Frances Kam Yuet Wong1, Ada Tak Yin Lau2, Rebecca Ng3, Elaine Wing Yee Wong4, So Man Wong5, Eva Ching Yee Kan6, Eva Liu7, Denise Bryant-Lukosius8. 1. Professor, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China. 2. Advanced Practice Nurse, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China. 3. Honorary Advisor (Central Nursing Division), Queen Elizabeth Hospital, Hong Kong, China. 4. Advanced Practice Nurse, Queen Elizabeth Hospital, Hong Kong, China. 5. Doctor of Nursing candidate, Nurse Manager, Queen Elizabeth Hospital, Hong Kong, China. 6. Diabetes Nurse Specialist, Queen Elizabeth Hospital, Hong Kong, China. 7. Cluster General Manager (Nursing), Kowloon Central Cluster, General Manager (Nursing), Queen Elizabeth Hospital, Hong Kong, China. 8. Associate Professor and Co-Director, Canadian Centre for Advanced Practice Nursing Research, School of Nursing, McMaster University, Hamilton, ON, Canada.
Abstract
PURPOSE: To examine the exemplary practice of nurse consultants (NCs) and derive a model to illustrate the highest level of advanced nursing practice. DESIGN: A descriptive study was conducted to examine the practice and outcomes of seven NC roles in varied clinical specialties in Hong Kong. Exemplary practice was examined in relation to competencies for advanced practice nursing in Hong Kong and the United Kingdom. METHODS: Data about NC characteristics and their practices were collected using a structured questionnaire and analyzed using descriptive statistics. Health service documents and clinical notes were analyzed using the framework approach. FINDINGS: All NCs demonstrated the competence expected of an advanced practice nurse with impacts on patients, nursing profession, and the organization as identified in the advanced nursing practice framework in Hong Kong. NCs also performed at the highest level of practice delineated by Skills for Health in the United Kingdom. They were involved in diagnostic and therapeutic practice, and identified patient satisfaction and symptom management as key outcomes. CONCLUSIONS: This study provides new insight into levels of advanced practice and illustrates the exemplary work of NCs to demonstrate how they have developed and shaped services to bring about positive patient and organizational outcomes. Career laddering that places NCs at the highest level of advanced practice is important for making the best use of nursing expertise to achieve optimal patient and organizational outcomes. CLINICAL RELEVANCE: This study addresses a knowledge gap to enrich our current understanding of the impact of advanced practice nursing roles by linking NC role practices and competencies to key outcomes.
PURPOSE: To examine the exemplary practice of nurse consultants (NCs) and derive a model to illustrate the highest level of advanced nursing practice. DESIGN: A descriptive study was conducted to examine the practice and outcomes of seven NC roles in varied clinical specialties in Hong Kong. Exemplary practice was examined in relation to competencies for advanced practice nursing in Hong Kong and the United Kingdom. METHODS: Data about NC characteristics and their practices were collected using a structured questionnaire and analyzed using descriptive statistics. Health service documents and clinical notes were analyzed using the framework approach. FINDINGS: All NCs demonstrated the competence expected of an advanced practice nurse with impacts on patients, nursing profession, and the organization as identified in the advanced nursing practice framework in Hong Kong. NCs also performed at the highest level of practice delineated by Skills for Health in the United Kingdom. They were involved in diagnostic and therapeutic practice, and identified patient satisfaction and symptom management as key outcomes. CONCLUSIONS: This study provides new insight into levels of advanced practice and illustrates the exemplary work of NCs to demonstrate how they have developed and shaped services to bring about positive patient and organizational outcomes. Career laddering that places NCs at the highest level of advanced practice is important for making the best use of nursing expertise to achieve optimal patient and organizational outcomes. CLINICAL RELEVANCE: This study addresses a knowledge gap to enrich our current understanding of the impact of advanced practice nursing roles by linking NC role practices and competencies to key outcomes.