ADVANCED PRACTICE NURSES IN MELBOURNE' S HOSPITALS: CLINICAL COORDINATORS IN A RAPID ASSESSMENT MEDICAL UNIT

Maintaining optimum health and functioning of ageing populations is an ongoing challenge for acute care facilities worldwide. As populations age, the risk of illness and potential debility increases with the increased rate of comorbidity, multipharmacy and sensory and muscle bulk loss that accompany old age. With these factors comes the potential for increased hospital admission rate, prolonged immobility, reduced function and increasing length of stay (NHMRC 2000). To address these issues, a hospital in Melbourne has developed a Rapid Assessment Medical Unit (RAMU) which provides comprehensive multidisciplinary assessment and commences discharge planning for all medical patients within 48 hours of admission. Coordinating this function is a Clinical Coordinator (CC), who is an advanced practice nurse (APN): a particular feature of the model. Parsons and McMurty (1997) argue that APNs in this role significantly enhance effective utilisation of health services through comprehensive assessment and conceptualisation of patient health issues. The result is a streamlining of care, effective and efficient use of resources with an emphasis on discharge planning and community support. (author abstract)