The CNS role of *Consultation*

Report
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Serena Butler
Abi Fitzgerald
Renee Latoures
The APN role of
“Consultation”
A Panel Presentation
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Introductions

Abi – moderator and presenter

Renee – panel member/presenter

Serena – panel member/presenter
Each member did their own reaserch and then we collaborated
as a team to develop the presentation.
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The 5 Role components of a APN
According to the California Board of Registered Nursing,
“There are 5 Major Role Components of the APN Role.”
1.
Expert Clinical Practice
2.
Education
3.
Research
4.
Consultation
5.
Clinical Leadership
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Consultation

Is a specific patient, diagnosis and proposed treatment by
two or more health care workers at one time.

Merriam-Webster’s dictionary describes it as:

1: council, conference; specifically : a deliberation between
practitioners on a case or its treatment

2: the act of consulting or conferring

3: a meeting in which someone (such as a doctor or lawyer) talks
to a person about a problem, question, etc.
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Consultant

A consulting health care worker who acts in an advisory
capacity.
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Why are consultants needed?
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The decision to call in a consultant is based on impulse;
feelings of frustration or desperation.

Consultants are often used when someone is trying to avoid
the discomfort and conflict related to making a difficult
decision.

Consultants can offer reinforcement for assessment and plan
of care for a patient.
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There are 4 categories of Consultation
 Client-centered
case consultation (direct care)
 Consultation recommendations are
communicated so that the patient understands
and can be involved in the decision making.
 Consultee-centered
case consultation (training
staff to do the work)
 Program-centered
administrative consultation
 Consultee-centered
administrative consultation
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6 phases of Consultation
 Phase
1 – Contact and entry change
 Make contact, identify needs, identify readiness,
discuss possibility of working together.
 Phase
2 – Formulating a contract and
establishing a helping relationship.
 Outline desired outcomes, assign job
responsibilities/duties, and formulate time
framework and accountability.
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6 phases of Consultation Cont.
 Phase
3 – Problem identification and diagnostic
analysis.
 Problem analysis, data collection, evaluation of
forces working for or against any movement, and
considerations of the readiness of change.
 Phase
4 – Goal setting and planning
 Project goals and plan of action
development/involvement
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6 phases of Consultation Cont.
 Phase
5 – Take action and cycling feedback
 Successful action taken based on expertise,
evaluation, feedback, revision of actions, and use
of additional resources.
 Phase
6 – Contract completion, continuity,
support and termination
 Designing continued support systems to assure
continued success and planning termination time
frame
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When Consulting…

The consultant is not responsible for
assuring that a recommended action
is taken with a patient. The consultee
is responsible for the action taken.

The consultee can accept or reject the
advice given by the consultant. Which
means the accountability for
implementation of recommended
actions lies with the consultee.
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APN Consultation

Is based on the APN’s knowledge, experience, and
confidence.

Beginning APN’s:

Offer direct practice and client centered consultation.

It takes time to be recognized as an expert and requires
confidence to provide expert consultation.
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Required Skills
to Function as a Consultant

The consultant chosen should have the skills specific to the
needs in question, should be able to easily relate to the
people involved, and be able to demonstrate the ability to
critically analyze data presented.
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Required Knowledge
to Function as an APN Consultant

Consultation

Nursing process
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Theoretical knowledge about systems

Change theory

Adult learning theory

Problem solving

Conflict resolution

Interpersonal skills

Listening skills

Time management/priority setting

Cultural understanding
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Jobs for an APN Consultant

Speaker/facilitator for educational program

Publish articles in peer reviewed journals

Assist companies in selling or educating staff about a product
or service

Expert witness/legal consultant
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The Activities within the Role
Component of Consultation
According to the California Board of Registered
Nursing Consultation includes the following:

Performs consultative functions in multiple health care
settings.

Provides clinical expertise and makes recommendations to
physicians, other health care providers, insurance
companies, patients, and health care organizations.

Reviews standards of practice to determine appropriateness
and to reflect current nursing clinical practice.

Evaluates policy and procedures for clinical practice in a
specialty area.

Uses evidence-based clinical practice to develop methods to
improve patient care and patient care outcomes.
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Performs consultative functions in
multiple health care settings
What health care settings can you think of that an APN might
provide consultation?

Hospitals

Primary care

Clinics

In home care

Long term care

Insurance companies
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Provides Clinical Expertise and
makes Recommendations

APNs integrate education,
research, management,
leadership, and consultation
into their clinical roles

The APN develops an
appropriate plan of care
based on their advanced
knowledge and expertise to
attain individualized
expected outcomes,
prioritizing multiple needs.
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Reviews Standards of Practice
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Evaluates Policy and Procedures
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Uses Evidence-Based Clinical Practice
to Develop Methods to Improve Patient
Care/ Outcomes.
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Consultation…

Expands nursing knowledge

Ensures a high standard of care
by sharing knowledge at
multiple levels

Allows the opportunity to be
independent

Provides a chance to make a
tangible difference in health
care
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References

American Association of Colleges of Nursing Task Force. (1996).Essentials of
masters education for advanced practice nursing. AACN: Washington, D.C.

Beecroft, Pauline, PhD., R.N., Editor.(1997). National association of clinical
nurse specialists statement on clinical nurse specialist practice and
education. Lippincott: Philadelphia, Pa.

Role of the Advanced Practice Nurse as Consultant (PowerPoint slides).
Retrieved from http://www.slideshare.net/bodo-con/role-of-the-advancedpractice-nurse-as-consultant#btnNext

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