharon's roles included nurse manager and advanced nurse practitioner before moving into higher education. She started in higher education in 2020, teaching undergraduates, postgraduates and apprentice students, and has now completed the PGCert and is a fellow of the Higher Education Academy.
Colin Roberts
Colin qualified as a GP in 1996 in Exeter. He has been involved in education since then, initially as a GP trainer and medical student educator, but increasingly focused on advanced practice. He now works as Associate Professor in advanced practice at Plymouth University. He remains clinically active as a GP, validating his academic role. Colin teaches advanced practice widely across the South West of England with a keen interest in developing a scientific foundation in advanced practitioners, underpinning clinical skills and diagnostics. He is a champion of the advanced practice role across all aspects of healthcare and works strategically in the region to enhance training routes and continuing professional development.
Vikki‐Jo Scott, RN, MA Learning and Teaching, SFHEA, current PhD student
Vikki‐Jo has a background in critical care nursing and returned to clinical practice to work in critical care during the initial peaks of the COVID‐19 pandemic. Since working in academia, she has focused on continuing professional development for health and social care professionals. She teaches on many courses, including those focused on quality improvement and application of learning to practice as well as leading the Advanced Clinical Practice programmes. She is a senior fellow of the Higher Education Academy and up until 2020 was Dean of the School of Health and Social Care at the University of Essex, England. She is currently undertaking a PhD focused on advanced clinical practice and is a reviewer for the Centre for Advancing Practice accreditation processes.
Sara Stevenson‐Baker, MSc, PGCE, BSc (Hons)
Sara is a Lecturer in nursing at King's College, London. She has worked in a variety of clinical and educational environments, including hospital and community within palliative care, oncology, general medicine and intensive care nursing and higher education. Sara has developed advanced clinical and educational skills by being committed to ensuring that her own practice, skills and knowledge are maintained. She has completed a BSc (Hons) degree in cancer nursing and an MSc in education for healthcare professionals. Sara successfully gained her Postgraduate Certificate in Education in 2012 and Advanced Assessment skills in 2011 at King's College University. She has also completed and delivered advanced communication training and Sage and Thyme Foundation communication training.
Vanessa Taylor, RGN, EdD, MSc Advanced Clinical Practice (Cancer Nursing), PGCE, BSc, DPSN
Vanessa is the Director of health and care partnerships/professor of cancer and palliative care at the School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK. Following clinical roles in cancer and palliative care, Vanessa moved into higher education. Her activities and published work focus on cancer, palliative and end‐of‐life care and education, evaluation of education and its impact on workforce development and clinical practice. As chair of steering group/lead author for the RCN Career and Education Framework for Cancer Nursing and chair of steering group/lead author HEE (Yorkshire and the Humber) End of Life Care Learning Outcomes, Vanessa has published unique resources that distinguish levels of knowledge, skills and practice for the workforce in these fields. Most recently, Vanessa chaired the steering group developing the HEE ACP‐Palliative and End of Life Care credential. She is a steering group member of the ACCEND project and chair of workstream 5 developing the ‘Career pathway, core cancer capabilities in practice and education framework’. Vanessa is a member of the NHSE/I group developing a career pathway and education framework for palliative and end‐of‐life care. She was awarded a National Teaching Fellowship in 2020 and is chair of the Biosciences in Nursing Education Group.
John Wilkinson, MBBS, PGCert Med Ed
John is an Anaesthetics Registrar in the Northern School of Anaesthesia and Intensive Care Medicine, with a special interest in education and simulation. After studying medicine at Newcastle University and completing Foundation training in Newcastle Trust Hospitals, he trained in anaesthetic and critical care departments across the north of England, including as a clinical and education fellow in critical care. He has presented on the development of a novel educational resource at the annual meeting of the Society for Education in Anaesthesia. He has a particular interest in multidisciplinary team simulation training, including creating resources for sessions involving medical, nursing and midwifery students from Newcastle and Northumbria Universities.
Alison Wood, PhD, RGN
Alison is a Lecturer in non‐medical prescribing in the Division of Nursing and Paramedic Science at Queen Margaret University, Edinburgh, Scotland. Alison's clinical nursing career has most recently focused on haemodialysis and renal medicine and this formed the focus of her PhD, exploring care in this clinical setting. Alison holds an honorary title within NHS Lothian as nurse consultant for non‐medical prescribing and remains active in a clinical capacity alongside her full‐time lecturing post. She is also a member of the Bioscience in Nurse Education (BiNE) group and engagement with science in pre‐ and postregistration healthcare education is a strong interest area, having led a project to develop a set of learning outcomes on physiology for pre‐registration nurse education.
Joe Wood
Joe is an Advanced Critical Care Practitioner, physiotherapist and point‐of‐care ultrasound educator at the Medway NHS Foundation Trust, Kent, England.
Preface
The Advanced Practitioner: A Framework for Practice is the first of its kind. It provides a multiprofessional resource that uses the four pillars underpinning advanced practice as a framework: clinical practice, leadership and management, research and education. The text offers essential reading that is related to contemporary advanced clinical practice topics.
The Advanced Practitioner: A Framework for Practice has been written primarily for the trainee advanced practitioner. Advanced practitioners (APs) come from a range of professional backgrounds, including physiotherapy, pharmacy, paramedics, occupational therapy and nursing, practising across the age continuum and in a variety of spheres of practice, at the top of their licence. The focus of this text is on the adult person.
The advanced practitioner role offers the added value of an experienced clinician; it is a co‐productive role that meets the needs of populations. Advanced practice offers a vision for the development of the workforce in a way that is consistent, ensuring safety, promoting quality and resulting in positive patient outcomes.
Advanced practice programmes have been developed to meet national and local policy drivers for workforce transformation through a Master's level programme. Using a level 7 taxonomy makes clear the expectation that practitioners working at this level are required to perform at Master's level. The Advanced Practitioner: A Framework for Practice is cognisant of this and the chapters in the text mirror this.
Readers will develop their knowledge, skills and behaviours required to act with a high level of autonomy, enhancing their skills in holistic and systematic assessment, complex decision making along with the provision of high‐quality evidence‐based interventions for patients and their families. This text will support the reader undertaking a programme of study to strengthen their learning through the application of theory related to their scope of practice in the workplace and the academic setting. The text will also be of value to those advanced practitioners who are seeking to update and review their knowledge and understanding of the various topics associated with advanced practice.
Throughout The Advanced Practitioner: A Framework for Practice, the service user is placed at the centre of all that is done, as is the case in practice. Key to education and training is understanding the importance of the time and experience required to build confidence in decision making and the management of risk. The Advanced Practitioner: A Framework for Practice facilitates individual and organisational development.
This is the ‘go to’ text for trainee advanced practitioners, with content written by experienced advanced practitioners and academics who are closely involved in the delivery of advanced practice programmes. A range of curricula have been assessed and wide consultation with key stakeholders has been undertaken to derive content for the chapters and format of the text.
Trainee advanced practitioners will undergo frequent assessment, using approaches such as consultation, observation tools, clinical portfolios and case‐based discussion. Examination and procedural skills undertaken as part of the advanced practitioner role are assessed in practice. The trainee advanced practitioner is required to demonstrate competence, and there are a number of directly observed procedures that need to be undertaken along with the ability to ‘see’ the whole person and fuse biomedical science with the art of caring, providing health promotion advice, counselling, assessment, diagnosis, referral, treatment and discharge.
The Advanced Practitioner: A Framework for Practice focuses on regulatory body requirements such as those of the Health and Care Professions Council and Nursing and Midwifery Council. The text has been aligned to nationally established advanced practitioner curricula, including the Faculty of Intensive Care Medicine (FICM), the Royal College of Emergency Medicine (RCEM) and the Royal College of Nursing (RCN).
Created for the busy practising clinician, the 21 chapters in this text have been written by a variety of experts in the field, across a range of specialties, and the information provided is accessible and engaging. Each chapter has been written using an approach that will enable the reader to delve deeper into essential subject matter, encourage curiosity and offer safe and effective care to people.
High‐quality colour illustrations, line drawings, tables, charts, graphs, and algorithms have been used in the comprehensive chapters to aid understanding as well as the retention of key facts. Pedagogical features are offered in such a way to support the trainee advanced practitioner to address the many curriculum requirements and to be successful when undertaking the various assessment challenges that they will face. These features aim to encourage the reader to delve deeper and challenge practice.
Containing numerous essential practical and theoretical components, The Advanced Practitioner: A Framework for Practice is the essential contemporary resource for all trainee advanced clinical practitioner as well as those healthcare students who are seeking to advance in this sphere of practice.
We sincerely hope you enjoy reading this text as much we have enjoyed editing it and providing you with a contemporary and useful resource as you make the transformation to advanced practitioner.
Ian Peate, London
Sadie Diamond‐Fox, Newcastle
Barry Hill, Newcastle
Acknowledgements
We are grateful to the contributors of the text for their input as they worked and are working through the ongoing COVID pandemic. Ian would like to thank his partner Jussi for his continued support. Barry would like to thank his family and friends for their continued support and give a special thanks to the chapter contributors and co‐editors Ian and Sadie. A big thank you to Wiley for this excellent opportunity. Sadie would like to thank her ‘tribe’. This book is dedicated to her family (in particular Andy & Oscar), her friends and her contributor colleagues, without whom this would not have been possible.
CHAPTER 1Advanced Clinical Practice
Sadie Diamond‐Fox and Vikki‐Jo Scott
Aim
The aim of this chapter is to provide the context in which this book is set and a background to the development of and current state of advanced practice in England. It sets out the framework within which advanced‐level practice operates and how this has been utilised to structure this book to guide the reader through the fundamental aspects expected of advanced practitioners.
LEARNING OUTCOMES
After reading this chapter the reader will:
understand the context in which advanced clinical practice operates
know the current policy reference points for advanced clinical practice
be aware of the themes that shape implementation of advanced clinical practice
comprehend the shared definition of advanced clinical practice.
INTRODUCTION
Advanced‐level practice began to emerge in the United States as far back as the 1960s (Dunn 1997). Examples of developing trained healthcare professionals to take on additional advanced tasks and skills or extended roles can now be found globally. Comparisons have been made between the UK trajectory and that in Europe and Australia, with recognition that different countries, and professions, specialties or particular healthcare services are at different stages of developing models of advanced practice (AP). The nomenclature surrounding this subject area is not universally applicable across the globe and can often be confusing, therefore a detailed glossary of the application in the context of UK practice is included at the end of this chapter and Table 1.1 details the universally accepted definition of advanced clinical practice (ACP) within the UK.
TABLE 1.1 Definition of advanced clinical practice as defined by Health Education England.
Advanced clinical practice:
is delivered by experienced, registered health and care practitioners
is characterised by a high degree of autonomy and complex decision making
is underpinned by a Master's level award or equivalent
encompasses the four pillars of clinical practice, leadership and management, education and research
demonstrates core capabilities and area‐specific clinical competence
embodies the ability to manage clinical care in partnership with individuals, families and carers
includes the analysis and synthesis of complex problems across a range of settings, enabling innovative solutions to enhance people's experience and improve outcomes.
Source: Adapted from HEE (2017).
This chapter will give the advanced practitioner the knowledge and understanding of the context of advanced clinical practice to provide a foundation which can be built upon in clinical practice in a supervised and independent manner.
Multi‐Professional Framework for Advanced Clinical Practice (MPFfACP)
This chapter relates to the following areas of the MPFfACP:
1.2, 1.2, 2.2, 2.10, 2.11, 3.1, 3.2, 3.8, 4.6
(HEE 2017)
Accreditation Considerations
This chapter is applicable to the following specialist curricula:
Acute Medicine (HEE
2022a
)
Critical Care (ACCP) (FICM
2015
)
Emergency Care – Adult & Child (RCEM
2022
)
Learning Disability and/or Autism (HEE
2020a
)
Mental Health (HEE
2022b
)
Older People (HEE
2022c
)
Primary Care (HEE
2020b
)
Surgical Care (HEE
2020c
)
This is an ever evolving field and work continues to agree various competence and capability frameworks for advanced clinical practice in other clinical specialties, therefore the readers is encouraged to refer to https://advanced‐practice.hee.nhs.uk/credentials
The Concept and History of Advanced‐Level Practice
Initial development of AP roles is typified by a need to reconfigure services to address unmet need. Increasing life expectancy, complexity and disease burden, the European Working Time Directive and a subsequent shortage of medical personnel have often been cited as drivers for the implementation of advanced practice roles (Boulanger 2008; Evans et al. 2020; Torrens et al. 2020). However, caution is advised when rationalising their introduction and development to that of the medical substitution paradigm. Advanced practice roles complement existing medical models and are not designed to replace them. Since their inception, there has been great diversity in ACP roles and also some controversy surrounding them. Nevertheless, a colossal effort from professional bodies such as the Council of Deans of Health (CoDoH), the Association of Advanced Practice Educators (AAPE UK) and the royal colleges as well as HEE has led to a huge investment in workforce development in this area of service delivery, in order to meet patient needs in the future. Development in this area has also included the introduction of a multiprofessional definition of advanced clinical practice, the first of its kind, to provide clarity for employers, service leads, education providers, health professionals and ACPs themselves (HEE 2017) (Table 1.1).
Frameworks and Toolkits for Advanced Clinical Practice
Advanced practice has been evolving across the four UK countries over decades. Health Education England, NHS England, NHS Improvement and NHS Employers (2022) have developed the Advanced Practice Toolkit. This resource is aimed at practitioners, educators, employers, commissioners, those planning the workforce across systems and patients/service users. NHS Scotland (2018) have also developed an online repository of the national resources that pertain to all four nations.
