IANPC 2023 - CONFERENCE KEYNOTE & WORKSHOPS ABSTRACT

Prof. ZHENG Jialin

Dean, School of Medicine, Tongji University, 

Shanghai, China

Prof. CHAIR Sek Ying

President, Hong Kong Academy of Nursing,

Vice Director (Research) and Graduate Division of the Nethersole School of Nursing,

Faculty of Medicine, The Chinese University of Hong Kong (CUHK)

Hong Kong, like everywhere else in the world, is grappling with challenges of ageing population, growing burden of chronic illnesses, shortage of physicians, suboptimal continuity of care, and demanding access to healthcare services. Moreover, cost-containing is critical in a subsidised system, as the Hospital Authority is shouldering 90% of inpatient care in Hong Kong. All these facilitate the development of innovative healthcare services, paving the way for the advancement of ANP in Hong Kong. In Nursing, the maturity of post-graduate education has prepared nurses to expand and extend the scope of practice. However, to achieve job retention, higher autonomy and job satisfaction should be considered.

The introduction of the Advanced Practice Nurse position in 2003 led to the launch of the Voluntary Scheme on Advanced and Specialised Nursing practice by the Nursing Council in 2021. However, in this voluntary registration exercise, the distinction between specialty nursing and advanced practice nursing remains unclear. In addition, objective criteria for programme accreditation are yet to be developed, and competency assessments on applicants are not mandatory, posing challenges to the benefits of this scheme to the healthcare system. In the upcoming legislative process, all these identified challenges should be tackled through collaborative efforts involving the government, the public and nurses, ultimately benefitting Hong Kong at large.

Ms. Paulin KOH

RN, RMW, BSc Nursing (Hons),

Adv.Dip. In Nursing (Midwifery), MBA,

Chief Nursing Officer, Ministry of Health, Singapore

This presentation aims to share the development of Advanced Practice Nurses (APNs) in Singapore, beginning with the definition of APN practice relevant to the Singapore context and the amendment of the Nurses’ and Midwives’ Act & Regulations to provide for the registration and certification of APN practice. Topics include the implementation of educational and internship programmes, regulatory framework and healthcare policies to support APN practice. Key policies relating to funding and the establishment of a collaborative prescribing framework will also be addressed here.

The development of APNs in Singapore has progressed in the last 20 years. With the ageing population and the evolving needs of the healthcare system, we are currently working on expanding the role and practice settings of APNs beyond the acute care setting into the community and primary care settings. This will help to ensure better integration of care, better patient outcomes and foster a resilient and empowered nursing profession.

Prof. Denise BRYANT-LUKOSIUS 

RN, CON(C), BScN, MScN, PhD
Professor, School of Nursing, McMaster University,
Canada

Increasingly, healthcare systems require advanced practice nurses with focused expertise in highly specialized areas of practice across varied settings to address complex and personalized patient healthcare needs resulting from advances in diagnosis, treatment, and technology. Specialty certification is one type of credential that is an essential building block for creating and sustaining an advanced practice nurse workforce with the knowledge, skills, and competence to deliver timely, safe, and effective patient care. This presentation will share the results of a multi-phase international research project that aimed to examine the current evidence and stakeholder recommendations about healthcare policies, practices, and resources that support specialty certification for advanced practice nurses. Guiding principles for making decisions about the design and implementation of specialty certification programs will be provided.

Dr. Anecita FADOL 

PhD, RN, FAANP, FAAN, FHKAN (Hon.),
Nurse Practitioner and Associate Professor,
Department of Nursing & Department of Cardiology,
University of Texas, MD Anderson Cancer Centre,
Texas, US

How the International Study Results on the Specialty Certification of Advanced Practice Nurses May Inform Hong Kong's Development

Cardio-Oncology is the intersection of two specialties (oncology and cardiology) focusing on the management and prevention of cardiovascular complications in cancer patients and survivors. Following cancer treatments in many patients, the risk of cardiovascular death may be higher than the actual risk of tumor recurrence. Given the complexities of this patient population, it is important for providers to possess knowledge of not only of cardiovascular disease but also cancer subtypes and their specific therapeutics.  Advanced practice nurses are pivotal to the delivery of evidence-based assessment and care for individuals who have preexisting cardiac conditions, as well as those for whom cardiac complications are related to the known and emerging toxicities of cancer treatment. Nurses bridge the gap between cardiologists, oncologists, and the inter-professional team to provide seamless care for patients with cancer with multiple comorbidities, including concurrent cardiovascular disease. With expanding populations of individuals with cardiotoxicities induced or exacerbated by cancer treatment, there is a unique demand for specialty-trained advanced practice nurses in Cardio-Oncology to care for this population.

KEYNOTE VI

Advanced Nursing Practice in Hong Kong and the Way Forward

Dr. Danny TONG

Chief Manager (Nursing) / Chief Nurse Executive (CM(N)/CNE) of Nursing Services Department,

Hospital Authority Head Office (HAHO)

Advanced Nursing Practice in Hong Kong and the Way Forward

 With an aging population and an increasing burden of chronic diseases, the continuously rising service demand consistently surpasses the available supply, raising concerns about the sustainability of our healthcare system. As the largest group of healthcare professionals in Hong Kong, nurses can play a crucial role in revolutionizing the healthcare system to meet the future challenges.

Shifting the focus to primary care is essential in meeting the healthcare needs of Hong Kong's population. By emphasizing prevention and, health promotion, primary care can alleviate the strain on secondary and tertiary services. Nurses, as frontline healthcare providers, are well-positioned to lead this change.

Advancing nursing practice is vital in addressing the complex healthcare challenges faced in Hong Kong. Nurses should continuously explore their potential in extending their roles to meet the emerging needs of the population. This includes delivering specialized and evidence-based care that enhances patient outcomes and satisfaction, improves care quality and safety, and contributes to a more efficient and sustainable healthcare system.

Technology and innovation have transformed healthcare globally, and Hong Kong can leverage these advancements to enhance nursing practice. The integration of digital health solutions, telehealth, and electronic health records streamlines communication, improves care coordination, and enables remote patient monitoring. Equipping nurses with technological skills and training enables effective utilization of these tools, increasing the efficiency of care. This not only alleviates the burden on hospitals but also empowers patients to take care of their own health.

In conclusion, by assuming responsibilities in primary care, expanding roles in advanced practice, and harnessing technology for improved care efficiency and effectiveness, nurses can make an enormous contribution to developing a sustainable healthcare system in the future.

WORKSHOP I

Framework for the Development, Implementation and Evaluation of the Impact of APN Roles

Prof. Denise BRYANT-LUKOSIUS

RN, CON(C), BScN, MScN, PhD
Professor, School of Nursing, McMaster University,
Canada

Framework for the Development, Implementation and Evaluation of the Impact of Advanced Practice Nursing (APN) Roles

The use of APN roles is a critical investment in health human resources, providing positive outcomes for patients/families, nurses/healthcare providers, organizations, and health systems. Yet, international research evidence illustrates a multitude of barriers to optimal APN role implementation and health systems integration. Consequently, the potential for advanced practice nurses to contribute to healthcare improvement and innovation is not fully realized. These barriers are also associated with poor advanced practice nurse job satisfaction, recruitment, and retention. Lack of evaluation data may negatively impact on APN role expansion and long-term sustainability.

Many barriers to effective APN role implementation can be avoided through improved planning. The PEPPA framework is Participatory, Evidence-Informed Patient-Centred Process for APN Role Development, Implementation, and Evaluation. Used worldwide, the framework has demonstrated utility for achieving successful APN role implementation. This workshop will provide an overview of the PEPPA framework and how it has been used internationally to support the introduction of APN roles. Practical strategies, resources, and tools for using the framework will be described. Opportunities to discuss solutions to APN role implementation barriers will be provided. This workshop will be of interest to advanced practice nurses and their supervisors, APN educators, researchers, and healthcare policy and decision-makers. 

WORKSHOP II

Clinical Challenges in Cardio-Oncology: Are You Ready for the Challenge?

Dr. Anecita P. FADOL

RN, FAANP, FAAN, FHKAN (Hon.),

Nurse Practitioner and Associate Professor,

Department of Nursing & Department of Cardiology,

University of Texas, MD Anderson Cancer Centre,

US

Clinical Challenges in Cardio-Oncology: Are You Ready for the Challenge?

Cardiovascular disease (CVD) and cancer are the leading causes of morbidity and mortality globally. It is not uncommon that nurses provide care for individuals with cancer and concurrent CVD. Anti-cancer treatments including chemotherapy, targeted therapy, and immune checkpoint inhibitors are associated with de novo and latent effects on the cardiovascular system resulting in “cardiotoxicity.” Cardiotoxicity resulting in heart failure (HF) is one of the most dreaded complications of cancer therapy, and if not appropriately managed may lead to frequent hospital admissions, cancer treatment delays, a diminished quality of life for the patient, and increased financial burden to the family and the health care system.  HF as a result of cancer therapy has been linked to a 3.5-fold increased mortality risk.  It is imperative that nurses should have the baseline knowledge and clinical skills to adequately manage these patients. This workshop will include a didactic lecture followed by an interactive case study to illustrate the application of theory to clinical practice. The didactic lecture will include most common cancer treatments with potential cardiotoxicity leading to heart failure, pathophysiologic mechanisms, diagnostic criteria, medical and nursing management across the continuum of cancer care, and patient education.

WORKSHOP III

Opening Remarks 

Roles of Nurses in the Primary Health Care Blueprint of Hong Kong 

Dr. PANG Fei Chau

MBChB, FHKAM(Medicine), FHKCCM, FRACMA, MBA

Commissioner for Primary Health Care, Primary Healthcare Office, Health Bureau

President, the Hong Kong Colleghe of Community Medicine

Roles of Nurses in the Primary Health Care Blueprint of Hong Kong 

Hong Kong has long history of discussion on development of primary healthcare, it continues the work by having more programs related to cancer screening and vaccination.  However, it is far from setting up a primary healthcare system at community level to tackle increasing health problems related to ageing population and poor health.  Even though Hong Kong has world leading longevity, the health life span did not extend in proportion to the prolong life expectancy.

With issue of Primary Healthcare Blueprint in December 2022, the government plans to drive and shift of healthcare focus from curative treatment to the prevention of diseases.  Primary Healthcare Office is committed to enhancing district-based primary healthcare services through district health centers, family doctor for all and chronic disease co-care program.

To achieve the above, the key hurdles will be the required expertise in primary care who could share the values and remove the barriers.  For instance, the leadership for integrating the programs and connecting with family doctors will be challenging concerns in terms of the existing capacity and competencies.  We believe that nursing professionals will be a key driver but we cannot see the primary care discipline well developed even in the Hospital Authority.

Besides, district health centers are expected to coordinate and become effective interface with secondary care.  However, they need time to incorporate chronic disease management framework into the existing social models in well-being promotion.  With reference to the current transformation of nursing practice for primary healthcare service revamping, the next step will be the scope of practices and competencies to be achieved so to integrate the services to become an effective primary healthcare system across private sector and public services.

WORKSHOP III

Advanced Practice in Primary Health Care 

Prof. Denise BRYANT-LUKOSIUS

RN, CON(C), BScN, MScN, PhD

Professor, School of Nursing, McMaster University, Canada

Advanced Practice in Primary Health Care 

Primary Health Care Reform, including the integration of advanced practice nursing (APN) roles is essential for addressing health inequities, optimizing health, and improving access, quality, and the efficiency of healthcare services. This workshop presentation will outline the evidence regarding the effectiveness of APN roles in primary health care. Examples of the various patient populations and models of care in which primary health care APN roles have been utilized will be described. Common barriers to the integration of APN roles into primary health care will be identified and opportunities to discuss evidence-informed solutions for optimal role design, implementation, and evaluation will be provided. This workshop will be of interest to advanced practice nurses and their supervisors, APN educators, researchers, and healthcare policy and decision-makers.