NURSE PRESCRIBER

Advancing Leadership for Quality

[Name of the Institutio

Introduction3

Background of a Problem5

Aim8

Objectives8

Benefits of Nurse Prescribers9

Role of Nurse Prescribers11

The Change Process12

Managing Change13

RAPSIES Seven Steps Model14

SWOT Analysis of Introducing Nurse Prescribers (Appendix2)16

GANTT CHART18

Strategies- Leadership Style19

Action Learning27

Barriers and Constrains28

Impact to This Organisation29

Financial Implications29

Conclusion29

References31

Appendix 143

Appendix 346

Force Field Analysis-Lewin(1951)46

Appendix 447

Appendix 548

Gantt Chart48

Appendix 6.49

Advancing Leadership for Quality

Introduction

Since 1948, the National Health Service (NHS) has grown into the largest health care provider in the UK. As proposed in the Darzi report (DOH 2009), in order to improve the patient experience, quality and staff satisfaction; changes were necessary throughout the healthcare system. Sound clinical governance serves to continually improve the quality of health care provision. Department of Health, 2011), which creates the foundation for change. Clinical effectiveness is one of the three pillars of clinical governance (Harding, 2011). The necessity to develop advanced practice in nursing is highlighted by Department of Health policy (DOH, 2006) and has been subject to regulatory consideration by the Nursing and Midwifery Council (NMC, 2005).

The NMC (2005-p8) defines an advanced nursing practitioner (ANP) as: 'A registered nurse who has command of an expert knowledge base and clinical competence, is able to make complex clinical decisions using expert clinical judgement, is an essential member of an interdependent health care team and whose role is determined by the context in which she practises.' Since then more comprehensive definitions have emerged, including ICN (2008), Skills for Health Equating Advanced Practice in Agenda for Change (Skills for Health, 2011) etc.

Internationally an ANP is defined as 'A registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice. A Master's degree is recommended for entry level' (ICN, 2008). These two definitions agree each other except on the ICN's suggestion that the characteristics are shaped by the context and/or country in which s/he is licensed to practice. It is hard to define the constantly changing and developing conventional nursing practice, and then it is harder still to distinguish the characteristics of ANP. There is a common agreement that the notion of advanced practice should be defined broadly as a set of attributes which describe expert practice in a professional field (DOH, 2011, Brook and Rushforth 2011). Similarly, Lowe et al. (2012) points out that a clearly articulated definition of the advanced roles is essential.

In the past decade the need to comply with Modernising Nursing Careers (DOH, 2006) and Working Time Directive (DOH, 2009) has brought challenges to healthcare services to look at the ways nursing could continue to develop to provide the best health care along with the reduction in junior doctors' working hours. This resulted in the need for more staff to cover different patient services. Consequently the need for more ANPs has been identified and more roles developed (Gilfedder, et al., 2010). The term 'advanced' has recently been added to the previous title of nurse practitioner to demonstrate the advancement in role (DOH, ...