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Karen Park

Karen Park. Lead Nurse Practitioner Rehabilitation and Intermediate Care Services. Aim. Explore the role of the Nurse Practitioner within the inpatient wards. Objectives Provide Nurse Practitioner input daily to one of the inpatient wards.

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Karen Park

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  1. Karen Park Lead Nurse Practitioner Rehabilitation and Intermediate Care Services

  2. Aim • Explore the role of the Nurse Practitioner within the inpatient wards. Objectives • Provide Nurse Practitioner input daily to one of the inpatient wards. • Identify activity levels, type of input and interventions, and the number of times the NP needed to request medical help and reasons why. • Find out how staff viewed the role within the inpatient service.

  3. Methods • Pilot for a three month period. • Attend Wallington Ward daily instead of the SHO. The SHO was available for medical assistance as they were still based within the hospital. The specialist registrar and consultant remained the next level of cover. • Collect data throughout the pilot on activity, input and interventions. • Send out questionnaires to all members of the multidisciplinary team who had contact with the NP, to ascertain their views regarding the role.

  4. Data Analysis - Activity • The NP ‘clerked’ in 80% of the admissions to the ward (other admissions were clerked in on the medical round or by the junior doctor who covered whilst NP on holiday). • The NP discharge scripts and letters for 85% of discharges. • 2 patients were transferred to other wards in the 3 months of the pilot period. • There were 5 deaths. It was significant that they were managed using the Integrated Pathway for the Dying Patient.

  5. Type of input and interventions by the Nurse Practitioner • Clerking patients • Venepuncture • Discharge letters and scripts • Scripts for overnight home visits and training for patients and carers on the ward • End of Life Care • Transcribing • Prescribing

  6. Type of input and interventions by the Nurse Practitioner • Triage • Investigations and referrals • Cannulation • Minor illnesses • Interpretation of results • Ward medical rounds • Ward multidisciplinary team meetings

  7. Staff QuestionnaireThemes • Support and advice giving, listening came through in all the questionnaires. • Staff would like to see 24hr cover and an NP on each ward. • NP role was responsive to patient need, early response when a patient became unwell. • Staff would like the NP to become involved in in house training. • There was some fear of de skilling nursing staff.

  8. Staff QuestionnaireThemes • Involvement with relatives was looked on positively. • Day to day management of patients helped prevent on call doctor having to come out. • There was positive recognition of the nursing element of the role. • The NP worked as part of the ward team. • End of Life Care – support to patients, relatives and staff on the ward was recognised

  9. THE FUTURE

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