GOVERNANCE, NURSING AND THE FUTURE

Governance, Nursing and the Future

Governance, Nursing and the Future

Developing governance criteria

A key developmental feature of the governance framework for advanced practitioners was the need to agree criteria that all clinicians, managers and assessors would have to subscribe to. The advanced practice steering group initially developed these criteria; these refined after the Welsh guidance was published (Phoenix & Lloyd 2001, 10-14).

Within the health board, any practitioner working at an advanced level:

Must have evidence of master's level study appropriate to their role and job description;

Must keep a portfolio of evidence structured in accordance with agreed health board templates. The templates include evidence of problem solving, critical thinking, reflection, clinical updating, leadership, research and relevant metrics;

May be expected to make their portfolio available for independent review;

Must identify competencies appropriate to their role and job description, and they (the practitioner and their competencies) must be assessed using appropriate tools. Evidence of this should be in the portfolio. Assessors could include peers, expert clinicians (multi professional), line managers, expert patients and academic specialists;

Must have an annual performance review conducted by appropriate others - for example (potentially) by peers, expert clinicians (multi professional), line managers, expert patients and academic specialists.

Developing the portfolio

We needed to develop a portfolio template that was prescriptive enough to bring some conformity while being flexible enough to cater for the diversity of advanced practice roles. That diversity cannot be over emphasised, with representation to the working groups from advanced nurse endoscopists to advanced practitioners working in rehabilitation and community settings.The advanced practice group drew up guidelines that would form the basis of the portfolio content. These guidelines aimed to help practitioners develop a portfolio of evidence to demonstrate advanced practice as outlined in the Welsh guidance (Madge & Connor 2005, 10-15 ). The portfolio was intended to be used as evidence in annual appraisals.

Assessment of competence Practitioners would be required to identify a work-based assessor(s) who would assess them against specified competencies, skills and knowledge. This should be reviewed every year and any learning needs incorporated into personal development plans (PDP). The university would support this through developmental program of study for both practitioners and assessors. Assessment of portfolio. As part of the governance framework, the health board would develop and maintain a database of advanced practitioners using the electronic staff record system. Internal assessors prepared by the university would assess practitioners' portfolios and decide whether there was ...