Transcript Slide 1

FOCUSING ON APN THROUGH A
GRADUATE PROGRAM
Raisa Gul
RN, RM, BScN, MHA
Assistant Professor and
Director, Diploma Programme
Aga Khan University, School of Nursing
PRESENTATION FLOW
Brief Overview of the Country
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Nursing Profession
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Challenges of MScN Program &
Integration of Advance Practice in Nursing
(APN)
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Potential Impact Of APN
PAKISTAN
56 Years of independence
ABOUT THE COUNTRY
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Population of 140 Million; 68% Rural and 32 % Urban
Population growth 2.2%
Poor public health facilities
Literacy 40%
Health care access, strong rural urban disparities
IMR, 95 per 1000 live birth
MMR, 200-700 per 100, 000
Double disease burden: infectious diseases ,
Hepatitis (TB) and Hypertension, diabetes, cancers,
mental Health problems
Estimated # of Doctors = >100’000 ; Nurses 33’000
so, 1 nurse: 3-4 doctors
NURSING IN PAKISTAN
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Have Nurses, Lady Health Visitors and Midwives
Entry to nursing education is grade 10-12
Nurses are confined to hospitals, 20-30 patients/nurse
Predominant use of students for services
Quality of nursing education is low
Nursing Education, diploma and post basic diploma
Demand for higher education by employer is low
except at AKUH
Opportunity for higher education is limited
Limitation of nursing leadership and physicians’
dominance in Health Care System.
AGA KHAN UNIVERSITY SCHOOL OF
NURSING : VISION Of THE CHANCELLOR
Promotion Of Nursing
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Begin with SON in 1980 as a “break through”
Had an expatriate director and national faculty with
post –basic diploma
23 years later, have national Dean and Directors
All faculties with at least undergraduate degree, but
also Masters and PhDs
Programmes development:
1980 –General Nursing Diploma
1988-Post RN BScN
First program in the country
1997 – BScN
2001- MScN
CHALLENGES OF
ESTABLISHING MScN
a) Conceptual Phase:
Creating awareness, ownership and approval
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Physicians, it takes nurses away from the
“real work”
Employer & university Administration, how
will they be different…do we need to spent
more money?
Nurse Leaders, sense of insecurity
Contd…
Strategies:
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Communication, rationalization with
current trends in nursing education
Success of the developed Countries
Assuring for strong consideration to
enhance clinical knowledge, i.e. 22/59
credits (37 %) as core courses in the
curriculum.
b) Planning Phase
Approval of the Board, concern for
resources both human and financial
Strategies:
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Faculty development plan,
sponsorship for graduate studies
Expatriate faculty, visiting and short
term contracts
Collaboration with other universities
abroad, Sheffield University and
Minnesota
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Curriculum composition, specialist
versus generalist Master
Took generalist approach, with emphasis on
Research and Clinical Practice due to:
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Limited pool of nurses with BscN at the national level
Diversity of potential candidates for MScN
Envisaging greater impact through developing
leaders
3. Developed transition programme in
view of the national needs
MScN CURRICULUM
Total Credit
hours – 59
Nursing Practice
Education
Management
Research
Electives
c) Implementation Phase
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Availability of expatriate faculty , 9/11/2001
Undesirable effects of Faculty development
plan
Variation in employer’s demand
Visa and licensure issues for students’
advance clinical practicum abroad
Students perspectives, program credibility,
cost benefits analysis
Pool of potential students further decreased
affecting enrollment in MScN.
Strategies
Pooling of resources within the
university:
Inter departmental collaboration
 Physicians as preceptors for
Advance clinical Practicum
 Visiting and Sessional faculty
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Our Experience of Advance
Clinical Practicum
Students’ comments :
“Culturally it is appealing, will have more
respect.”
“Our role of counseling and teaching was very
much appreciated.”
“50% of patients need counseling and teaching
to cope with their diagnosis.”
“ patient were receptive to get examined or
advised by a nurse.”
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“Doctors were learning from us and we learned from
them” this “Will definitely impact nurses’ image.”
“If we identified what was missed out, they [Physician]
were appreciative rather then defensive.”
“Me and my preceptor have begun to work on research
project.”
Physician remarked “I am afraid if you have a clinic
next to me. I will loose my patients to you.”
Students, Patients and
Physicians perspectives
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Chance of independent decision making
Application of knowledge, especially
counseling and patient education
Enhancement of assessment skills
Projects nurses strengths and potential,
Source of mutual and enrich learning
experience
Strengthening Nurse- Physician collegiality
Enhance awareness among public about the
scope of nurses’ work.
Advance Practice in Nursing (APN)
Concept to implementation
Need a vision
 Availability of human and financial resources
 Educational preparation of nurses at
graduate level
 Creation of systems to recognize the APN
role
 Requires credentialing and licensure by the
regulatory body of nursing in the country.
Note: Importance of the decision maker should
never be overlooked
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CONCLUSION
Although the issue of role creation and
Licensure by Pakistan Nursing Council
for Advance Practice in nursing (APN)
yet to be addressed, the potential
Impact of APN in Pakistan appears
promising with greater awareness and
outcome in future.
Chances for APN role are bright in the
private sector, but it will take time for
acceptance in the public sector.
ACKNOWLEDGMENT
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Graduate Nursing Committee, Aga Khan
University School of Nursing
Madrean Schober
THANK YOU