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The Concept of Advanced Practice

The Concept of Advanced Practice. Foundations of Advanced Practice APH4000 November 2008. Concepts. A mental image of a phenomenon, idea or a construct in the mind about a thing or action Kaplan, 1964 ‘…Categorising all the things that are alike about them…’

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The Concept of Advanced Practice

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  1. The Conceptof Advanced Practice Foundations of Advanced Practice APH4000 November 2008

  2. Concepts • A mental image of a phenomenon, idea or a construct in the mind about a thing or action • Kaplan, 1964 • ‘…Categorising all the things that are alike about them…’ • Walker L & Avant K (2005) Strategies for Theory Construction in Nursing • Pearson/Prentice Hall New Jersey

  3. Concept analysis • Language we use to communicate AP to other people • Words and terms used to describe AP • Attribute meaning • Be able to debate AP • Reduce ambiguity • Determines the attributes and characteristics that make AP unique from other concepts (nurse practitioner, specialist, extended scope, doctor)

  4. Careful examination of AP literature • Explanation of what is an AP and how it is not like ? • Gives us an operational definition • Clarifies vagueness • Standard language

  5. What is our concept? • Advanced Practice • Identify when and how its used in literature • What are the characteristics of AP?

  6. Model AP case • Has all defining attributes • Well if that’s not AP I don’t know what is? • What things are different? • Is there anything missing?

  7. GMSHA (NHSNW) • An Advanced Practitioner is an • Experienced non-medical registered professional who has developed his or her knowledge to a very high standard in a specific and often high level of practice. This high standard is such that not only is the individual the expert in the base domain:- but can also accept the full responsibilities for providing those services hitherto supplied by doctors, in defined circumstances. • J. Sargent 2003

  8. Process • Select a concept • Determine the aims/purpose of analysis • Identify all the uses of the concept you can • Determine the defining attributes • Identify a model case • Identify borderline, related, contrary, invented and illegitimate cases • Identify antecedents and consequences

  9. GMSHA Advanced Level of Practice • Expert practitioner • Transformational leadership • A high level of communication & influencing skills, deals with complexity • Develops policy, does not work through protocols • High level decision-making • Utilisation & application of research & evidence based practice & knowledge • A Progressive, critical thinker / challenger • Change agent

  10. What? • Concept – Advanced Practitioner • Capture the critical elements at this moment in time from your own experiences • Allows differentiation ie like and also unlike • Enable you to communicate your role to colleagues/other professionals • Negotiate responsibilities etc

  11. Why? • Discriminate between AP and other roles/titles

  12. Where? • Consider all uses of the term / USA/other countries identify literature • Professional groups

  13. Cluster of defining attributes • Identify the cluster of attributes that are the most frequently associated with the concept • Iterative – ie the ones that appear over and over again • This list will become the defining characteristics • May change over time

  14. Additional cases • Identify cases that are not exactly same but similar/contrary • A bit fuzzy at the edges • Some defining characteristics

  15. Borderline cases • Contain most of the attributes but not all • May differ significantly in just 1 characteristic

  16. Related cases • Related to the concept but do not contain all the defining attributes • Very similar ideas but differ under closer examination

  17. Contrary cases • Definitely NOT an AP

  18. Antecedents/context to AP • Antecedents are those events that must occur prior to the AP role

  19. Consequences • Events that occur as a consequence of AP • Outcomes

  20. How to measure AP

  21. Concept analysis process • Select a concept • Determine aims of analysis • Identify all uses of the concept • Determine defining attributes • Identify a model case • Identify borderline, related and contrary cases • Identify antecedents and consequences • Define empirical referents

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