An evidence based change proposal: advanced practitioner led claudication clinics within the primary care setting

Whiston-Norbury, Emma (2017) An evidence based change proposal: advanced practitioner led claudication clinics within the primary care setting. Masters thesis, University of Cumbria. Item availability may be restricted.

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Abstract

The focus of this evidence based change proposal (EBCP) is the introduction of an Advanced Practitioner (AP) led service providing claudication clinics within the primary care setting within the local area. Peripheral arterial disease (PAD) is an atherosclerotic process that causes stenosis and occlusion of non-cerebral and non-coronary arteries. It has an estimated worldwide prevalence of almost 10%, rising to 15-20% in people over 70 years of age (Peach, 2012). Critical limb ischaemia (CLI) is one of the most severe manifestations of the disease, and can result in limb loss or even death if not treated promptly and appropriately. Each year, 500-1000 new cases of CLI are diagnosed per million of the population, with an estimated annual cost to the National Health Service (NHS) of more than £200m (Peach, 2012). The literature review undertaken demonstrates the importance of the early detection of PAD and appropriate management in relation to its prognosis and secondary prevention of further cardiovascular events. To structure and support the proposal, Kotter’s (1998) eight stage change model was utilised. The change chapter looks at the different leadership styles such as Laisse faire, Democratic and Autocratic which can be adapted as per the situation and to different people (Mitchell, 2013). The author remained aware and adhered to the Nursing and Midwifery Council guidance for advanced level nurses (NMC, 2010). PAD is a chronic disease which is considered a public health issue and health improvement is what health professionals strive to achieve by devoting skill and will to evaluate public health actions. To aid the evaluation of the EBCP, the 6-step evaluation framework from the Centres for Disease Control (CDC) (2011) will also be utilised. Effective program evaluation is a systematic way to improve and account for program actions involving methods that are useful, feasible, ethical, and accurate. Lessons learned and shared is an integral part to the success of on-going change and demonstrates the value of the AP as a change agent within the team.

Item Type: Thesis (Masters)
Departments: Faculty of Health and Science > Nursing, Health and Professional Practice
Additional Information: Dissertation submitted in part fulfilment for the MSc Advanced Practice.
Depositing User: Anna Lupton
Date Deposited: 11 Oct 2017 13:33
Last Modified: 30 Nov 2017 16:58
URI: http://insight.cumbria.ac.uk/id/eprint/3283

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