Developing an ANP post for an Older Person

Background • Staff Nurse on Our Lady’s Ward • Completed Grad Dip Care of

Older People by Numbers SVUH Local Data Population Projections 1 in 5 attenders →

Vision My Vision Team Vision • Rapid Assessment Clinic • Early Cognitive Assessment Clinic

Local Need – numbers attending day hospital 1200 1000 800 New 600 Review 400

Local Information • Waiting time >10 weeks • Active Cancellation List • Patients awaiting

Developing Case Load • • Not disease specific Impact on the service already provided

Plan……… 1. Support & Intervention following diagnosis of dementia 2. Domiciliary visits for patients

Plan……. . 5. Further Development of CGA documentation – enhance development of specific pathways

Challenges • • Transition from CNM 2 to c. ANP Role within team Developing

Conclusion • At times I may think change is slow • Exciting & challenging

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Developing an ANP post for an Older Person Day Hospital Sarah Cosgrave, c. ANP Older Persons 24 th May 2018 s. cosgrave@svhg. ie

Background • Staff Nurse on Our Lady’s Ward • Completed Grad Dip Care of the Older Person & MSc Care of the Older Person 2008 -2011 UCD • CNM 2 Carew House Day Hospital • Research Nurse with ARCH 2011 - 2018 • Dementia Champion DCU, Nurse Prescribing with Health Assessment UCD 2018 • Commenced Candidate ANP post Older Persons • Advanced Practice Modules UCD

Older People by Numbers SVUH Local Data Population Projections 1 in 5 attenders → approaching 1 in 3 Attendances at Day Hospital New Patients Return 2014 597 857 2015 593 881 2016 604 995 2017 676 1116

Vision My Vision Team Vision • Rapid Assessment Clinic • Early Cognitive Assessment Clinic • PHN – ANP referrals • ANP & CPN combined assessments • Dementia Support & follow up tele- clinic • APN assessments in Emergency Department • Domiciliary Visits • Input in Memory Harbour • Input with inpatient team • Dementia Support

Local Need – numbers attending day hospital 1200 1000 800 New 600 Review 400 200 0 2014 2015 2016 2017 2018

Local Information • Waiting time >10 weeks • Active Cancellation List • Patients awaiting cancellation – both new & review patients • DNA rate is high • Requests for assessments – – – Cognitive concerns Falls Accessing services PHN request LTC application Query PD

Developing Case Load • • Not disease specific Impact on the service already provided Reduce waiting times Integrating Services between hospital & community

Plan……… 1. Support & Intervention following diagnosis of dementia 2. Domiciliary visits for patients who continue to DNA 3. PHN to ANP referrals for nurse led clinic 4. 2 sessions a month with Memory Harbour Clonskeagh with community OT

Plan……. . 5. Further Development of CGA documentation – enhance development of specific pathways 6. Education on acute wards 7. Work with local day hospitals on development of vision between sites

Core Competencies as ANP

Challenges • • Transition from CNM 2 to c. ANP Role within team Developing case load Advanced decision making

Conclusion • At times I may think change is slow • Exciting & challenging times ahead • Worthwhile for our patients & families attending our service