THE NURSE PRACTISIONERS’ ROLE IN AREAS OF SPECIALISATION, CRITICAL
EXAMINATION OF THE HEALTH SERVICE AND APN PRACTICE, STRATEGIES TO
PROMOTE COLLABORATIVE AND MULTIDISCIPLINARY CLINICAL PRACTISE AND
PARTNERSHIPS
JOSEPHINE W MWANGI
SM 20/45767/20
COURSE UNIT: CONCEPTS OF ADVANCED NURSING PRACTICE
COURSE CODE: NUMS 824
ASSIGNMENT SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENT OF THE
AWARD OF MASTERS OF SCIENCE IN NURSING IN CHKA UNIVERSITY
DATE: 8/12/2020
DEFINATION
Nurse practitioners are advanced practice nurses who typically work in primary and
specialty care and have a broader more advanced scope of practice. They are involved in
assessing patients, determines how best to treat and improve patients health and working
with patients to integrate healthier strategies in to their lifestyles. Most nurse practitioners
specialize in a certain area of care such as pediatrics, neonatology, critical care, psychiatric
mental health, community health, adult health nursing, nurse anesthetist, nurse
educationist, leaders and researchers etc.
The nurse practitioners role in areas of specialization varies depending on what the
specific nurse has specialized on. There are several specialties across the world but
different countries have adopted specific specialties, in Kenya nurses specialize in neonatal,
pediatrics, medical surgical, oncology, critical care, anesthetist, etc, while in America they
have a wide range of specialization including family nurse practitioner, certified nurse
midwife, clinical nurse specialist etc. for one to become a specialized nurse practitioner in
America he/she Must be a registered nurse who is licensed by the regulatory body.
1. FAMILY NURSE PRACTITIONER
Family Nurse Practitioner Roles and Responsibilities
Because of their high level of education, expertise and skill, Family Nurse Practitioners
(FNP) will often take on some of the roles of a physician. However, they will still generally
work under the supervision of, or in close conjunction with, a physician. FNPs must be able
to offer the care and support consistent with high-quality nursing to patients and families,
diagnosing and treating patients across a wide variety of conditions. Here are some of the
core duties of family nurse practitioners:
Educate
FNPs are expected to educate their patients and the families of their patients. This can
cover a wide variety of subjects, including childbirth and care for newborns with expectant
mothers, methods for managing cholesterol or stress in aging patients, geriatric issues with
the elderly, and many other topics. Education is the front line in the battle against
preventable diseases.
Diagnose
A family nurse practitioner must be able to effectively diagnose patients across a wide
variety of age ranges, which places them in the role of the diagnostician. FNPs often have
access to the patient’s medical history, as well as the ability to order tests, and will combine
all of this information with physical symptoms to formulate an informed diagnosis.
Treatment
After diagnosing a patient, FNPs will then transition into the role of a provider of
treatment. These duties may vary on a state-to-state basis but mainly consists of ordering
or performing diagnostic tests, prescribing medications, and treating any and all injuries or
chronic illnesses that fall under primary care.
Collaborate
FNPs, while having a wide range of skills and training, do not work completely alone. It is
paramount to the successful career of a family nurse practitioners to collaborate with
fellow healthcare professionals to discuss best practices, tough decisions, and the results of
treatments.
With so many distinct and equally important roles to fill, the responsibilities of a Family
Nurse Practitioner are many. Highly educated and highly experienced Family Nurse
Practitioners are incredibly valuable healthcare professionals, especially now that the U.S.
healthcare system is evolving to serve a higher number of people in need at the same, or
even lower, cost.
2. NEONATAL NURSE PRACTITIONER
How to Become a Neonatal Nurse Practitioner
Neonatal Nurse Practitioner Eligibility Requirements
Prior education, certification and clinical practice are among the requirements for
acceptance into a nurse practitioner program. Here is a step-by-step guide to becoming a
neonatal nurse practitioner.
1. Become a registered nurse. In order to apply to a neonatal nurse practitioner program,
one must have a license as a registered nurse in a U.S. state or territory. Passing the
NCLEX-RN examination is required for certification as a registered nurse. Working as
an RN for two years before applying for an NNP certificate is required.
2. Successfully complete a NNP program that meets National Certification Corporation
(NCC) requirements. These programs must be master’s, postgraduate or doctoral
programs.
3. Apply for approval to take the neonatal nurse practitioner exam administered by the
NCC within eight years of completing an NNP program to earn your neonatal nurse
practitioner certification. Pass the NNP exam. The exam tests comprehension of
general assessment, general management, the disease process and professional issues.
Final transcripts and proof of education are required. Any applicants applying outside
of the required timeframe of application, must provide proof of obtaining a current
graduate degree that meets current requirements.
4. Apply for state certification as a neonatal nurse practitioner in the state in which you
wish to practice.
5. Be approved to take the exam/pass the exam.
6. Renew your certification every three years. In addition to renewing certification
through the board, renewal through the state is also required and additional
fulfillment of continuing education contact hours may be necessary.
Neonatal Nurse Practitioner Role
Neonatal nurse practitioners (NNPs) are experts in neonatal care and provide advanced
medical management and support to families during times of significant stress.
Practitioners work collaboratively with other health care providers in both acute and non-
acute settings as they assess, diagnose and manage the health of newborns and infants.
Family-centered and development care are also focuses of a neonatal nurse practitioner.
Neonatal Nurse Practitioner Scope of Practice
An NNP is an advanced practice registered nurse who specializes in the care and treatment
of preterm and full-term newborn infants through the first few years of their lives. The
NNP manages high-risk infants in an intensive neonatal hospital setting independently and
often in collaboration with a neonatologist or other specialist. NNPs also may work in
private practices outside of the acute care setting.
3. CLINICAL NURSE SPECIALIST
A clinical nurse specialist is one of the four major advanced practice roles for nurses.
Although requirements for becoming a clinical nurse specialist vary by state, they are
generally registered nurses who hold both a master’s degree in nursing and certification as
a clinical nurse specialist from an approved national certifying body, such as the American
Nurses Credentialing Center (ANCC) or the American Association of Critical-Care Nurses
(AACN).
Each national certifying body has its own requirements, which generally include a master’s
degree, a certain level of experience and a certification examination. Individuals should
check with their state boards of nursing to determine which certifications are accepted.
Clinical Nurse Specialist Role
Clinical nurse specialists are responsible for applying expert knowledge and experience to
a specific patient population, such as adult acute and critical care, in a clinical setting. In
contrast with nurse practitioners, clinical nurse specialists often function as educators and
consultants to the nursing staff and as experts on ensuring evidence-based practice and
quality patient outcomes. The AACN has designated the following as core competencies for
clinical nurse specialists: direct care, consultation, system leadership, collaboration,
coaching of staff, research, and interpretation of evidence.
Clinical Nurse Specialist Scope of Practice
Clinical nurse specialists work within a specialty area defined by various parameters. They
may work with a specific population such as adults or children, a specific setting such as
the emergency room, or a certain health specialty such as pain, cardiovascular, oncology
and gynecology. Their expertise within their specialty area allows them to be good
consultants and coaches to other staff members.
How to Become a Clinical Nurse Specialist
There are many steps to becoming a clinical nurse specialist. Prior education, certification
and clinical practice are among the requirements for being accepted into a relevant
graduate program, like an MSN programme. Here is a step-by-step path you can take to
become a clinical nurse specialist.
1. Become a registered nurse. In order to apply to a clinical nurse specialist program, you
must have completed a degree in registered nursing and be certified as a registered
nurse in a U.S. state or territory.
2. Apply to programs accredited by the Commission on Collegiate Nursing Education or
the Accreditation Commission for Education in Nursing. These programs must be
master’s, postgraduate or doctoral programs.
3. Apply to take the exam relevant to your specialty administered by the ANCC to earn
your CNS certification. The exam tests clinical knowledge and skills.
4. Apply for state CNS certification in the state where you wish to practice.
5. Once you have earned your clinical nurse specialist certification, it must be renewed
every five years. In addition to renewing certification through the board, renewal
through the state is also required and may require additional fulfillment of continuing
education contact hours
4. PEDIATRIC NURSE PRACTITIONER
Pediatric Nurse Practitioner Role
Pediatric nurse practitioner duties include a great deal of interaction with children and
their parents, working alongside pediatricians to provide primary care for infants, young
children and adolescents up to 21 years old. They analyze assessment data, lab work, and
diagnostic tests to come to a diagnosis for their patients. Pediatric nurse practitioners are
responsible for prescribing medication and require attention to detail since they deal with
age- and weight-appropriate doses for children. Pediatric nurse practitioners will also need
to assess the growth and development of their patients to determine if they are meeting the
milestones relative to their age groups. Educating patients and their families is another
important duty. There is a growing demand for pediatric nurse practitioners who can
provide cost-effective health care for children.
How to Become a Pediatric Primary Care Nurse Practitioner
Pediatric Primary Care Nurse Practitioner Eligibility Requirements
There are many steps to becoming a pediatric nurse practitioner. Prior education,
certification and clinical practice are among the requirements for being accepted into a
nurse practitioner program. Here is a step-by-step path you can take to become a pediatric
nurse practitioner.
1. Become a registered nurse. In order to apply to a pediatric nurse practitioner program,
one must have a license as a registered nurse in a U.S. state or territory. Passing the
NCLEX-RN examination is required for certification as a registered nurse.
2. Apply to a nurse practitioner program with a specialization in pediatric primary care
accredited by the Commission on Collegiate Nursing Education (CCNE) or the
Accreditation Commission for Education in Nursing (ACEN). They must be master’s,
postgraduate or doctoral programs.
3. Apply for state certification as a pediatric nurse practitioner in the state where you
wish to practice.
4. Apply to take the pediatric primary care nurse practitioner exam administered by the
PNCB to earn your certification. The exam tests comprehension of assessment and
diagnostic techniques, pharmacology, theory and more. Final transcripts and proof of
education are required.
5. Once you have earned your pediatric primary care nurse practitioner certification, it
must be renewed every year. In addition to renewing certification through the board,
renewal through the state is also required and may require additional fulfillment of
continuing education contact hours.
5.PSYCHIATRIC AND MENTAL HEALTH NURSE PRACTITIONER
Psychiatric and Mental Health Nurse Practitioner Role
According to the American Psychiatric Nurses Association (APNA), PMHNPs provide
assessment, diagnoses, and treatment to individuals or families with psychiatric disorders
while also identifying risk factors for such. PMHNPs are crucially aligned in contributing to
policy development, improvement in quality of care, practice evaluation, and healthcare
reform. However, a nurse does not need to be a nurse practitioner in order to be a
psychiatric-mental health nurse. PMHNPs may diagnose, prescribe medication, and
administer psychotherapy. PMH-RNs cannot.
Psychiatric and Mental Health Nurse Practitioner Scope of Practice
Psychiatric and mental health nurse practitioners work with mental health patients of all
ages, and may specialize in a specific age population. PMHNPs can practice in a variety of
locations including, but not limited to, in-patient psychiatric facilities, state psychiatric
facilities, correctional facilities, mental health centers, home health locations, and schools.
How to Become a Psychiatric-Mental Health Nurse Practitioner
Psychiatric-Mental Health Nurse Practitioner Eligibility Requirements
There are several steps that must be taken to become a PMHNP. Here is a step-by-step path
you can take to become a psychiatric-mental health nurse practitioner.
Become a registered nurse. In order to apply to a nurse practitioner program,
you must have earned a license as a registered nurse in a U.S. state or territory.
Passing the NCLEX-RN examination is required for certification as a registered
nurse.
Apply to PMHNP programs accredited by the Commission on Collegiate Nursing
Education (CCNE) or the Accreditation Commission for Education in Nursing
(ACEN). These programs must be master’s, postgraduate or doctoral programs.
The APNA offers a list PMHNP of programs by state.
Apply to take the psychiatric-mental health nurse practitioner
exam administered by the ANCC to earn your psychiatric-mental health nurse
practitioner certification.
Apply for state certification as a psychiatric-mental health nurse practitioner in
the state where you wish to practice.
Once you have earned your psychiatric-mental health nurse practitioner
certification, certification must be renewed every five years. In addition to
renewing certification through the board, renewal through the state is also
required and may require additional fulfillment of continuing education contact
hours.
6. ONCOLOGY NURSE PRACTITIONER
An oncology nurse practitioner or oncology NP works closely with physicians,
surgeons, and families to assist cancer patients with treatment. Not only do they
play a key role in patient assessment, education, and coordination of care, but they
also provide support to both patients and caregivers during treatment and beyond.
With more and more cancer research becoming available, the role of an oncology
nurse practitioner will evolve, but at its core, the occupation will remain patient-
centered. The path to becoming an oncology nurse practitioner requires many steps,
but once achieved, you may actively seek out positions in this important area of
clinical practice.
Common Steps to Become an Oncology Nurse Practitioner
There are a number of common steps in order to obtain certification as an oncology
nurse practitioner. Above all, the criteria include a number of educational and
clinical practice requirements that are to be completed before becoming certified
oncology nurse practitioner.
Become a registered nurse.
To become certified as an oncology nurse practitioner, you must first become a
registered nurse (RN). Your RN license must be active during the time you decide to
pursue your oncology nurse practitioner career. To obtain your RN license, you have
to complete and pass the NCLEX-RN exam, which is administered by the National
Council of State Boards of Nursing.
Apply to an oncology nurse practitioner program.
You must pursue an advanced degree for a nurse practitioner, such as a master of
science in nursing (MSN). There are some programs that offer oncology as a
concentration. To ensure that the program is providing you with the highest level of
standards and ethics in the field, verify that your program is accredited by
the Commission of Collegiate Nursing Education (CCNE) or the Accreditation
Commission for Education in Nursing (ACEN).
Apply to take the oncology nursing exam.
Once you’ve completed the necessary educational and clinical experience steps to
become an oncology nurse practitioner, you can pursue the oncology nurse exam
administered by the Oncology Nursing Certification Corporation (ONCC).
7. CERTIFIED REGISTERED NURSE ANESTHETIST
Certified registered nurse anesthetist (CRNA) is one of the major advanced practice
areas for nurses. Although requirements for becoming a CRNA vary by state, they
must graduate from a nurse anesthesia educational program accredited by
the Council on Accreditation (COA) and pass the certification examination
administered by the National Board of Certification and Recertification for Nurse
Anesthetists .
COA accredited nurse anesthesia educational programs require a bachelor’s degree,
a registered nursing (RN) license and a minimum of one year experience as a nurse
in a critical care setting, according to the American Association of Nurse
Anesthetists (AANA)’s CRNA Fact Sheet. Upon completion of the program, aspiring
CRNAs must pass the national certifying exam in order to practice as nurse
anesthetists.
Certified registered nurse anesthetists administer care in a variety of settings from
medical centers to community hospitals, pain clinics, dentist offices or physicians’
offices, just to name a few. Their practice includes, but is not limited to, general and
local anesthesia, sedation, epidural, spinal or peripheral nerve blocks.
Common roles of the nurse anesthetist may include caring for patients before and
after surgery, providing pain control during childbirth, overseeing conscious
sedation, teaching students and conducting research. Nurse anesthetists must
possess advanced assessment skills and be able to work directly with other
members of the patient care team to provide the best possible outcomes.
8. CERTIFIED NURSE MIDWIFE
A CNM is an advanced practice registered nurse who goes through comprehensive training,
mainly providing care to pregnant women from labor to delivery to postpartum care.
Before you get to this point, becoming a certified nurse-midwife involves several steps,
including becoming a registered nurse, applying for an accredited nurse-midwifery
program, and, after the program, taking the The American Midwifery Certification Board
(AMCB) Nurse-Midwifery/Midwifery examination to earn certification. After earning
certification, you must apply for state licensure to practice as a CNM in your state.
What’s the difference between a CNM and a CM?
It is important to note that a certified nurse-midwife is different than a certified midwife. A
CNM is a registered nurse who graduates from a nurse-midwifery program, while a
certified midwife is not a registered nurse. Instead, CMs have a healthcare-related degree
or educational background and they graduate from a midwifery program. Both CNMs and
CMs take the same certification exam to practice but their professional designations are
different.
How to Become a Certified Nurse-Midwife
1. Be a Registered Nurse (RN)
2. Apply to a Nurse-Midwifery Program
3. Take and pass the Certified Nurse-Midwifery Exam
4. Apply for State Licensure
Your first step toward becoming a CNM is to become a registered nurse, which is a
requirement that must be met in order to apply to a nurse-midwifery program. To become
an RN, you must complete an accredited nursing program and pass the NCLEX-RN
examination to earn certification to practice as an RN in your state.
Certified Nurse Midwife Roles and Responsibilities
Certified nurse-midwife roles and responsibilities involve aspects of women’s health and
gynecologic healthcare. Nurse-midwife duties involve aiding women throughout their
pregnancy, including prenatal and postpartum treatment. Nurse-midwives care for a
woman giving birth by providing her with woman-centered support that emphasizes the
normalcy of birth. This extends to the postpartum period as well. They can care for
newborns at birth and in those first few months of life.
While mostly associated with care around pregnancy, CNM roles include more general
healthcare for women as well. This means that certified nurse-midwives can assess and
manage contraceptive and birth control methods, offer general gynecological care, and
preventive care. They prescribe medications, medical devices, and treatments. Think of a
certified nurse-midwife as a healthcare guide for female patients from adolescence through
menopause.
You can find certified nurse-midwives working nationwide — from major hospitals to
private practices and health and maternity homes. Certified nurse-midwives also attend
and assist with home births.
The different between a certified nurse midwife and an obstetric gynaecologist is that;
although a CNM may hold a doctoral degree in nursing, a midwife is not a medical doctor. A
CNM is an advanced practice registered nurse who completes graduate-level training
through programs accredited by the regulating bodies in different countries.
In contrast, a physician practicing within the specialties of obstetrics, gynecology, or
both (OB-GYN) has met the requirements to practice medicine in these specialties—which
includes undergraduate education, a degree from a medical school, medical licensure, and 3
to 7 years in internship and residency programs.
However, both CNMs and OB-GYN physicians provide comprehensive medical care
throughout a woman’s lifespan—including pregnancy and childbirth. They diagnose, treat,
and help prevent diseases women may experience, especially those affecting the
reproductive system.
In Kenya conditions of becoming a nurse practitioner are more or less like in the USA
whereby for a nurse to specialize to a certain discipline one must first be a registered nurse
licensed by the nursing council of Kenya, however the number of years one may have
worked is not a specific condition unlike in the USA whereby one must have some
experience. Roles and responsibilities of nurse specialists are the same in different
countries.
CRITICAL EXAMINATION OF HEALTH SERVICE AND APN PRACTICE
Health care is the maintenance or improvement of health via the prevention, diagnosis,
treatment, recovery, or cure of disease, illness, injury, and other physical and mental
impairments in people. It is delivered by health professionals and allied health fields.
There are several determinants for health service which include availability of resources to
meet daily needs, access to health care, affordability, among many others.
A well functioning health system working in harmony is built on having trained and
motivated health workers, a well maintained infrastructure and a reliable supply of
medicines and technologies backed by adequate funding, strong health plans and evidence
based policies, this is as per WHO guidelines, national health policies, strategies and plans.
WHO is in support of countries implementing people centered and integrated health
services by way of developing policy options, reform strategies, evidence based guidelines
and best practices that can be tailored to various county settings.
APN practice is increasingly being offered to specific areas e.g. in critical care department
where by the service is being offered to offset physician shortages but no data exist about
outcomes of critically ill patients continuously cared for by advanced critical nurse
practitioners (JS Landsperger 2016)
APN- These are registered nurses who holds masters or doctorate degree in nursing. They
are engaged in critical thinking skills which are very important in the nursing field because
they are what the nurse uses to priotise and make key decisions that can save lives. Nurses
give critical care throughout patients’ life so the critical care skills of the nurse can make a
difference between someone living or dying. APN serve many functions in a clinical setup
which include; Maintaining patients records and ensuring patient privacy and hospital
compliance. Evaluating patients progress and responses to various treatment to modify
treatment and care plans as necessary. Provision of counselling to patients and families.
Critical thinking is applied by APN in the process of solving problems of patients and daily
monitoring process with creativity to enhance the effect, it is an essential process for a safe,
efficient and skillful nursing intervention.
Administrators who consider employing APNs in their health care organizations must deal
with internal issues, such as how to define the value an APN will bring or how to identify
what groups APNs might threaten within the organization. For organizations that support
APN roles, the fiscal well-being of the organization and politics among the various
clinicians can shape how APNs are included in the model of care. Numerous external
factors also influence how advanced practice nursing is embraced and how care is
delivered in all health care settings, whether community- or institution-based. Lack of
consensus about the definition of roles, need for second licensure, reimbursement,
prescriptive privilege, and scope of authority are some of the external national
environmental issues that compound the internal issues about how organizations use
APNs.
Administrators, partnering with clinicians, could lead the transformation of health care by
building strong alliances among the health care professions to meet society's needs for
accessible and affordable health care. However, Christensen, Bohmer, and Kenagy (2000)
maintained that health care is the most entrenched, change-averse sector in the United
States. They introduced the concept of disruptive innovations in health care—less
expensive, simpler, and more convenient services that initially threaten the status quo but
ultimately raise the quality of health care—and suggested that NPs are a disruptive
innovation. As they noted, studies have shown that primary care NPs reliably diagnose and
treat illnesses and spend more time counseling about prevention and wellness. However,
numerous barriers, including resistance from health care organizations and restrictive
state regulations, prevent NPs from working to their full potential
STRATEGIES TO PROMOTE COLLABORATIVE AND MULTIDISCIPLINARY CLINICAL
PRACTICE AND PARTINERSHIP
Collaborative practice is an approach that enables health care providers to deliver high
quality, safe person-centered services to achieve the best possible individual health
outcomes. In a health care system that uses collaborative practice; health care providers
will develop competencies for collaborative practice and will demonstrate the principles of
collaboration through their actions. It occurs when healthcare providers work with people
from within their own profession, with people outside of their profession and with
patients/clients and their families. Collaborative practice requires a climate of trust and
value, where healthcare providers can comfortably turn to each other to ask questions
without worrying that they will be seen as unknowledgeable. When healthcare providers
are working collaboratively, they seek common goals and can analyze and address any
problems that arise.
Strategies to promote collaborative and multidisciplinary practice include: Using
appropriate language when speaking to other healthcare providers or patients/family
Understanding that all healthcare providers contribute to the team or collaborative unit
Showing respect and building trust among team members Introducing new members of the
team in a way that is welcoming and gives them the information they need in order to be a
contributing member Turning to colleagues for answers Supporting each other when
mistakes are Collaborative practice is built on a set of competencies that create a standard
of behavior required by all health providers. The competencies outlined in the
Interprofessional Competency Framework released by the Canadian Interprofessional
health Collaborative have been described as follows: Role Clarification- providers
understand their won role and the roles of those in other professions, and use this
knowledge appropriately to establish and achieve patient/client/family and community
goals, Individual/Client/Family and Community-Centred Care- providers seek out,
integrate and value, as a partner, the input and the engagement of the
patient/client/family./community in designing and implementing care/services, Team
Functioning- providers understand the principles of team work dynamics and group/team
processes to enable effective interprofessional collaboration, Collaborative Leadership-
providers understand and can apply leadership principles that support a collaborative
practice model, Interprofessional Communication- providers from different professions
communicate with each other in a collaborative, responsible and responsible manner,
Interprofessional conflict resolution- providers actively engage self and others, including
the individual/client/family, in positively and constructively addressing disagreements as
they arisemade, and celebrating together when success is achieved.
In Kenyan situation health professionals have been debating the merits of collaborative
practice over the past decade, a period during which National Health Sector reforms have
been implemented (DoH 1990, 1992, 1993, 1999) addressing the issue. An area of
particular interest has been the varying levels of team working that currently exist, from
interdisciplinary to multi-agency collaboration. Similar debate has accompanied health-
related legislative reform, which has involved integrating health promotion practices into
clinical practice (DoH 1995). This has helped to establish a close relationship between
health promotion and collaborative practice (Delaney 1994). Health professionals have
come to recognize the potential benefits of collaboration in terms of planning and
delivering services (Delaney 1994, Rawson 1994), as well as influencing current and future
practice. Docherty (2000), for example, states that the overall standard of nursing can be
greatly improved through collaborative working.
Benefits of multidisciplinary clinical practice and partnerships include; for Patients -
improves care by increasing the coordination of services, integrates health care for a wide
range of health needs , empowers consumers as active partners in care, results in better
patient outcomes. For Providers - increases professional satisfaction due to clearer, more
consistent goals of care and improved communication with other providers, enables the
provider to learn new skills and approaches to care and work to full scope, provides an
environment for innovation, allows providers to focus on individual areas of expertise. For
Students- placements with interprofessional opportunities attract a higher number of
students, tend to return to such placement sites after graduation. for Health system -
increases the potential for a more efficient and cost-effective delivery of care, maximizes
resources and facilities , decreases burden on acute care facilities. Collaborating does not
mean that the providers are always joined at the hip. It means that providers/leaders can
make better referrals and start to think about the composition of their team, developing
common goals (care plans), and/or negotiating task distribution.
MULTIDISCIPLINARY CLINICAL TEAM
The core function of a multidisciplinary clinical team (MDCT) is to bring together a group of
healthcare professionals from different fields in order to determine patients' treatment
plan.
This is a group of health care workers who are members of different disciplines
(professions e.g. Psychiatrists, Social Workers, etc.), each providing specific services to the
patient. The team members independently treat various issues a patient may have, focusing
on the issues in which they specialize.
The activities of the team are brought together using a care plan. This co-ordinates their
services and gets the team working together towards a specific set of goals. Sometimes the
person has a key worker, who becomes the main point of contact for the person. The key
worker will likely be the nurse specialist in a specific field eg oncology nurse taking care of
cancer patients.
Effective MDCT-driven care depends on a multitude of inputs (individuals, teams,
environment, and patients) and processes (interactions, tests, results). It subsequently
results in a range of outputs (patient experience, outcomes, organizational outcomes),
which taken together are aspired to achieve high-quality, efficient care for patients.
Successes of MDCT working;
Becoming an essential member of the practice team and changing the thinking of MDCT
away from the traditional model of care; Each member of the team can do what they do
best, Patients can see the most appropriate health professional for their problems, Greater
knowledge and respect for other professional roles, Right skills, right time, first time –
essential for emergencies in primary care, Being able to use professional skills and
knowledge to improve patient safety.
FOR MDCT TO BE EFFECTIVE;
Frequency, timings and methods of how the team will communicate need to be agreed, so
the team can function and make decisions effectively. The scope of practice and knowing
when patients will be referred to a member of the team needs defining. Knowing which
member of the team the specific skill set has needed is essential if the team is to function
effectively. Negotiation on the scope of the role, workload, and expectations for working
together and expected outcomes must be clearly agreed. It is important to define the need
for co-location, how and when teams will communicate, and the provision of peer support
(in the context of an increasing use of technology). Interpersonal trust between
multidisciplinary clinical team members must be established and maintained. This also
requires tangible action and defined boundaries, such as access to patient records and the
ability to share risks and concerns openly. For the general practice MDCT to be a success,
awareness rising will be required to promote the team and explain this way of working to
the public. Patient stories and proven outcomes will help change patient behavior. Above
all, the role of the MDCT must be made easy to understand for patients and team members
alike. Quick access for patients to the right member of the team will help reinforce the
benefits of the MDCT.
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www.herzing.edu>types>nurse-practitioner
nursejournal.org
www.jmirs.org
www.researchgate.net
ojin.nursingworld.org
www.advisory.com
