+ The APN role of “Consultation” A Panel Presentation Serena Butler Abi Fitzgerald Renee Latoures

+ Introductions Abi – moderator and presenter Renee – panel member/presenter Serena – panel member/presenter Each member did their own reaserch and then we collaborated as a team to develop the presentation.

+ The 5 Role components of a APN According to the California Board of Registered Nursing, “There are 5 Major Role Components of the APN Role.” 1. Expert Clinical Practice 2. Education 3. Research 4. Consultation 5. Clinical Leadership

+ Consultation Is a specific patient, diagnosis and proposed treatment by two or more health care workers at one time. Merriam-Webster’s dictionary describes it as: 1: council, conference; specifically : a deliberation between practitioners on a case or its treatmentcouncilconference 2: the act of consulting or conferringconsulting 3: a meeting in which someone (such as a doctor or lawyer) talks to a person about a problem, question, etc.

+ Consultant A consulting health care worker who acts in an advisory capacity.

+ Why are consultants needed? The decision to call in a consultant is based on impulse; feelings of frustration or desperation. Consultants are often used when someone is trying to avoid the discomfort and conflict related to making a difficult decision. Consultants can offer reinforcement for assessment and plan of care for a patient.

+ There are 4 categories of Consultation Client-centered case consultation (direct care) Consultation recommendations are communicated so that the patient understands and can be involved in the decision making. Consultee-centered case consultation (training staff to do the work) Program-centered administrative consultation Consultee-centered administrative consultation

+ 6 phases of Consultation Phase 1 – Contact and entry change Make contact, identify needs, identify readiness, discuss possibility of working together. Phase 2 – Formulating a contract and establishing a helping relationship. Outline desired outcomes, assign job responsibilities/duties, and formulate time framework and accountabil ity.

+ 6 phases of Consultation Cont. Phase 3 – Problem identification and diagnostic analysis. Problem analysis, data collection, evaluation of forces working for or against any movement, and considerations of the readiness of change. Phase 4 – Goal setting and planning Project goals and plan of action development/involvement

+ 6 phases of Consultation Cont. Phase 5 – Take action and cycling feedback Successful action taken based on expertise, evaluation, feedback, revision of actions, and use of additional resources. Phase 6 – Contract completion, continuity, support and termination Designing continued support systems to assure continued success and planning termination time frame

+ When Consulting… The consultant is not responsible for assuring that a recommended action is taken with a patient. The consultee is responsible for the action taken. The consultee can accept or reject the advice given by the consultant. Which means the accountability for implementation of recommended actions lies with the consultee.

+ APN Consultation Is based on the APN’s knowledge, experience, and confidence. Beginning APN’s: Offer direct practice and client centered consultation. It takes time to be recognized as an expert and requires confidence to provide expert consultation.

+ Required Skills to Function as a Consultant The consultant chosen should have the skills specific to the needs in question, should be able to easily relate to the people involved, and be able to demonstrate the ability to critically analyze data presented.

+ Required Knowledge to Function as an APN Consultant Consultation Nursing process Theoretical knowledge about systems Change theory Adult learning theory Problem solving Conflict resolution Interpersonal skills Listening skills Time management/priority setting Cultural understanding

+ Jobs for an APN Consultant Speaker/facilitator for educational program Publish articles in peer reviewed journals Assist companies in selling or educating staff about a product or service Expert witness/legal consultant

+ The Activities within the Role Component of Consultation According to the California Board of Registered Nursing Consultation includes the following: Performs consultative functions in multiple health care settings. Provides clinical expertise and makes recommendations to physicians, other health care providers, insurance companies, patients, and health care organizations. Reviews standards of practice to determine appropriateness and to reflect current nursing clinical practice. Evaluates policy and procedures for clinical practice in a specialty area. Uses evidence-based clinical practice to develop methods to improve patient care and patient care outcomes.

+ Performs consultative functions in multiple health care settings What health care settings can you think of that an APN might provide consultation? Hospitals Primary care Clinics In home care Long term care Insurance companies

+ Provides Clinical Expertise and makes Recommendations APNs integrate education, research, management, leadership, and consultation into their clinical roles The APN develops an appropriate plan of care based on their advanced knowledge and expertise to attain individualized expected outcomes, prioritizing multiple needs.

+ Reviews Standards of Practice

+ Evaluates Policy and Procedures

+ Uses Evidence-Based Clinical Practice to Develop Methods to Improve Patient Care/ Outcomes.

+ Consultation… Expands nursing knowledge Ensures a high standard of care by sharing knowledge at multiple levels Allows the opportunity to be independent Provides a chance to make a tangible difference in health care

+ References American Association of Colleges of Nursing Task Force. (1996).Essentials of masters education for advanced practice nursing. AACN: Washington, D.C. Beecroft, Pauline, PhD., R.N., Editor.(1997). National association of clinical nurse specialists statement on clinical nurse specialist practice and education. Lippincott: Philadelphia, Pa. Role of the Advanced Practice Nurse as Consultant (PowerPoint slides). Retrieved from practice-nurse-as-consultant#btnNext