Spotlight on Other Nursing Activities in the Park
AIGNA (the All Ireland Gerontological Nurses Association) is the only organisation for nurses working with older adults in Ireland and it is an essential resource for any nurse working in this area. The purpose of AIGNA is to promote healthy ageing and well being of older people through the advancement of excellence in gerontological nursing. AIGNA provides a platform for the dissemination of and engagement in research. This enhances the gerontological nurses’ knowledge, skills and expertise through networking, information sharing and other knowledge translation activities. AIGNA will be hosting a master class on 12th November in University College Dublin on two key areas of nursing older adults - palliative care and acute care. For further information on attending this master class and on becoming a member of AIGNA check out the website www.aigna.ie
Advanced Nurse Practitioner
I registered with NMBI in October 2012 as a RANP Care of the Older Adult Community and my specialist area is assessment of the older adult living in the community and the promotion of healthy ageing. My post is based in St Mary’s Hospital and serves the older adult population in Dublin North City
As an ANP my aim is to support the provision of a timely, quality service to the older person and their family, promoting healthy ageing and optimum levels of independence. Through the use of my expert skill and knowledge I focus on preventive care interventions such as health screening, disease /disability prevention, case finding, evidence based diagnostic practice and health education and health promotion. I facilitate the appropriate treatment of older adults in their own home setting with early interventions and utilisation of the skills and resources available in St Mary’s that aims to reduce admissions to the acute care setting. Through comprehensive nursing assessment, planning, implementing, evaluating and reassessing, care will be carried out and interventions put in place quicker. I listen to older adults and have a pivotal role in supporting and developing appropriate care in the appropriate settings.
I participate in educating nursing staff and other healthcare professionals through role-modelling, mentoring, sharing and facilitating the exchange of knowledge both in the classroom, the clinical area and the wider community. I work in partnership with national and international experts in care of older adults in order to ensure the provision of the highest standard of care to all patients. From a research prospective to date I have been involved in local and national research groups on key areas of bone health, falls prevention and assessment of the older adult.
While engaging with local research – PARTNERs, into the development of electronic patient records in 2008 I was formally introduced to the concept of nursing informatics and recognised the value of it in the future healthcare of older adults. I am currently a member of the Health Informatics Society of Ireland Nursing and Midwifery Special Interest Group (HISINM). In 2011 in collaboration with Anne Spencer an Educational Technologist, we launched Bone Health in the Park I am not falling for you! This was Phase One of an E learning education programme. In 2012 a falls prevention programme Forever Autumn – Phase Two of Bone Health in the Park, was developed and implemented in St Mary’s. The material is available to all on our website The interest in this work from the wider nursing community across differing care settings has generated a national community of practice in the area of falls prevention and management in which I look forward to developing further.
A key requisite to the role of ANP is continual professional development and the application of evidence based practice as it is for all nurses. Therefore being a member of AIGNA – the All Ireland Gerontological Nurses Association is essential for me and in fact any nurse working with older adults of which I am currently a management committee member. For further information on AIGNA and becoming a member check out the website I am regularly involved with, attend and present at local and national conferences and education days on all aspects of older person care.
Recently the Specialist Geriatric Services Report (2012) advocated the role of the ANP in effective community care of the older adult and as my role develops I look forward to working in collaboration with other healthcare professionals to ensure continuity of care resulting in better health outcomes - a vision I have for the future of older person care.
In early 2006 the Irish Medicines Board (Miscellaneous Provisions) Act was introduced which contained an enabling provision for prescriptive authority for nurses and midwives. The Minister for Health and Children in May 2007 signed into law the medicines regulations providing the regulatory framework for this national initiative.
In November 2007 twenty two nurses and midwives in Ireland were presented with a Certificate in Nurse/Midwife prescribing at the Royal College of Surgeons in Ireland (RCSI) and were registered with NMBI as Registered Nurse Prescribers. There are now over 500 RNP/RMP in Ireland.
The nursing management and medical director in St Mary’s have welcomed this initiative by supporting the education and supervision of the nurses through the programme, the development of the Collaborative Practice Agreements and the registration process with NMBI. St Mary’s now has seven RNP’s. These nurses work in differing areas across the campus including infection control, tissue viability, intermediate care, residential care and community care of older adults.
There is active representation by the RNP’s on the Local Drug and Therapeutics Committee where issues in relation to medication management are discussed, reviewed and updated in line with evidence based practice. A representative from St Mary’s also attends the national nurse prescribing forum where contributions are made to the ongoing review and development of nurse prescribing in Ireland.
Health and social care is changing. The concept of an individual receiving health care in an isolated fashion, as a passive recipient of care, is no longer an appropriate model of care for the 21st Century. Health and healthcare today demands choice. Citizens today can be presented as consumers who want a more individualised choice and wish to determine who, what, where and how their healthcare package is designed and delivered. International evidence demonstrates an ageing population with the growing number of those over 65 years keen to maintain their health. Policy makers in Europe are increasingly recognising the role that integrated health records will have to play in delivery of such healthcare models.
In Ireland the Health Informatics Society of Ireland Nursing and Midwifery Special Interest Group (HISINM) has been in existence since 1996. It recognises the landscape is changing and also the challenges facing the nursing and midwifery profession to embrace technology in the workplace. HISINM’s new strategy for 2013 - 2016 lays out its plans to promote, support and guide nurses and midwives on the progression of the informatics agenda in Ireland - to design health records, to educate and train staff and to protect and sustain nursing and midwifery practice.
To date in Ireland, Care of Older Adult healthcare delivery has been through much restructuring. To ensure a seamless patient journey for older adults, there have been many new initiatives and projects developed, to ensure choice and continuity of care is achieved. Of interest most of these are based around information technology and are evident across all care settings eg. electronic health records, nursing metrics, e prescribing, to name a few. Gerontology nursing is at the forefront of these changes and therefore actively ensuring quality care provision for the patients and residents in their care.
St Mary’s nurses have embraced the nursing informatics agenda and have representation on the HISINM special interest group as well as engaging in developments using information technology for the benefit of the future care of older adults in Ireland.
NMPDU - Nursing and Midwifery Practice Development Unit
The NMPDU Dublin North, under the direction of Ms Ann Brennan, has afforded on-going support to the nursing staff in St Mary’s allowing for their continual professional development over the past number of years. They have been proactive in their response to new initiatives and developments through funding, education and facilitation of projects. The NMPDU were instrumental in assisting with the development of the Advanced Nurse Practitioner post - Care of the Older Adult Community, for Dublin North City based in St Mary’s. All of this support has seen the community of nursing skills, experience and knowledge in St Mary’s flourish. Their achievements are evident in their day to day practice and some are listed in the Research Activity and Staff Education Achievements pages on this website.
The nursing staff in St Marys would like to acknowledge this support and look forward to continued engagement with the NMPDU in the future.