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

Background 2008 -2011 Staff Nurse on Our Lady’s Ward Completed Grad Dip Care of the Older Person & MSc Care of the Older Person UCD 2011- 2018 CNM 2 Carew House Day Hospital Research Nurse with ARCH 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 Team Vision APN assessments in Emergency Department Domiciliary Visits Input in Memory Harbour Input with inpatient team Dementia Support

Local Need – numbers attending day hospital

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

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

Core Competencies as ANP

Challenges Transition from CNM 2 to cANP 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