Article Figures & Data
Figures
- FIGURE 1.
The present situation: a marked variation of views on entry-level and advanced practice.
- FIGURE 2.
Each country could populate its own national model for entry-level and advanced practice.
- FIGURE 3.
Comparison of entry and advanced levels in 1990 and 2010.
- FIGURE 4.
Illustration of how, within the United Kingdom, the nursing profession has negotiated roles that were formerly within the domain of the medical profession.
Tables
Category of advanced practice Examples Medication management Deciding when medication needs to be stopped Deciding when to give medication (adjunct) Deciding what dose to give Assessing for contraindications or drug incompatibilities Administering medications Responding to adverse reactions (minor and major) Writing a report after a reaction Nonmedical cardiac stress testing Standing in when there is no physician in the stress room Preparing the patient Taking the lead in cardiac stressing Being responsible for monitoring the patient Taking appropriate action if the patient has a problem Deciding when to administer a radiopharmaceutical Deciding when to cease a stress test Responding to cardiac events; deciding when help is required X-ray imaging Requesting before ventilation–perfusion imaging Requesting to investigate unexplained hot areas seen on a bone scan Requesting CT after SPECT to establish Precise location (could be low-dose CT) Diagnosis (diagnostic-quality or high-dose CT) Surgical preparations (mark up for surgery) Being involved with nuclear medicine scanning Identifying the nodes on a scan Marking skin to suggest where the node is for the surgeon Formal reports about scans Describing what is seen Noting whether there are incidental findings and whether they are clinically significant Answering the clinical question Making a (pathologic) diagnosis or indicating normality Suggesting a prognosis based on scan findings Suggesting the next step (e.g., further imaging) Radionuclide therapy sessions Assessing the clinical presentation Evaluating information from the diagnostic work-up Deciding whether the case is suited to radionuclide therapy Taking a lead role in calculating the dose Preparing the patient for the dose; including assessment of contraindications Administering the dose Assessing the patient for complications Following up the patient Facilitator Barrier Laws or regulations that enable change Laws or regulations that restrict advancement of a role or change in responsibilities Guidelines for practice that enable change Fear of litigation Presence of key players who support the desired change Presence of trainee doctors who want roles that allow them to develop Shortage of nuclear medicine physicians Fear of change Technologic advancement Fear of losing money in cases of fee for service Financial pressure in the health care sector Fear of losing turf Effective use of the potential skills and capabilities of all professionals Fear of losing power and status Role models who already do advanced practices Conflict about roles Inability to support suitable advanced practice education and training Fear of accepting new responsibilities
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- Article
- AN INTERNATIONAL PERSPECTIVE ON ADVANCED PRACTICE
- RATIONALE FOR ADVANCED PRACTICE
- EXAMPLES OF ADVANCED PRACTICES
- EVOLUTION OF PROFESSIONAL RESPONSIBILITIES
- LEADING AND MANAGING CHANGE
- EDUCATION AND COMPETENCY
- EVALUATION OF ADVANCED COMPETENCIES THROUGH AUDITING
- CONCLUSION
- Acknowledgments
- Footnotes
- SELECTED READING
- Figures & Data
- Info & Metrics
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