By Cecilia Nasmith
Northumberland Hills Hospital is pleased to announce an expansion to the scope of practice provided by Nurse Practitioners within Post-Acute Specialty Services, specifically Inpatient Rehabilitation and Restorative Care.
NP practices are more common to larger urban hospital, but – as a community hospital - NHH was on the cutting edge hiring its first one in 2013
Steady and targeted recruitment followed, with NPs increasingly demonstrating their value to NHH families, their patients and day-to-day hospital operations. Today, there are 10 NPs on staff, key professionals within the interdisciplinary teams of the Emergency Department, Mental Health, Medical-Surgical Unit and Post-Acute Specialty Services.
Within PASS, NP expertise has grown along with their numbers, adding specific skills geared to the evolving needs of the community in the areas of general rehabilitation, stroke care and gerontology.
Since 2013, the NP scope of practice has also steadily expanded to include controlled drug-prescribing, admission and discharge of hospitalized patients, and broader scope in ordering selected diagnostic imaging tests.
PASS program Medical Chief Dr. Wang Si says patient feedback has been very positive.
When a patient is admitted, a doctor is traditionally assigned as Most Responsible Practitioner. At NHH, this may be one's own family physician (in those instances where that physician has privileges at NHH). But in more than 60% of admissions nowadays, that person is a hospitalist – a physician whose job it is to provide for hospitalized inpatients for the duration of their stay,
In recent years, NPs have provided clinical leadership in collaboration with the hospitalist team to support the care of PASS inpatients, which includes the Inpatient Rehabilitation Unit and the Restorative Care Unit.
NP education requires a Master’s degree, and their scope of practice (the set of services they are permitted to perform as regulated health professionals) places them in the Registered Nurse Extended Class which allows Nurse Practitioners also to work independently. To this end, NHH is pleased to announce that NPs are now practicing with that expanded scope, formally serving, since Feb. 1 as MRPs for all patients without local NHH-affiliated primary-care providers who are admitted to Inpatient Rehabilitation or Restorative Care.
“By augmenting the NP role to now include MRP in the PASS program, we have further broadened the scope of NPs within the organization, and enhanced care,” Dr. Xi added.
In their capacity as MRPs, two PASS NPs - Rachel Klompmaker (1A, Inpatient Rehabilitation) and Karen Truter (1B, Restorative Care) – are responsible for overseeing the care of patients in those two units who would have previously been under the care of the Hospitalist. This includes ordering blood and other medical tests within the NP’s scope and prescribing medications. They provide advice and input on over-all health-care management, and convey information to/from their patients’ primary-care provider when they are discharged. For duties outside the scope of the NP (for example, ordering MRI), a physician consult is provided from either the family physician on-call team or the hospitalist program.
In addition, Dmitri Goold is trailblazing a new role at NHH as the Integrated Care Nurse Practitioner. This role has been introduced to develop new programs and services that link patients to our community. The ICNP will also be delivering primary-care services at Colborne's newly opened Ontario Health Team-Northumberland Rural Outreach Clinic, creating a direct patient pathway for heart-failure patients in that area and acting as a clinical liaison between community partners and the hospital.
“We are very pleased to formally welcome all three of these NPs into this expanded MRP role,” said Susan Walsh, VP, Patient Services, Chief Nurse Executive and Chief Clinical Information Officer.
“By investing in Nurse Practitioners in this way, and steadily growing our team within the Post-Acute Specialty Service, we are matching skill set to the unique needs of each program, and the patients and families each exists to serve.
“AI have already received significant positive feedback about the care experience the NP as MRP model offers. It is an example of a model that has been developed by the PASS care team, in consultation with the patients and families served, and it is proving to be a win-win-win for all involved.”
