Women's Health Week: Advanced Practitioners in Women's Health

In 2019, the Chief Nursing Officer of the Department of Health, published The Policy on Development of Graduates to Advanced Nursing and Midwifery Practice.

An Advanced Nurse Practitioner (ANP) and Advancedwifery Practitioner (AMP) is a highly skilled and experienced expert in clinical practice and provides a complete episode of care in response to patient needs which includes; patient assessment informed by relevant examinations and diagnostics, medication prescribing, patient referral and follow up as required.

This policy aims to maximise the nursing and midwifery response, addressing health service challenges, reduce waiting times, reduce hospital admissions and improve the patient experience.

Both Registered Advanced Midwifery Practitioners (RAMPs) and Registered Advanced Nurse Practitioners (RANPs) have been appointed to support Women’s Health across the country. These practitioners work across a diverse range of services including Maternity, Women’s Preventative Health, Sexual Assault and Forensic Examination, Sexual Health, Ambulatory Gynaecology and Perinatal Mental Health. Advanced Nursing and Midwifery Practitioners can provide a full episode of care for a patient; assessing, carrying out an intervention, prescribing medication and discharging.

The positive impacts for patients and services through the roles of Advanced Nurse Practitioners include:

• each ANP removes on average 3.9 patients per week from specialist waiting lists
• on average 4.3 patients per ANP are avoiding hospital admission on a weekly basis
• there is a reduction in overall Patient Experience Times (PET) of up to 2 hours 43 minutes for patients seen in emergency care areas which include ANPs as part of the care delivery model
• over 95% of patients reporting a positive experience of the care received from an ANP

Registered Advanced Midwifery Practitioners promote wellness, offer healthcare interventions and advocate healthy lifestyle choices for women, their families and the community in a wide variety of settings in collaboration with other healthcare professionals. All nineteen maternity units now have at least one registered or candidate AMP in post. Their role is effecting positive changes in culture and practice.

AMPs are providing advanced service across multiple care pathways, ensuring that women are provided with continuity of care through the entire episode of pregnancy to discharge.

They lead in many specialised care pathways including, Diabetes in Pregnancy Care, VBAC clinics (Vaginal Birth After Caesarean) and Urodynamics (service to antenatal, postnatal and gynaecology patients who develop urinary retention or urinary issues as a result of their pregnancy, in the postnatal period or as a result of gynaecology interventions).

Advanced Nurse Practitioners working in Women’s Health provide a nurse led service in Colposcopy, providing holistic care to women with abnormal smear cytologies.

Specialist Perinatal Mental Health Services are concerned with the prevention, detection and management of perinatal mental health problems that complicate pregnancy. The postnatal period and care is provided by a specialist multi-disciplinary team including ANPs. The first Advanced Midwife Practitioner in Perinatal Mental Health was appointed in 2021.

There are three registered ANP Sexual Assault Forensic Examiners in Ireland with recruitment underway for the remaining 3 posts as part of the implementation of the Department of Health’s [external-link https://www.gov.ie/en/publication/e9ee89-department-of-health-policy-review-of-the-national-sexual-assault-tr/ | ‘Sexual Assault Treatment Unit (SATU) Policy Review (2019)’.

Future developments in advanced practice in Women’s Health will include ambulatory gynaecological care. It is estimated that approximately 70% of benign gynaecology referrals are suitable for the ambulatory setting, alleviating pressures on acute beds and theatre access. As per the Ambulatory Gynae model, it is proposed that 90% of the women attending these Ambulatory Care Centres will be managed completely by Registered ANPs as their lead professional.

Interview opportunities available with Advanced Midwife Practitioners. Requests can be made to press_office@health.gov.ie

Women's Health Week is an annual event established under the Women's Health Action Plan, published this week by the Department of Health. Women's Health Week 2022 is running from 7 - 11 March. #WomensHealthWeek | #WomensHealthIRL | gov.ie/womenshealth