Education, Scope of Practice, Regulation:

Issues and Perspectives15:45 – 16:20 6/28/03

Panel Members

• Moderator: Rosemary Goodyear - United States

• Sue Cross – United Kingdom• Nelouise Geyer – South Africa• Marion Clark – New Zealand

NP Education USA

Rosemary Goodyear EdD, RNC, FAANP

Director/ConsultantNurse Consultant Associates

Education: USA

• USA- Certification programs to MS degrees 1965-2003– Varied in length– ’75-Competency

tested– 80’s-Moved into

colleges and universities

– Degrees granted– National

recognition

NP/APNEducation

USAUK

InternationalRole

Education USA

• Scope and Standards were developed by Professional Organizations

• Regulation began on a state by state basis

• Federal Government recognized and funded educational programs

Education USA

• Payment for services by NPs began with governmental programs

• Prescribing regulations were instituted on a state by state basis and continue in 2003

• Change in the delivery of health care increased the demand for NPs

Education USA

• Increase in demand for NPs• Accreditation of educational

programs by professional organizations

• Continued public relations for recognition of NPs in health care systems– Private Health Care Systems– Managed Care Systems– Public Health Care Systems

Nurse Practitioner Strengths

CareCare

Care

Care

CareCare

Care

Care

CareCare

CareCare

QualityQuality

Quality

Quality

Quality

Quality

Quality

Quality

Cost Effective

Effective

Effective

Cost

Cost

Effective

Effective

Cost

Cost

Education UK

Sue Cross RN, BSc (Honors) PGCE, FANNP

International Project Manager

Respiratory Education Resource Centers

Education UK

The role and education of the

UK Nurse Practitioner

Education UK

•Nurses taking on the roles of doctors

•Who makes clinical and management decisions?

•Prescribing•Status of nurses

Education UK

•Effects of health sector changes on nursing practice

•Effects of tight health budgets on nursing practice

Education UK

Changing and developing role of nurse involvement

1990’sChanges in NHS drive towards

more involvement- New GP Contract Number

PNs (1990)- CDM programme

reimbursement (1992)

Education UK

• Publication Guidelines Framework (1993)

• Specialised education available (1989)

Education UK

• Partnership - health & social services

• Performance - clinical & productivity

• Professions - flexibility• Patient care - access,

empowerment & information• Prevention - inequalities

Education UK

Dilemma

Division between cure and care

Cure--------------------Care

Education UK

DilemmaDivision between cure and care

Cure-----------------Care

Nursing often seen as an extension of the doctor’s role

Education UK

Nursing RolesNurse Specialist Nurse Practitioner

Condition Specific General PracticeArea Specific Client group specificClient Group Area specific

Community/ClinicalPublic Health Nursing

Education UK

Four EssentialsAdoption of a systematic means of

determining and designating nursing specialties

Setting of minimum standardsEstablishment of regulatory

mechanisms for nurse practitionersResource planning

Education UK

The Nurse Practitioner Role

• Agree role is needed• Decide on role parameters and

scope• Support for appropriate

education• Agreement on intr and intra

professional issues

Education UK

Nurse Practitioner

• Expert practice• Professional leadership and

consultancy• Education and training• Service development• Research and evaluation

Scope and Standards

Nelouise GeyerDeputy Director Professional

MattersDENOSA

Pretoria, South Africa

Scope and Standards

• The Policy Subgroup was initiated in 2000-2001

• Consisted of 8 members from 7 different countries

• Three persons withdrew due to work constrains

• Liaison with Core Steering Group was Rosemary Goodyear

Scope and Standards

•Project initiated in 2001•All members were requested

to submit their information on Scope and Standards

•The first draft documents were prepared from this information

Scope and Standards

•The documents were circulated to all Subgroup members for comment

•A few amendments were made to this draft

•The second draft was prepared and presented in Adelaide, AU 2002

Scope and Standards

•Adelaide, Australia October 2002

•Second Draft discussed•Meeting of Subgroup of

members in attendance• Identified need to develop

a glossary to accompany the documents

Scope and Standards

•Valuable discussion with both Subgroup and Core Steering Group members

•Amendment of draft documents December 2002

•Work on third draft during early part of 2003

Scope and Standards

• 30 March Conference call with subgroup members (Canada, New Zealand, South Africa, USA)

• Work divided among Subgroup members

• Third draft of scope and standards and a glossary are available for comment

Scope and Standards

• Subgroup will meet in Geneva• Evolving scope and standards

New Zealand Model

Marion Clark BA; MPP; RGON; FCNA

Chief Executive/RegistrarNursing Council of New

Zealand

Regulation in NZ

An Overview

Regulation in NZ

A Regulatory Framework

• Protection of title(s)• Appropriate legislative

authority• Development of scope,

standards and competencies• Educational qualifications• Who regulates?

Regulation in NZ

Process for assessment

• Examination• Graduates of approved

programmes• Individual competence-based

assessment

Regulation in NZ

New Zealand Model• Brief overview• Profile of Nurse Practitioners• Roles of regulatory authorities

and professional organizations• Regulatory framework• Assessment of applicants• Issues

Summary

• NP Education in USA• NP Education in UK• Scope and Standards for

International NP/APN Network• The New Zealand Model

http://www.icn.ch