Advanced Practice in Healthcare (4^th Ed.) Dynamic Developments in Nursing and Allied Health Professions Advanced Healthcare Practice Series

The definitive resource for advanced practice within nursing and the allied health professions?revised, expanded, and updated throughout.

Advanced practice is an established and continuously evolving part of healthcare workforces around the world as a level of practice beyond initial registration. Advanced practitioners are equipped to improve health, prevent disease, and provide treatment and care for patients in a diverse range of settings.

This comprehensively revised fourth edition emphasises the importance of practice in advanced healthcare, presenting a critical examination of advanced practice roles in nursing and allied health professions through a series of learning features designed to facilitate the development of vital knowledge and skills.

Advanced Practice in Healthcare presents:

• International developments in advanced practice as a global response to the need to modernise services, reduce costs and increase access to healthcare services
• Country-specific examples of advanced practitioners? roles in delivering patient care in diverse settings
• The impact of advanced practice in nursing and the allied health professions
• Controversial issues including prescribing, regulation and credentialing, and the interface with medical practice
• Ethical and legal dimensions of advanced practice
• The preparation of advanced practitioners

Advanced Practice in Healthcare is an essential resource for all students, practitioners, managers and researchers of advanced practice in healthcare.

Note on Contributors xi

Introduction xv

Part 1 Advanced Practice as a Global Phenomenon

1 The Conceptualization of Advanced Practice 3
Paula McGee and Chris Inman

1.1 Introduction 3

1.2 Competence 5

1.3 Variations in Advanced Practice 12

1.4 Conclusion 15

References 16

2 An International Perspective of Advanced Nursing Practice 19
Madrean Schober

2.1 Introduction: Overview of Advanced Nursing Practice 20

2.2 Advanced Nursing Practice Defined: An International Position 20

2.3 Drivers and Motivation 23

2.4 Influence of International Organizations 24

2.5 Regional and Country Profiles of Advanced Nursing Practice 26

2.6 Country‐specific Initiatives 28

2.7 International Collaboration for a New Initiative 30

2.8 Controversial Issues 31

2.9 Challenges 33

2.10 Conclusion 36

References 37

3 Development of Advanced Practice Nursing Roles in the Netherlands 39
Christine de Vries de Winter

3.1 Introduction 39

3.2 The Dutch Healthcare System 40

3.3 Development of Advanced Nursing Practice in the Netherlands 41

3.4 Regulation of Advanced Practice 42

3.5 Preparation of Advanced Nurse Practitioners 42

3.6 Issues in Advanced Practice in the Netherlands 45

3.7 Education 46

3.8 The Future of Advanced Nursing Practice: Innovation in Healthcare and Education 46

3.9 Conclusion 48

References 49

4 Advanced Practice in Nursing and Midwifery: The Contribution to Healthcare in Australia 51
Grainne Lowe and Virginia Plummer

4.1 Introduction 51

4.2 Advanced Practice in Australia 52

4.3 Current Issues in Advanced Practice in Australia 57

4.4 Advanced Practice in Midwifery 60

4.5 Conclusion 61

References 62

5 Influences on the Development of Advanced Nursing Practice in the UK 65
Paula McGee

5.1 Introduction 65

5.2 The National Health Service in the UK 66

5.3 Health Policy 67

5.4 Influence of Health Policies and Reform of the National Health Service 67

5.5 Influence of Nursing Strategies 71

5.6 Influence of Nursing Organizations 73

5.7 Conclusion 79

References 80

Part 2 Advanced Practice in Allied Health Professions

6 The Development of Advanced Practice in the Allied Health Professions in the UK 85
Paula McGee

6.1 Introduction 85

6.2 Background to the Development of Advanced Practice in Allied Health Professions 87

6.3 Advanced Practice in Allied Health Professions 90

6.4 Advanced Practice in Physiotherapy 90

6.5 Advanced Practice Paramedics 91

6.6 Current Issues in Advanced Practice in Allied Health Professions 92

6.7 Conclusion 98

References 99

7 Advanced Practice in the Radiography Professions 101
Nick White and Helen White

7.1 Introduction 101

7.2 Worldwide Variation in the Adoption of Advanced Practice in Radiography 102

7.3 Four‐tier Service and Advanced Practice in Radiography 102

7.4 Educational Preparation for Advanced Practice Roles in Radiography 104

7.5 Defining Advanced Practice – Do Role Specialism and Role Extension in Radiography Truly Lead to “Advanced Practice”? 105

7.6 Taking Stock: The Deployment of Advanced Practitioners within the Diagnostic Imaging, Radiotherapy, and Ultrasound Communities of Practice 107

7.7 Future Developments and Opportunities 110

7.8 Conclusion 112

References 113

8 Advanced Practice in Speech and Language Therapy 115
Susan Beaumont

8.1 Introduction 115

8.2 The Role of the Advanced Practitioner Speech and Language Therapist 120

8.3 Current Challenges in Advanced Speech and Language Therapy 123

8.4 Conclusion 124

References 125

Part 3 The Advanced Practitioner in Direct Patient Care

9 Prescribing and Advanced Practice 131
Andrew Campbell

9.1 Introduction 131

9.2 The History of Non‐medical Prescribing in the UK 132

9.3 Registered Non‐medical Prescribers in England 133

9.4 Preparing for Prescribing 133

9.5 Who May Prescribe What? 135

9.6 The Principles of Effective Prescribing 138

9.7 Safety and Clinical Governance 141

9.8 The Future of Non‐medical Prescribing 142

9.9 Conclusion 144

References 145

10 The Advanced Clinical Nurse Practitioner and Direct Care 147
Mary Hutchinson

10.1 Introduction 147

10.2 Holistic Health Assessment 154

10.3 Conclusion 155

References 156

11 The Advanced Critical Care Practitioner 159
Paula McGee and Jonathan Downham

11.1 Introduction 159

11.2 The Advanced Critical Care Practitioner Role 160

11.3 Scope of Practice 161

11.4 Competences for the Advanced Critical Care Practitioner Role 164

11.5 Processes in the Development of the Advanced Critical Care Practitioner Role 165

11.6 Current Issues in Advanced Critical Practice 169

11.7 Conclusion 170

References 171

12 The Interface between Advanced Nursing and Medical Practice 173
Lesley Kavi and Paula McGee

12.1 Introduction 173

12.2 General Practice in the UK 174

12.3 Current Issues in General Practice 175

12.4 Advanced Nursing Practice 176

12.5 The Advantages and Disadvantages of Advanced Nursing Practice in General Practice 181

12.6 Conclusion 184

References 185

Part 4 Developing Advanced Practitioners’ Skills

13 Legal and Ethical Issues Related to Professional Practice 189
Nicola J Stock

13.1 Introduction 190

13.2 Ethical Theories 190

13.3 The Mental Capacity Act 194

13.4 Deprivation of Liberty Safeguards 195

13.5 Consent, Autonomy, and Advocacy 196

13.6 Negligence 197

13.7 Handling Complaints 199

13.8 Whistleblowing 200

13.9 Duty of Candor 201

13.10 Improving Care Quality 202

13.11 Conclusion 202

References 204

14 Advanced Practice in a Diverse Society 205
Paula McGee

14.1 Introduction 205

14.2 Human Rights 206

14.3 Tackling Discrimination 209

14.4 Advanced Practice Competences 213

14.5 A Way Forward – Having That Difficult Conversation 217

14.6 Conclusion 218

References 220

15 Educational and Professional Influences on Advanced and Consultant Practitioners 223
Chris Inman

15.1 Introduction 223

15.2 The Education of Advanced Practitioners in the UK 224

15.3 Collaboration with the Netherlands 225

15.4 Consultant Practitioners 227

15.5 Consultant Roles and Research 228

15.6 The Interface between Medicine and Advanced and Consultant Practitioners 229

15.7 The Advanced Practitioner’s Role – Enhancing the Impact on Care 230

15.8 Conclusion 231

References 232

16 Assessment of Advanced Practice 235
Chris Inman

16.1 Introduction 235

16.2 Stages and Subject Areas of Advanced Practice Master’s Courses in the UK 237

16.3 Advanced Health Assessments and OSCEs in Universities in the UK 239

16.4 OSCEs – Recent Published Research 241

16.5 Practice Assessments and Requirements for a Portfolio of Evidence 244

16.6 The Second and Third Stages of Assessment for a Master’s Degree 246

16.7 End‐point Assessment – Master’s‐degree Apprenticeship 246

16.8 Conclusion 247

References 248

17 Leadership in Advanced Practice 251
Paula McGee

17.1 Introduction 251

17.2 The Nature of Leadership 252

17.3 Attributes of the Leader 253

17.4 Leadership and Management 255

17.5 Leadership in Advanced Practice 255

17.6 Conclusion 262

References 263

18 Research Competence in Advanced Practice 265
Paula McGee

18.1 Introduction 265

18.2 Research Competence in Advanced Practice 266

18.3 Direct Patient Care 270

18.4 Publication of Research Results 273

18.5 An Agenda for Research 277

18.6 Conclusion 278

References 279

19 Conclusion: The Future for Advanced Practice 281
Paula McGee and Chris Inman

19.1 Introduction 281

19.2 Full Practice Authority 283

19.3 The Relationship with Medicine 284

19.4 The Preparation of Advanced Practitioners 285

References 286

Index 287

Paula McGee is Professor Emerita of Nursing, Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK.

Chris Inman is Senior Lecturer and former long-standing Programme Director, Masters in Advanced Practice, Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK and a committee member of the Association of the Advanced Practice Educators, UK.