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Assessing the impact of introducing trainee advanced clinical practitioners onto an acute oncology triage unit

07 July 2022
Volume 31 · Issue 13


Advanced clinical practitioners (ACPs) have largely been based within acute emergency areas such as emergency departments (EDs) and acute medical units. At The Royal Wolverhampton NHS Trust, ACPs are a new element within oncology services. The acute oncology triage unit sees patients who have received systemic anti-cancer therapy (SACT) presenting with a variety of side effects and symptoms including oncological emergencies, reducing the need for ED attendance. The trainee ACPs identified the neutropenic sepsis pathway as an area requiring urgent change. Through the creation of a new neutropenic sepsis screening tool, as well delivering educational sessions to nursing staff on the unit, the trainee ACPs were able to significantly improve door-to-needle times for patients as well as increasing the use of patient group directions (PGDs), thus reducing delays in antibiotic administration.

Advanced practice roles have existed within nursing for many years, some since the 1970s (Leary and MacLaine, 2019), under various titles such as advanced nurse practitioner, nurse consultant, advanced practitioner and nurse practitioner. The first official advanced nurse practice course was developed in 1990 at the Royal College of Nursing Institute (Leary and MacLaine, 2019). It was a common misconception that advanced practice roles were a substitute for a shortfall in medical roles (Coombes, 2008), however, the role is now becoming more recognised and the idea of collaborative working between nurses, allied health professionals and doctors is more accepted. Advanced clinical practitioners (ACPs) have been largely based within acute emergency areas such as emergency departments (EDs) and acute medical units. More recently, ACP roles have expanded to include a multitude of healthcare backgrounds—including nurses, physiotherapists and pharmacists—in a variety of specialties (Evans et al, 2020). This has allowed many professionals to expand their skills and knowledge, often taking on roles traditionally recognised as that of a doctor such as advanced clinical assessment and prescribing (Health Education England (HEE) et al, 2017; Hooks and Walker, 2020).

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