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‘Partnership between physicians, nurses crucial to introducing advanced nursing’

Introducing advanced practice nursing, particularly in countries with fragile healthcare systems, will be crucial to meeting the ever-increasing needs of patients and improving health outcomes, said experts at a two-day virtual conference organised by the Aga Khan University Schools of Nursing and Midwifery in Pakistan and East Africa.

The current Covid-19 pandemic has placed nurses in the spotlight and revealed the need for nursing expertise and experience as never before. In 2020, the International Year of the Nurse and the Midwife, governments and healthcare institutions are being called on to support, empower and advance the nursing profession.

Advanced practice nursing, APN, is one of the most efficient ways of delivering high-quality, affordable and patient-focused care, accessible especially to those vulnerable groups and populations living in the remotest communities where other healthcare professionals may not reach.

However, developing policies and strategies to support the transition process in order to integrate the APN model into the fabric of healthcare systems in Pakistan, Kenya, Tanzania and Uganda might be challenging and it will require collaborative efforts.

Dr Rozina Karmaliani and Dr Eunice Ndirangu, deans of the schools in Pakistan and East Africa respectively, talked about the support required from the nursing regulatory bodies and government legislatures to build, develop and sustain the role of APNs.

“The government is working on important regulatory reforms for nursing. An important initiative that we will be taking is to improve the quality of nursing education at the graduate level that will consequently lead to better trained nurses from whom APNs will be developed in the future,” said Dr Faisal Sultan, special assistant to the prime minister on national health services, regulation and coordination, Pakistan, at the stakeholders’ session during the event.

He also highlighted the importance of a multidisciplinary partnership and collaboration amongst healthcare professionals, especially between physicians and nurses, to take this model forward.

Afshan Nazly, president of the Pakistan Nursing Council, also present at the session, reinforced the need for cooperation and noted that embracing the APN model would be far easier if nurses and physicians worked as allies, and if concentrated efforts were made to enhance the capacity and competency of nurses.

“The current Pakistan Nursing Council Act needs amendment and it should include the [role of] advanced practice nurses to make this model viable in the country,” Nazly added.

Global nursing leaders and APN experts from the United States, Canada and Kenya shared their experiences of pioneering this role in their respective regions and in the developing world, and the associated challenges and measures to mitigate issues.

Chief guest Dr Afaf Meleis, professor of Nursing and Sociology and Dean Emerita, University of Pennsylvania, drew on her considerable years of nursing. “From my own experience in leading APN programmes and witnessing APNs in action in different parts of the world, I want to offer you three principles vital in planning and effective utilisation of APNs in healthcare: Innovation and problem-solving skills in advanced nursing practice and Influence and impact that APNs can create in health outcomes.”

Dr Maria W. O’Rourke, clinical professor of nursing at the University of California San Francisco, the keynote speaker, identified and shared an APN implementation framework from a more universal perspective.

“Health and illness are a complex, multifaceted experiences, and to meet those needs, we need people with specialised knowledge, skills and especially, the ones who are accessible in both rural and urban settings.”

The university’s and university hospital’s leadership, including Dean Medical College Dr Adil Haider and Interim CEO AKUH Shagufta Hassan, supported this initiative and shared willingness to facilitate the integration of APNs at the AKUH.

Dr Elissa Ladd from the International Council of Nursing’s Advanced Practice Nursing Network pointed out that hundreds of millions of people around the world were able to access quality, safe and affordable healthcare services as nurses made the largest group of healthcare providers, particularly in the primary care setting. “In this context, it is not surprising that an investment made on the nursing workforce can yield significant improvement in patient care outcomes,” she said.

The event also commemorated SONAM’s 40 years in Pakistan and 20 years in East Africa.

Six APN competency-building workshops were offered online and attended by nurses and midwives from Afghanistan, Canada, Kenya, Pakistan, Tanzania, the UAE, Uganda, the USA and the UK.

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