Advanced Comprehensive Health Assessment

There have been many changes and developments in the Irish health service and in nursing and midwifery roles over the recent decade. Demographic changes such as growing & ageing populations and consequent increases in chronic illnesses are shaping health care provision and policies, i.e. to primary care and development of Integrated Care Pathways. These include changes in systems of care provision, reforms in professional education and expansion of the scope of nursing and midwifery practice roles. Nursing will also be critical in implementing the Sláintecare health reform programme. All the evidence shows that when practitioners with advanced skills and knowledge are located in sufficient numbers in specific areas, they can have a real impact on some of the key challenges in the health service.

As highlighted by the NMBI standards for the Scope of Nursing and Midwifery Practice Framework (the Framework) (2015) “it is appropriate that nursing and midwifery practice should respond to the ever-changing needs of the population and the health service”. There is an expectation in the standards that nurses, and midwives are proactive in identifying areas where expansion in their scope of practice would improve patient outcomes and quality in a range of healthcare settings. Nurses and midwives are generally willing to expand their scope of practice and see it as resulting in improved patient care. Advanced health assessment as a speciality has developed rapidly over the last number of years both nationally and internationally. It is concerned with the immediate and early specialist management of adult patients who may present to or from within hospitals as urgencies or emergencies (RCoP 2007). Given the acuity of patients who present to acute medical units or who can rapidly deteriorate in healthcare settings, it is recognised that there is a need to develop additional clinical expertise among nurses working in a range of settings. While advanced health assessment has been linked with advanced practice and nurse prescribing, the COVID pandemic has highlighted the need for nurses working in a range of healthcare settings to develop knowledge and skills in recognising the deteriorating patient. In light of this, the Special Purpose Award in Advanced Health assessment for nurses working in a range of healthcare setting has been developed.

The aim of the award is to enable nurses to develop their knowledge and skills in the assessment and management of acutely ill adults. A requirement for continued development of such nurses to have advanced clinical skills and theoretical knowledge in assessing patient health, including advanced critical thinking and decision-making expertise. This programme is aimed at educationally preparing nurses to expand knowledge and skills required to undertake a comprehensive health history and perform advanced physical assessment in a range of health and social care settings.