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Advanced Clinical Practice

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Advanced practice is a level of practice, rather than a specific role or title and has four pillars of practice.

Advanced Practice
Advanced Practice

Within the clinical practice pillar practitioners working at advanced level must demonstrate competence in:

  • Comprehensive history taking
  • Clinical Assessment
  • Differential Diagnosis
  • Investigations
  • Treatment
  • Admission, discharge and referral (Chief Nursing Officer Directorate, Transforming Roles Paper 2 (2017).

The Nursing, Midwifery and Allied Health Professions Development Framework provides details of generic knowledge, skills, and behaviours (KSBs) that all clinicians working at an advanced level of practice should possess. In addition, the development framework recommends that these generic KSBs are supplemented by role specific/speciality specific KSBs to fully describe the full complement of KSBs under the given pillar (ie in this instance the clinical pillar).

For example, an MSK Advanced Practice Physiotherapist would be required to develop and evidence their ability to fulfil the requirements of the generic KSBs within the development framework (clinical pillar) together with the role speciality specific KSBs identified within the UK MSK AP standards.

Clinical skills
Clinical Skills

Many clinical skills which were once considered to be extended or advanced skills are now core across roles and not viewed as higher level or advanced. Within advanced clinical practice there are many procedures undertaken which, due to the associated risks of harm, are generally considered to be advanced for example arterial stabs, lumbar puncture, insertion of central/arterial lines, abdominal paracentesis, various surgical procedures, confirmation of death and authorisation of blood products. 

It is vital that robust training and competency assessment is in place if such procedures are to be undertaken and that appropriate clinical and professional governance is in place. 

Within mental health nursing clinical interventions may include therapies, medicines, lifestyle advice and care as per Advanced Practice Mental Health Curriculum and Capabilities Framework (hee.nhs.uk).

Useful Resources
Useful Resources

Please note this is not an exhaustive list, it is a collated selection of resources suggested by advanced practitioners that we hope you will find helpful.

BASICS (2023) Paediatric Tele-education

Blood tests

Confirmation of Death: Confirmation of death policy (NES)

Clinical Skills Managed Educational Network (CSMEN)

Communication

eBook by Skills you Need on advanced communication skills

Clinical Knowledge Summaries

e-Learning for Healthcare

Fitnote training

Guidelines

Joint and Soft Tissue Injection Information

Lymes Disease

Shared decision making

The Mastery Skills Pathway

The NHS Lothian Mastery Skills Pathway is an educational, quality assurance and patient safety initiative to promote high-quality training and safe, effective patient care for high-risk procedural skills. Can be accessed via this link The Mastery Skills Pathway (scot.nhs.uk)

Values-based care

Values Based Reflective Practice Values based reflective practice (VBRP®) | Turas | Learn (nhs.scot)

 

Profession Specific Links
Advanced Nursing Practice

Advanced Nursing Practice
Advanced Practice Allied Health Professions

Advanced Practice Allied Health Professions
Advanced Pharmacy Practice

Advanced Pharmacy Practice
Other Professions

Other Professions