DEVELOPMENT OF ADVANCED PRACTICE

Local, National and International Drivers and their impact On Development of Advanced Practice

Local, National and International Drivers and their impact On Development of Advanced Practice

Introduction

Advanced practice roles in ophthalmic settings have enabled the delivery of the policy agenda with high quality outcomes. It was found that while roles are diverse and continue to respond to service need, ophthalmologists, rather than nurses, control many of the parameters of the role and undertake much of the training and assessment.

Discussion

The role of 'Paramedic Practitioner' has developed against a background of change in primary care service provision, apparently resulting in an increase in demand for emergency ambulance services. This presents opportunities to extend the scope of practice of paramedics and other health professionals in the diagnosis and management of patients with minor illnesses and injuries. Paramedic practitioners can reduce the number of patients inappropriately transported to hospital by approximately half, thus meeting an NHS aim of 'treating the right patients in the right place at the right time'. Other opportunities exist in the form of extended roles in critical care and the management of the chronically ill in the community. Currently, a number of pilot programmes are in place, but these vary considerably with respect to the type and duration of training, the permitted scope of practice, and even the job title of the new practitioners. To be successful these major changes in the role of ambulance professionals will require the paramedic profession to take leadership through its own professional body (the British Paramedic Association) in the establishment of defined standards of practice. A shift from vocational training to university-based education will be necessary to meet the intellectual demands of the autonomous management of these patient populations. Uniformity of job title and legal restrictions on its use are also required. Paramedics are currently at best seen as a 'semi-profession' and a great deal of discussion about whether the discipline actually wants to achieve full professional status exists. Comparisons will be made with the professions of nursing and physiotherapy, outlining how and why they progressed from a semi-professional status to a fully recognized profession, culminating in a discussion about which characteristics the paramedics discipline as yet lacks. Meeting the expectation of delivering safe, effective, and timely health care services within current financial and workforce envelopes requires all health care clinicians to refine and adapt to their clinical roles. The arena of critical care is currently receiving increasing scrutiny regarding developing dedicated advanced practice roles. This is challenging to critical care nurses who historically neither have been exposed to nor have chosen to engage in such specific role developments.

The Advanced Care Paramedic Distributed Learning program prepares Primary Care Paramedic learners with an advanced scope of practice to meet the needs of the health care system throughout Canada. The distributed learning model will offer the working Primary Care trained Paramedic the option of completing most of their ACP studies in a distance delivery format. The health care system is in constant change to ...