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HOSPITAL AUTHORITY CONVENTION 2016 Service Enhancement Presentations

F2.2 Staff Engagement and Empowerment 10:45 Room 421

All-round Enhancement of Advanced Practice Nurses’ Clinical Management Competency
Ko YTP, Yang SFA, Tsang HY, Yeung SH
Nursing Services Division, Tung Wah Eastern Hospital, Hong Kong

Tuesday, 3 May Introduction

In this highly modernised era with rapid technology development, there is a growing global awareness on an ever-changing
and increasingly complex healthcare system. Healthcare services in Hong Kong also faces challenges such as reduction
of doctor’s working hours and the continued shortage of manpower that somehow led to the need of extending Advanced
Practice Nurse (APN) roles especially in out-of-hours care in Tung Wah Eastern Hospital (TWEH). They have to demonstrate
exemplary knowledge and skills with critical thinking in clinical practice. High analytical skills in the form of intuition is
required in critical situations, and effective and efficient clinical management skills is essential for the quality and safety of
hospital care. Thus, a series of training programmes and comprehensive backup strategies have been initiated to enhance
APNs’ competency at work.

Objectives

(1) To better equip OverallNnurse Ssupervisors to be the on-site supervisors; (2) to enhance decision making and leadership
skills in clinical management and supervision; (3) to provide practical hints on night supervision and managing clinical risks; (4)
to reiterate explicit instructions on managing clinical risks while maintaining professional accountability.

Methodology

Training on Cclinical Mmanagement Sskills for APNs. The training composed of two levels: A cluster and a hospital-based
Night Overall Supervisor Enhancement workshop was provided to all APNs. The two-day cluster programme focused mainly
on the leadership training and the general management principles of most possibly happened critical situations at night time.
The TWEH training workshops were organised twice for all TWEH APNs including those newly promoted. Experienced APNs
were arranged to teach and share their real experience. Open discussion on special local situation was led by head nurse with
problem solving approach. Upon completion of the workshop, the APNs are expected to undertake the clinical supervisor
roles with more confidence, and be more able to identify clinical risks and manage the critical situations appropriately with
demonstration of effective communication skills. Training materials were also uploaded onto web for staff easy reference.
Nursing Overall Clinical Management Reference on web includes: (1) Workshops training materials which were uploaded onto
Nursing Service Division web for staff easy reference. (2) A “hot or special clinical management issues” site developed by
General Manager of Nursing (GMN) to facilitate sharing of practical management lessons learnt. (3) Emergency preparedness
management guidelines and information for staff quick reference. They are targeted for ensuring the safety of acute out-of-
hours management and continuous enhancement of APNs ability. Participation in Tthird Ttier Patient Safety Round (PSR),
which is an interdisciplinary monitoring process involving the senior executives, physicians, senior managerial nurses, allied
health professionals and APNs in wards. The PSR team conducts visits to different wards quarterly. Areas of focus vary and
are planned in advance. Through participation in PSR, APNs can understand more about how to improve patient safety from
different perspectives. Their clinical management skills are further developed.

Results

100% of APNs had attended the Night Overall Clinical Supervisor Enhancement Workshops by 4Q15. On self-evaluation
and feedback from peers and supervisors, APNs felt more confident and secured at work. They all agreed that the
training programme built up their competency on intuitive clinical judgement in providing acute out-of-hours care. With a
collaboratively agreed scope of training and the comprehensive backup measures, APNs are comfortable and capable to
perform advanced decision making in the management of holistic quality patient care. The onus is on the APNs to ensure that
their management skills remain sharpened by dedication to lifelong learning.

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