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Hong Kong College of Medical Nursing

Advanced Practice Nursing Certification Program

Specialty Module for Preparing Fellowship Exit Examination

Syllabus

Hong Kong College of Medical Nursing

LG1, School of Nursing, Princess Margaret Hospital, 232 Lai King Hill Road,

Lai Chi Kok, Kowloon, Hong Kong

Website: http://www.hkcmn.com Email address: hkcmn2010@yahoo.com

Endorsed on: 10 April 2017

Hong Kong College of Medical Nursing

Advanced Practice Nursing (Medicine) Certification Program

Syllabus of Fellow Membership Examination (Sub-Specialty Module)

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Working Group HKAN Fellow

AU Kwai Kam Medicine – Haematology

CHOY Wai Ka Medicine – Haematology

NG See See, Celia Medicine – Haematology

NG Yuen Bing Medicine – Haematology

CHAN Ming Fung Maggie Medicine – Oncology

CHAN Sau Yee Medicine – Oncology

LEUNG Wai Yee Carenx Medicine – Oncology

MAK So Shan, Suzanne Medicine – Oncology

WONG Sin Ting, Michelle Medicine – Oncology

HO Eva Medicine – Renal

TAM Bonnie Medicine – Renal

CHAN Kristy Medicine – Respiratory

HUNG Ming Kuen Asenla Medicine – Respiratory

KO KT Medicine – Respiratory

CHAN Bik Ki Medicine – Rheumatology

CHENG Suk Ki Cheryl Medicine – Rheumatology

CHOI King Yee Joyce Medicine – Rheumatology

LEE Pik Fan Medicine – Rheumatology

LEUNG Wai Yan Medicine – Rheumatology

YU Yin Lai Judy Medicine – Rheumatology

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Advanced Practice Nursing (Medicine) Certification Program Syllabus of Fellow Membership Examination (Sub- Specialty Module)

Table of Contents:

I INTRODUCTION……………………………………………………………………………………………………………..3

II GOALS AND LEARNING OBJECTIVES………………………………………………………………………………3-4

III TRAINING ARRANGEMENT OF THE SUB-SPECIALTY MODULE………………….………..…………….…4-5

IV ENTRY REQUIREMENT …………………………………………………………………………………………………..5

V HAEMATOLOGY NURSING …………………………………………………………………………………......…6-10

VI ONCOLOGY NURSING……………………………………………………………………………………………….11-15

VII RENAL NURSING………………………………………………………………………………………………………16-22

VIII RESPIRATORY NURSING……………………………………………………………………………………………23-25

IX RHEUMATOLOGY NURISNG……………………………………………………………………………………..26-29

COURSE CALENDER ………………………………………………………………….…………………………………..11 X COURSE CALENDER………………………………………………………………………………………………………30

XI FELLOW MEMBERSHIP EXIT ASSESSMENT …………………………………………………….…………30-31

XII AWARD ……………………………………………………………………..……………………………………….……….31

XIII APPENDIX ………………………………………………………………………………………………………………32-37

-ROAD MAP

-THE COMPETENCE FRAMEWORK OF 7 DOMAINS

ATTACHMENT

- CLINICAL LOG BOOK – Haematology Nursing - CLINICAL LOG BOOK – Oncology Nursing - CLINICAL LOG BOOK – Renal Nursing - CLINICAL LOG BOOK – Respiratory Nursing

- CLINICAL LOG BOOK - Rheumatology Nursing =

- CLINICAL LOG BOOK – Rehabilitation - CLINICAL LOG BOOK – Rheumatology

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I Introduction

1.1 For nurses who desired to be Fellow Members of Advanced Practice of the Hong Kong College of Medical Nursing (HKCMN), they must pass the Membership Exit Examination and gain the award of Ordinary Members of HKCMN and HKAN respectively, and then they will take one of the Sub-Specialty Modules (provided they have acquired a minimum of 1 year in the sub-specialty prior to obtaining Ordinary Member award) to prepare for the Fellow Membership Exit Assessment. (appendix 1)

1.2 Sub-Specialty Module

- Advanced Medical Nursing - Hematological Nursing - Infectious Disease Nursing - Neurology Nursing - Oncology Nursing - Palliative Nursing - Renal Nursing - Rehabilitation Nursing - Respiratory Nursing - Rheumatology Nursing

1.3 The S u b - Specialty Module aims to provide a compressive range of advanced practice strategies to facilitate the Ordinary Members of HKCMN/HKAN to polish his/her skills and knowledge in relation to Medical Nursing. Through practice, the candidates will integrate the theory and practice to build up unique professional knowledge and practice to enhance the medical nursing services provision, enabling the patients and families to cope with the illness episodes, to promote and protect their health. The candidates will lead the development of quality improvement programs to minimize risk- prone activities for betterment of healthcare services. To enhance healthcare for community at large, the candidates will advocate and participate actively in health care policy.

II Goals and Learning Objectives

2.1 The S u b - Specialty Module is designed to prepare nurses working in medical related healthcare area to fulfill the training requirement to sit for the fellow membership assessment organized by HKCMN.

2.2 Learning objectives :

Upon completion of the Sub-specialty Module, the Candidate shall be able to :

2.2.1 Master and apply the contemporary and advanced health care knowledge in caring patients and families with acute / chronic medical diseases in various health care settings

2.2.2 Advocate and implement evidence-based practice in daily nursing care of acute / chronic medical patients of the following s u b - specialties: Advanced Medicine, Hematology; Infectious Disease; Neurology; Oncology; Palliative; Rehabilitation: Renal; Respiratory; Rheumatology;

2.2.3 Initiate comprehensive assessment, screening to facilitate the diagnosis

2.2.4 Analyze the support system to identify factors related to the family, social support and coping mechanism to facilitate the patient(s) recovery and/or rehabilitation through the illness episode(s)

2.2.5 Implement and evaluate therapeutic interventions

2.2.6 Identify etiology, pathogenesis and clinical manifestation of the disease(s)

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2.2.7 Work in partnership with the healthcare team to interpret laboratory and other diagnostic tests for differential diagnosis and care plan formulation

2.2.8 Identify patients with deteriorating conditions early and enables patient to receive appropriate treatment promptly

2.2.9 Maintain treatment regimens recognizing the pharmacodynamics and pharmacokinetic processes

2.2.10 Exercise professional autonomy and decision making in clinical case management with interventions as indicated and coordinate multi-disciplinary approach treatment plan

2.2.11 Promote health to patients and their families to enforce health life styles 2.2.12 Strengthen cross specialties / cross hospital (s) / community resources to improve service

delivery to meet complex patient care needs.

2.2.13 Initiate and lead nursing research to enhance nursing care practice in medical patient management.

III Training Arrangement of the Sub-Specialty Module

3.1 The duration of the Sub-Specialty Module including theory and clinical practice should be of a minimum of 1 year and not more than 2 years.

3.2 To fulfill the requirement, the candidates should in addition to attending the Advanced Practice Nursing Certification S u b - Specialty Module Program organized by HKCMN; they are to pursue healthcare related specialty training programs organized by external institutions to enrich their knowledge.

3.3 Criteria for accreditation :

- Organizing institutions whom are CNE providers accredited by the Nursing Council of Hong Kong or accredited/ recognized education providers in Hong Kong

- The program is structured to map the competency framework (Appendix 2) of HKCMN

3.4 The Candidates are to log the clinical experience into the respective Clinical Log Book, produce evidence of learning and be assessed by a designated mentor. The clinical learning experiences are to be carried out in various healthcare institutions accredited by HKCMN.

3.5 Criteria of Accredited training sites:

- The hospital/ health care institution is preferably accepted training ground by the Nursing Council of Hong Kong

- The hospital management is supportive to the training by setting conducive learning environment

- Learning resources are available such as library, e learning resources - Continuous professional development system is available - Workload are at an optimal level to facilitate learning

3.6 Criteria of Mentors - Fellow of HKAN and appointed by HKCMN - Actively engaged in the practice of Nursing - Able to conduct training in accredited training programs - Cannot hold trainer status in more than 2 subspecialties - Cannot at the same time undergo specialty training in any other subspecialties within

the Academy Colleges - He/she cannot take more than 3 trainees.

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3.7 Evidence of Learning: - Reflective learning paper - Active participation in nurse rounds - Research project related to the working areas - Paper presentation in a local or international conference - Leading quality improvement/patient safety activities - Initiate a new project/ program in practice - Handling of complicated patient episode(s)

IV Entry Requirement

4.1 Entry requirement for Fellow Exit Assessment - Holder of a valid Registered Nurse (RN) Certificate issued by the Nursing Council of Hong Kong

and with valid Practicing Certificate - Accepted as the Ordinary Member of Hong Kong College of Medical Nursing and Hong Kong

Academy of Nursing - Worked in medical nursing related specialty for at least an accumulative 6 years in the most

recent 9 years - With the accumulative 6 years in medical nursing experience of which current 3 years must be

working in related Sub-Specialty area

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V Haematology Nursing Sub-specialty Module 5.1 Fundamental Module

5.1.1 Haematological Disease: Clinical features, diagnostic criteria and Related Management i. Red Cell Disorders and Anaemia

- Erythropoiesis and Anaemia - Nutritional Anaemia - Iron (Fe) Deficiency Anaemia - Vitamin B12 Deficiency - Folate Deficiency - Paroxysmal Nocturnal Haemoglobinuria (PNH) - Autoimmune Haemolytic Anaemia - Aplastic Anaemia - Red Cell Aplasia - Iron Overload - Thalassemia

ii. White Cell Disorders Neutropenia, Lymphocytosis, lymphopenia, basophilia and basopenia

iii. Platelet Disorders, Haemostasis and Bleeding Disorders - Von Willebrand Disease (vWD) - Haemophilia A and B - Thrombocytopenia - Disseminated Intravascular Coagulation (DIC) - Immune Thrombocytopenic Purpura (ITP) - Acute Venous Thromboembolism (VTE): Heritable thrombophilia, Acquired

thrombophilia, - Inherited bleeding disorders (Haemophilia A, Haemophilia B, Von Willebrand

Disease) - Thrombotic Thrombocytopenic Purpura (TTP)

iv. Plasma Cell Disorders - Monoclonal gammopathy of undetermined significance – MGUS - Amyloidosis

v. Haematological Malignancies - Leukemia:

Acute Myeloid Leukemia (AML); Acute Promyelocytic Leukemia (APL); Acute Lymphoblastic Leukemia (ALL); Chronic Lymphoblastic Leukemia (CLL) Chronic Myeloid Leukemia (CML)

- Myeloproliferative Neoplasm (MPNs) Polycythemia Ruba Vera (PRV) Essential Thrombocythaemia (ET)

- Myelodysplasia Myelodysplastic Syndromes (MDS) and classification

- Malignant Lymphoma Hodgkin’s Lymphoma Non-Hodgkin’s Lymphoma

- Plasma Cell Myeloma vi. Supportive

- Hepatitis & anti-viral therapy in haematological malignancies - Antifungal therapy - Common haematological emergencies:

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Blood Transfusion Reaction Hypercalcaemia Hyperviscosity Disseminated Intravascular Coagulation (DIC) Superior Vena Cava obstruction Tumor Lysis Syndrome Cord Compression All-Trans Retinoic Syndrome

5.1.2 Ambulatory Medical / Haematology Care and Community Service

i. Patient empowerment - Self-care on: Central Venous Access Devices ( CVADs); Desferroxime

injection - G-CSF injection and factor replacement - Care & education before, during and after chemotherapy, complications

and upon discharge ii. Community and patient collaboration: patient group communication and activities

5.2 Health Assessment Module

5.2.1 Initial assessment on patient newly diagnosed with Haematological malignancies and patient for Haematopoietic Stem Cell Transplantation (HSCT)

5.2.2 Initial assessment on patient for Apheresis procedure 5.2.3 Nutritional assessment for patient undergone HSCT 5.2.4 Oral care and prevention of emesis 5.2.5 Symptomatic based assessment for post chemotherapy complication and neutropenia

5.3 Nursing Care Module

5.3.1 Establishment of patient centered care Therapeutic relationship 5.3.2 Management of patients with blood product transfusion.

5.3.3 Management of patients with Central Venous Access Devices ( CVADs): - Hickman’s catheter - Haemostar catheter - Peripherally Inserted Central Venous Catheter (PICC) - Port-A Cath

5.3.4 Management of patients with complex Haematological conditions: - Haematological Emergencies:

Septic shock, Disseminated intravascular coagulation, hypercalcaemia, superior vena cava obstruction (SVC), tumor lysis syndrome, cord compression, All-trans retinoic syndrome, Hyperviscosity

- Neutropenic sepsis 5.3.5 Management of patients with chemotherapy and biotherapy for haematological

malignancies. 5.3.6 Management of Haematopoietic Stem Cell Transplant (Allogeneic and Autologous) patients, including pre and post transplantation coordination and management.

5.3.7 Management of patient with post transplantation relapses. 5.3.8 Management of patient with inherited anaemia. 5.3.9 Management of patient with inherited bleeding disorders. 5.3.10 Management of patients with Acquired coagulation disorders, thrombocytopenia and haemophilia.

5.3.11 Management of patients with Leukemia. 5.3.12 Management of patients with Lymphoma 5.3.13 Management of patients with Multiple Myeloma 5.3.14 Management of patients with Aplastic Anaemia.

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5.3.15 Management of patients with haematological conditions on palliative care, pain management, psychological support and end of life care . 5.3.16 Management of patients underwent the following procedures: - Bone Marrow Biopsy - Radiotherapy - Intrathecal Chemotherapy - Intravenous access cannulation and blood taking - Stem cell harvest - Stem cell infusion - Pre-transfusion compatibility test: Type and Screen - Human Leukocyte Antigen (HLA) tissue typing - Pentamidine Inhalation - Funding subsidy coordination and follow up 5.3.17 Management of patients with apheresis. - Therapeutic Apheresis - Stem cell harvest 5.3.18 Infection control for haematological and HSCT patients 5.3.19 Management of patients with haematological conditions undergone radiotherapy.

5.4 Development of Nurse Led Clinics 5.5 Legal and ethical issues 5.6 Quality and risk management 5.7 Management and leadership skills 5.8 Facilitate change and adopt evidence-based practice in nursing care

5.9 Design and Framework of Haematology Nursing Sub-Specialty Module The Haematology Nursing Sub-Specialty Module is designed under the competency framework (appendix 2) of HKCMN. Below indicated the Sub-Specialty Module matching the competency framework:

No. Subject Areas Domains

1 2 3 4 5 6 7

Fundamental Module 5.1.1 Haematological Disease: Clinical features, diagnostic criteria and related

management

i. Red Cell Disorders 1,4,5,6,9,11

All 1,3,4,5,6

1 6,7 1

ii. Aplastic Anaemia 1,4,5,

6,9,11

All 1,3,4,

5,6

1 6,7 1

iii. Inherited anaemia (Thalassemia) 1,4,5,

6,9,11

All 1,3,4,

5,6

1 6,7 1

iv. Inherited bleeding disorders

(Hemophilia)

1,4,5,

6,9,11 All 1,3,4,

5,6 1 6,7 1

v. White Cell Disorder 1,4,5,

6,9,11 All 1,3,4,

5,6 1 6,7 1

vi. Platelet, Haemostasis and bleeding

disorders

1,4,5,

6,9,11 All 1,3,4,

5,6 1 6,7 1

vii. Plasma cell disorders 1,4,5,

6,9,11 All 1,3,4,

5,6 1 6,7 1

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viii. Myelodysplastic Syndromes 1,4,5,

6,9,11 All 1,3,4,

5,6 1 6,7 1

ix. Myeloproliferative Disease 1,4,5,

6,9,11 All 1,3,4,

5,6 1 6,7 1

x. Thrombotic thrombocytopenic Purpura

(TTP)

1,4,5,

6,9,11 All 1,3,4,

5,6 1 6,7 1

xi. Immune Thrombocytopenic Purpura (ITP) 1,4,5,

6,9,11 All 1,3,4,

5,6 1 6,7 1

xii. Haematological Malignancies 1,4,5,

6,9,11 All 1,3,4,

5,6 1 6,7 1

xiii. Haematological Emergencies 1,4,5,

6,9,11 All 1,3,4,

5,6 1 6,7 1

5.1.2 Ambulatory Medical / Haematology Care and Community Service

i. Patient empowerment All 3,4 1,2,3 1

ii. Community and patient collaboration: patient group communication and activities

2,3,4,5,6,7,8,9,10,11

1,3,4,5,8

1,2 13 1

Health Assessment Module

5.2.1 Initial assessment on patient newly diagnosed with Haematological Malignancies and patient for Haematopoietic Stem Cell Transplantation (HSCT)

All All 1,3 1,2,3,5,6

1,3, 4,6

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5.2.2 Initial assessment on patients for apheresis procedure

All 1,4, 1,3, 4,6

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5.2.3 Nutritional assessment for patient undergone HSCT

All 1,4, 1,2,3,4

1,2,3,5,6

1,3, 4,6

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5.2.4 Oral care and prevention of emesis All 1,4, 1,2,3,5,6

1,3, 4,6

6, 8

5.2.5 Symptomatic based assessment for post chemotherapy complication and neutropenia

All 1,2,3,4,5,6,8

1,2,3 1,2,3,5,6

1,3, 4,6

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Nursing Care Module

5.3.1 Establishment of patient centered care and therapeutic relationship

All All 1,3,4,5

2 1

5.3.2 Management of patients with blood product transfusion

All 1,2,3,4,5,6,8

1,3,4 1,2,3 1,2,3 2,3,4,5,9,10.11

5.3.3 Management of patients with CVADs All 1,2,3,4,5,6,8

1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

5.3.4 Management of patient with complex Haematological conditions

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9

1

5.3.5 Management of patients with chemotherapy and biotherapy for haematological malignancies

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9

1

5.3.6 Management of HSCT (Allogeneic and Autologous) patients, including pre and post transplantation coordination and management

All All 1,2,3,4,5

1,2,4 1,2 2,3,4,5,9

1

5.3.7 Management of patients with post HSCT All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9

1

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transplantation relapses

5.3.8 Management of patients with inherited anaemia

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9

1

5.3.9 Management of patients with inherited bleeding disorders

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9

1

5.3.10 Management of patients with Acquired coagulation disorders, thrombocytopenia and haemophilia

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9

1

5.3.11 Management of patients with Leukemia All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9

1

5.3.12 Management of patients with Lymphomas

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9

1

5.3.13 Management of patients with Multiple Myeloma

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9

1

5.3.14 Management of patients with Aplastic Anaemia

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9

1

5.3.15 Management of patients with haematological conditions on palliative care, pain management, psychological support and end of life care

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9

1

5.3.16 Management of patients undergone Haematological procedures

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9

1

5.3.17 Management of patients with apheresis All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9

1

5.3.18 Infection control for Haematological and HSCT patients

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9

1

5.3.19 Management of patients with haematological conditions undergone radiotherapy

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9

1

5.4 Development of nursing service and nurse-led clinic

All 5,6 1,2,3,4,5,6,

2,5 1,2

5.5 Legal and ethical issues 3,8 1,2,4 1,4 1,4,14

5.6 Quality and risk management 1,3,4, 1,2,3,4,5,6,

2,3,4,5

All 1

5.7 Management and leadership skills All 7 1,2,3,4,5,6

1,2,3,4,5,6

4,5,6,7

9,10, 11,12,13

1,2

5.8 Facilitate change and adopt evidence-based practice in nursing care

5 1,5 1,5,6 2,3,5,6,7

1,9,11,12,13,14

1,2

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VI Oncology Nursing Sub-Specialty Module Reference: Gobel B. M., Triest-Robertson S. & Vogel W.H. (Eds). (2015). Advanced Oncology Nursing Certificate Review and Resources Manual. Pittsburgh: Oncology Nursing Society. 6.1 Prevention, Early detection and Screening of Cancer 6.1.1 Epidemiology 6.1.2 Prevention 6.1.3 Cancer screening and diagnostic test 6.1.4 Public participation in prevention, screening and early detection

6.2 Diagnosis and Staging of Cancer 6.2.1 Pathophysiology of cancer 6.2.2 Classification and staging 6.2.3 Diagnostic measures for specific cancer types

6.3 Treatment Modalities a) Surgery b) Systemic therapy: chemotherapy, biological agents, hormone and targeted

therapies c) Radiation therapy d) Concurrent combination therapy e) Hematopoietic stem cell transplant f) Complementary alternative health care

6.4 Knowledge of Cancer Diseases 6.4.1 Management of patients with a) Breast cancer b) Brain and central nervous system cancer c) Colorectal cancer d) Gastrointestinal cancer e) Genitourinary cancer f) Gynecological cancer g) Head and neck cancer h) Leukemia i) Lung cancer j) Lymphomas K) Melanoma l) Myelomas m) Prostate cancer

6.5 Symptom and Treatment Management 6.5.1 Oncology emergencies a) Disseminated intravascular coagulation (DIC) b) Extravasations c) Febrile neutropenia d) Hypercalcemia e) Hypersensitivity f) Increased intracranial pressure g) Malignant bowel / urinary obstruction

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h) Neoplastic cardiac tamponade i) Pneumonitis j) Sepsis K) Spinal cord compression l) Superior vena cava obstruction m) Syndrome of inappropriate antidiuretic hormone (SIADH) n) Tumour lysis syndrome 6.5.2 Treatment delivery device and systems 6.5.2.1 Role and types and safe management of treatment delivery devices (e.g.

peripheral and central venous access devices, infusion pumps) 6.5.2.2 Assessment, care and maintenance of venous access devices 6.5.2.3 Patient education and subsequent monitoring 6.5.3 Management of disease symptoms and treatment related side effects

including alternations in the followings a) Bone marrow function b) Mobility c) Skin / mucosal integrity d) Neurological status e) Mental status f) Circulation g) Ventilation h) Gastrointestinal function i) Metabolic function j) Urinary function k)

l) Comfort i.e. Pain Psychosocial status

6.6 Supportive Care 6.6.1 Patient diversity 6.6.2 Sexuality and intimacy 6.6.3 Patient and family support throughout the cancer continuum 6.6.4 Rehabilitation 6.6.5 Survivorship 6.6.6 Palliative and End-of-Life care 6.6.7 Bereavement

6.7 Continuity of Care 6.7.1 Navigate the patient in the health care system 6.7.2 Inter-professional health care team communication and collaboration

6.8 Ethics, Legal Obligations and Research 6.8.1 Ethical principles in care of cancer patient 6.8.2 Ethical dilemmas 6.8.3 Legal obligations 6.8.4 Purpose and design of research studies 6.8.5 Ethical principles associated with research

6.9 Development of Nurse-led Clinics 6.10 Facilitate change and adopt evidence-based practice in nursing care

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6.11 Quality and risk management 6.12 Management & leadership 6.10 Design and Framework of Oncology Nursing Sub-Specialty Module

The Oncology Nursing Sub-Specialty Module is designed under the competency framework (appendix 2) of HKCMN. Below indicated the Sub-Specialty Module matching the competency framework:

Subject areas Domains

1 2 3 4 5 6 7 6.1 Prevention, Early Detection and Screening of Cancer

2,3,5,9,10,11 1,2,3,4,5,6,8 1,2 1,4 1,2,3,4,5,8,

9,10 1

6.2 Diagnosis and Staging of cancer

1,2,3,4,5,6,7, 9,10

1,3,4,6,8 2 1,6 1,2,5,8 1

6.3 Treatment Modalities

a) Surgery all all 1,2,3,4,5 2,4,5,6 1,2,3,4,5,6 1,2,3,4,5,6,7,8,

9,10,11,12 1

b) Systemic therapy all all 1,2,3,4,5 2,4,5,6 1,2,3,4,5,6 1,2,3,4,5,6,7,8,

9,10,11,12 1

c) Radiation therapy all all 1,2,3,4,5 2,4,5,6 1,2,3,4,5,6

1,2,3,4,5,6,7,8, 9,10,11,12

1

d) Concurrent combination therapy

all all 1,2,3,4,5 2,4,5,6 1,2,3,4,5,6 1,2,3,4,5,6,7,8,

9,10,11,12 1

e) Hematopoietic stem cell transplant

all all 1,2,3,4,5 2,4,5,6 1,2,3,4,5,6 1,2,3,4,5,6,7,8,

9,10,11,12 1

f) Complementary alternative health care

1,2,6,7,8,9,11 all 1,2,3,4,5 4 2,8,9,10

6.4 Knowledge of Cancer Diseases – Management of Patient with

a) Breast cancer all all all all all all all

b) Brain and central nervous system cancer

all all all all all all all

c) Colorectal cancer all all all all all all all

d) Gastrointestinal cancer all all all all all all all

e) Genitourinary cancer all all all all all all all

f) Gynecological cancer all all all all all all all

g) Head and neck cancer all all all all all all all

h) Leukemia all all all all all all all

i) Lung cancer all all all all all all all

j) Lymphomas all all all all all all all

k) Melanoma all all all all all all all

l) Myelomas all all all all all all all

m) Prostate cancer all all all all all all all

6.5 Symptom and Treatment Management

6.5.1 Oncology emergencies

a) Disseminated intravascular coagulation (DIC)

1,2,3,4,5,6,7, 8,9,11

all all all all 1,2,3,4,5,6,7,8,

9,10,11,12 1

b) Extravasations 1,2,3,4,5,6,7, 8,9,11

all all all all 1,2,3,4,5,6,7,8,

9,10,11,12 1

c) Febrile neutropenia 1,2,3,4,5,6,7, 8,9,11

all all all all 1,2,3,4,5,6,7,8,

9,10,11,12 1

d) Hypercalcemia 1,2,3,4,5,6,7, 8,9,11

all all all all 1,2,3,4,5,6,7,8,

9,10,11,12 1

e) Hypersensitivity 1,2,3,4,5,6,7, 8,9,11

all all all all 1,2,3,4,5,6,7,8,

9,10,11,12 1

f) Increased intracranial pressure

1,2,3,4,5,6,7, 8,9,11

all all all all 1,2,3,4,5,6,7,8,

9,10,11,12 1

g) Malignant bowel / urinary obstruction

1,2,3,4,5,6,7, 8,9,11

all all all all 1,2,3,4,5,6,7,8,

9,10,11,12 1

h) Neoplastic cardiac tamponade

1,2,3,4,5,6,7, 8,9,11

all all all all 1,2,3,4,5,6,7,8,

9,10,11,12 1

i) Pneumonitis 1,2,3,4,5,6,7, 8,9,11

all all all all 1,2,3,4,5,6,7,8,

9,10,11,12 1

j) Sepsis 1,2,3,4,5,6,7, all all all all 1,2,3,4,5,6,7,8, 1

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8,9,11 9,10,11,12

k) Spinal cord compression 1,2,3,4,5,6,7, 8,9,11

all all all all 1,2,3,4,5,6,7,8,

9,10,11,12 1

l) Superior vena cava obstruction

1,2,3,4,5,6,7, 8,9,11

all all all all 1,2,3,4,5,6,7,8,

9,10,11,12 1

m) Syndrome of inappropriate antidiuretic hormone (SIADH)

1,2,3,4,5,6,7, 8,9,11

all all all all 1,2,3,4,5,6,7,8,

9,10,11,12 1

n) Tumour lysis syndrome 1,2,3,4,5,6,7, 8,9,11

all all all all 1,2,3,4,5,6,7,8,

9,10,11,12 1

6.5.2 Treatment delivery device and systems

6.5.2.1 Role and types and safe management of treatment delivery devices

2,10 3

3,7 1,5,6,8,10,11

6.5.2.2 Assessment, care and maintenance of venous access devices

1,2,3,4,5,6,7, 8,9,11

1,2,3,4,5,6,8 all 1,2,3 all

1,2,3,4,5,6,7,8, 9,10,11

1

6.5.2.3 Patient education and subsequent monitoring

1,2,3,4,5,6,7, 8,9,11

1,2,3,4,5,6,8 1,2,3 3,4,5,6 all

1,2,3,4,5,6,7,8, 9,10,11

1

6.5.3 Management of disease symptoms and treatment of related side effects including alterations in the following

a) Bone marrow function 1,2,3,4,5,6,7, 8,9,11

1,2,3,4,5,6,8 3 1,2,3,4,6 all all 1

b) Mobility 1,2,3,4,6,7,9, 11

1,2,3,4,5,6,8 3 1,2,3,4,6 all all 1

c) Skin/ mucosal integrity 1,2,3,4,6,7,9, 11

1,2,3,4,5,6,8 3 1,2,3,4,6 all all 1

d) Neurological status 1,2,3,4,5,6,7, 8,9,11

1,2,3,4,5,6,8 3 1,2,3,4,6 all all 1

e) Mental status 1,2,3,4,5,6,7, 8,9,11

1,2,3,4,5,6,8 3 1,2,3,4,6 all all 1

f) Circulation 1,2,3,4,5,6,7, 8,9,11

1,2,3,4,5,6,8 3 1,2,3,4,6 all all 1

g) Ventilation 1,2,3,4,5,6,7, 8,9,11

1,2,3,4,5,6,8 3 1,2,3,4,6 all all 1

h) Gastrointestinal function 1,2,3,4,5,6,7, 8,9,11

1,2,3,4,5,6,8 3 1,2,3,4,6 all all 1

i) Metabolic function 1,2,3,4,5,6,7, 8,9,11

1,2,3,4,5,6,8 3 1,2,3,4,6 all all 1

j) Urinary function 1,2,3,4,5,6,7, 8,9,11

1,2,3,4,5,6,8 3 1,2,3,4,6 all all 1

k) Comfort i.e. Pain 1,2,3,4,5,6,7, 8,9,11

1,2,3,4,5,6,8 3 1,2,3,4,6 all all 1

l) Psychosocial status 1,2,3,4,5,6,7, 8,9,11

1,2,3,4,5,6,8 3 1,2,3,4,6 all all 1

6.6 Supportive Care

6.6.1 Patient diversity 2 all 3 4 3,7,8 1

6.6.2 Sexuality and intimacy 1,2,9,11 all 3 2,3,4 3,7,8 1

6.6.3 Patient and family support throughout the cancer continuum

1,2,3,11 all 3

4 1,8 1

6.6.4 Rehabilitation 1,2,3,4,6,7,8, 10,11

all 3

1,2,3,4,5,6 3,4,5,6,7,8 1

6.6.5 Survivorship 1,2,5,9,10,11 all 3

2,4,6,7

1,2,3,4,5,6,8,9 10,11,13,14

all

6.6.6 Palliative and End-of-Life care

1,2,3,4,5,6,7, 8,9,11

all 3 1,2,6 all all all

6.6.7 Bereavement 1,2,3,4,5,6,7, 8,9,11

all 3 1,2,6 all all all

6.7 Continuity of Care

6.7.1 Navigate the patient in the health care system

1,2,3,7,9,10, 11

1,3,4,8 1 4 4,6 2,8,9

6.7.2 Interprofessional health care team communication and collaboration

1,2,3,7,10

4 6

13

6.8 Ethics, Legal Obligations and Research

6.8.1 Ethical principles in care of cancer patient

3 3,4

2,3,8,9,11,14 1

6.8.2 Ethical dilemmas 3 3,4 2,3,8,9,11,14 1

6.8.3 Legal obligations 3 3,4 2,3,8,9,11,14 1

6.8.4 Purpose and design of research studies

6

3,6 1,5,6,7 1,4,5,6,7 1

15

6.8.5 Ethical principles associated with research

3,6 3,4 2,3,8,9,11,14 1

6.9 Development of nurse-led clinics

all all 1,3,4,5,6 all all 1,2,8,9,10 all

6.10 Facilitate change and adopt evidence-based practice in nursing care

all all 1,2,3,5 5 2,3,7 3,4,5,9,10 all

6.11 Quality and risk management

9 1,3,4 all 2,3,4,5,7 all 1

6.12Management & leadership all all all 3,4,5,6,7 all all

16

VII Renal Nursing Sub-specialty Module 7.1

Fundamental Module 7.1.1 Applied Anatomy & Physiology 7.1.2 Electrolyte & Acid-base Balance 7.1.3 Investigations on Renal Diseases

7.1.4 Health assessment module 7.1.4.1 Assessment of patient prior to renal replacement therapy (RRT), blood purification

or renal palliative care 7.1.4.2 Assessment of patient on either type of therapeutic therapy 7.1.4.3 Nutritional assessment of patient on various therapeutic therapy

7.2 Clinical manifestation and management of Renal Diseases (medical): 7.2.1 Primary glomerular disease:

7.2.1.1 Rapidly progressive glomerulonephritis (GN) 7.2.1.2 Membranoproliferative GN 7.2.1.3 Mesanginal proliferative GN 7.2.1.4 Minimal change diseases 7.2.1.5 Focal segmental glomerulosclerosis 7.2.1.6 Membraneous Nephropathy 7.2.1.7 IgA Nephropathy 7.2.2 Secondary Glomerular disease:

7.2.2.1 Autoimmune: SLE, Polyarteritis nodosa 7.2.2.2 Good pasture’s syndrome 7.2.2.3 Post-infectious glomerulonephritis: Hepatitis B or C virus 7.2.2.4 Herpes Zoster, HIV 7.2.2.5 Hypertension nephropathy 7.2.2.6 Renal vascular disease: Wegener’s granulomatosis, Henoch- Schonlein purpura,

ANCA small vessel vasculitis 7.2.2.7 Tubulo-interstitial disease: Acute interstitial nephritis, pyelonephritis 7.2.2.8 Urinary tract infection 7.2.2.9 Toxic nephropathy 7.2.2.10 Drug-induced: heroin, gold, mercury, NSAIDs, Interferon 7.2.2.11 Malignancy: Hodgkin’s disease, lymphoma, leukaemia, multiple myeloma, renal

papillary adenoma, renal cell carcinoma 7.2.2.12 Amyloidosis 7.2.2.13 Diabetic nephropathy

7.2.3 Clinical manifestation and management of Kidney Diseases (surgical approach): 7.2.3.1 Cystic disease of kidney : 7.2.3.1.1 Polycystic kidney disease

7.2.3.1.2 Solitary kidney cyst 7.2.3.1.3 Autosomal dominant polycystic kidney disease 7.2.3.1.4 Autosomal recessive polycystic kidney disease

7.2.3.2 Developmental disease: Vesico-ureterc reflux 7.2.3.3 Urinary tract obstruction disease

7.2.3.3.1 Obstructive nephropathy 7.2.3.3.2 Obstructive uropathy 7.2.3.3.3 Hydronephrosis 7.2.3.3.4 Benign prostatic hypertrophy 7.2.3.3.5 Urinary stone 7.2.3.3.6 Renal stone

17

7.3 Nursing Care Module 7.3.1 Acute Kidney Injury 7.3.2 Chronic Kidney Disease 7.3.3

Renal replacement therapies: 7.3.3.1 Peritoneal dialysis (PD)

7.3.3.1.1 Mode of peritoneal dialysis: Continuous Ambulatory Peritoneal Dialysis (CAPD), Automated Peritoneal Dialysis (APD)

7.3.3.1.2 Care of patient with PD therapy 7.3.3.1.3 Nursing management of patient with complications of PD

7.3.3.2 Hemodialysis (HD), hemofiltration (HF) 7.3.3.2.1 Types of vascular access for HD and its nursing management

7.3.3.2.2 Water treatment system for HD 7.3.3.2.3 Anticoagulation of HD

7.3.3.2.4 Mode of hemodialysis 7.3.3.2.5 Mode of hemofiltration 7.3.3.2.6 Care of patient with hemodialysis therapy 7.3.3.2.7 Nursing management of patient with complications of HD 7.3.3.2.8 Pediatric Hemodialysis & its nursing management

7.3.3.3 Renal transplantation 7.3.3.3.1 Pre-operative management of patient with renal transplantation

7.3.3.3.2 Post-operative management of patient with renal transplantation 7.3.3.3.3 Management of patient with renal graft rejection 7.3.3.3.4 Organ Transplant & Procurement : Ethical & Legal Implication on Services 7.3.3.3.5 Management of potential deceased and living donors 7.3.3.3.6 Tissue typing and matching 7.3.3.3.7 Renal transplant and immunology

7.3.4 Nursing management of patient with Diabetes on dialysis 7.3.5 Therapeutic blood purification

7.3.5.1 Plasma exchange 7.3.5.2 Light-chain dialysis 7.3.5.3 Hemoperfusion

7.3.6 Renal palliative care 7.3.6.1 Physical and psychological symptoms management

7.3.6.2 Care of patient and family 7.3.6.3 Care of the dying person in various settings 7.3.6.4 Advance care planning

7.4 Training of patient for home based renal dialysis 7.4.1 Training of patient with PD therapy 7.4.2 Training of patient with HD therapy

7.5 Rehabilitation of patient with end stage renal failure

7.6 Infection control in renal unit

7.7 Development of Nurse Led Clinics

7.8 Legal and ethical issues

7.8.1 Ethical principles in caring of patients with renal failure 7.8.2 End of life care 7.8.3 Ethical dilemmas 7.8.4 Legal obligations

18

7.9 Quality and risk management

7.10 Management and leadership skills

7.11 Facilitate change and adopt evidence-based practice in nursing care

7.12 Research 7.12.1 Research Proposal 7.12.2 Ethical principles associated with research

7.13 Data Management

7.13.1 Renal Registry 7.13.2 Clinical Audit

7.14 Design and Framework of Renal Nursing Sub-Specialty Module The Renal Nursing Sub-Specialty Module is designed under the competency framework (appendix 2) of HKCMN. Below indicated the Sub-Specialty Module matching the competency framework:

No. Subject Areas Domains

1 2 3 4 5 6 7

7.1 Fundamental Module

7.1.1 Applied Anatomy & Physiology 1,3,4,5,6,7,11

1

7.1.2 Electrolyte & Acid-base Balance

1,3,4,5,6,7,8,11

1,2,3,6

1,2 1 4,5,7

7.1.3 Investigation on Renal Diseases 1,3,4,5,6,7,8,11

1,2,3,6

1,2 1 4,5,7

7.1.4 Health assessment module

7.1.4.1 Assessment of patient prior to renal replacement therapy (RRT), blood purification or renal palliative care

All All 1,3 1,2,3,5,6

1,3, 4,6

8

7.1.4.2 Assessment of patient on either type of therapeutic therapy

All 1,4, 1,3, 4,6

8

7.1.4.3 Nutritional assessment of patient on various therapeutic therapy

All 1,4, 1,2,3,4

1,2,3,5,6

1,3, 4,6

8

7.2 Clinical manifestation and management of Renal Diseases (medical)

7.2.1 Primary Glomerular disease:

7.2.1.1 Rapidly progressive glomerulonephritis (GN) 1,4,5,6,9

,11

All 1,3,4,

5,6

1 6,7 1

7.2.1.2 Membranoproliferative GN 1,4,5,6,9

,11

All 1,3,4,

5,6

1 6,7 1

7.2.1.3 Mesanginal proliferative GN 1,4,5,6,9

,11

All 1,3,4,

5,6

1 6,7 1

7.2.1.4 Minimal change Diseases 1,4,5,6,9

,11

All 1,3,4,

5,6

1 6,7 1

7.2.1.5 Focal segmental glomerulosclerosis 1,4,5,6,9

,11

All 1,3,4,

5,6

1 6,7 1

7.2.1.6 Membraneous Nephropathy 1,4,5,6,9

,11

All 1,3,4,

5,6

1 6,7 1

19

7.2.1.7 IgA Nephropathy 1,4,5,6,9

,11

All 1,3,4,

5,6

1 6,7 1

7.2.2 Secondary Glomerular disease:

7.2.2.1 Autoimmune: SLE, Polyarteritis nodosa

All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.2.2 Good pasture’s syndrome All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.2.3 Post-infectious glomerulonephritis: Hepatitis B or C virus

All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.2.4 Herpes Zoster, HIV All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.2.5 Hypertension nephropathy All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.2.6 Renal vascular disease: Wegener’s granulomatosis, Henoch- Schonlein purpura, ANCA small vessel vasculitis

All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.2.7 Tubulo-interstitial disease: Acute interstitial nephritis, pyelonephritis

All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.2.8 Urinary tract infection All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.2.9 Toxic nephropathy All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.2.10 Drug-induced: heroin, gold, mercury, NSAIDs, Interferon

All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.2.11 Malignancy: Hodgkin’s disease, lymphoma, leukaemia, multiple myeloma, renal papillary adenoma, renal cell carcinoma

All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.2.12 Amyloidosis All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.2.13 Diabetic nephropathy All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.3 Clinical manifestation and management of Kidney Diseases (surgical approach):

7.2.3.1 Cystic disease of kidney :

7.2.3.1.1 Polycystic kidney disease All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.3.1.2 Solitary kidney cyst All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.3.1.3 Autosomal dominant polycystic kidney disease All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.3.1.4 Autosomal recessive polycystic kidney disease All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.3.2 Developmental disease: Vesico-ureterc reflux All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.3.3 Urinary tract obstruction disease All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.3.3.1 Obstructive nephropathy All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.3.3.2 Obstructive uropathy All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.3.3.3 Hydronephrosis All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.3.3.4 Benign prostatic hypertrophy All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.3.3.5 Urinary stone All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.2.3.3.6 Renal stone All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.3 Nursing Care Module

20

7.3.1 Acute Kidney Injury All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.3.2 Chronic Renal Failure All All 1,2,3,4,5,6

1,2,4 1,2 2,3,4,5,9

1

7.3.3 Renal replacement therapies:

7.3.3.1 Peritoneal dialysis (PD)

7.3.3.1.1 Mode of peritoneal dialysis: Continuous Ambulatory Peritoneal Dialysis (CAPD), Automated Peritoneal Dialysis (APD)

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.3.1.2 Care of patient with PD therapy All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.3.1.3 Nursing management of patient with complications of PD

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.3.2 Hemodialysis (HD), hemofiltration (HF)

7.3.3.2.1 Types of vascular access for HD and its nursing management

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.3.2.2 Water treatment system for HD

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.3.2.3 Anticoagulation of HD All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.3.2.4 Mode of hemodialysis

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.3.2.5 Mode of hemofiltration All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.3.2.6 Care of patient with hemodialysis therapy All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.3.2.7 Nursing management of patient with complications of HD

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.3.2.8 Pediatric Hemodialysis & its nursing management

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.3.3 Renal transplantation

7.3.3.3.1 Pre-operative management of patient with renal transplantation

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.3.3.2 Post-operative management of patient with renal transplantation

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.3.3.3 Management of patient with renal graft rejection

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.3.3.4 Organ Transplant & Procurement : Ethical & Legal Implication on Services

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.3.3.5 Management of potential deceased and living donors

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.3.3.6 Tissue typing and matching

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.3.3.7 Renal transplant and immunology All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.4 Nursing management of patient with Diabetes on dialysis

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

21

7.3.5 Therapeutic blood purification

7.3.5.1 Plasma exchange All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.5.2 Light-chain dialysis All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.5.3 Hemoperfusion All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.6 Renal palliative care

7.3.6.1 Physical and psychological symptoms management

All 1,2,3,4,5,6,7,8,9,10,11

nil All all 1,2,3,4,5,6,7,8,11,12,13,14

1

7.3.6.2 Care of patient and family All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.6.3 Care of the dying person in various settings All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.3.6.4 Advance care planning All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.4 Training of patient for home based renal dialysis

7.4.1 Training of patient with PD therapy All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.4.2 Training of patient with HD therapy

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.5 Rehabilitation of patient with end stage renal failure

All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9,1011

1

7.6 Infection control in renal unit All All 1,3,4,5

1,2,4 1,2,3,7

2,3,4,5,9

1

7.7 Development of Nurse Led Clinics All All 4, 5,6 All 2,5 All 1,2

7.8 Legal and ethical issues 3,8 4, 5,6 1,2,4 1,4 1,4,14

1

7.8.1 Ethical principles in caring of patients with renal failure

3 3,4

2,3,8,9,11,14

1

7.8.2 End of life care 3 3,4

2,3,8,9,11,14

1

7.8.3 Ethical dilemmas 3 3,4

2,3,8,9,11,14

1

7.8.4 Legal obligations 3 3,4

2,3,8,9,11,14

1

7.9 Quality and risk management 9 1,3,4, 4, 5,6 All 2,3,4,57

All 1

7.10 Management and leadership skills All 7 All All 3,4,5,6,7

All 1,2

7.11 Facilitate change and adopt evidence-based practice in nursing care

9 5 1,5,6 1,3,,5,6

2,3,5,6,7

1,6,7,9,11,12,13,14

1,2

7.12 Research

7.12.1 Research Proposal 6

3,6

1,5,6,7

1,4,5,6,7

1

7.12.2 Ethical principles associated with research 3,6 3,4

2,3,8,9,11,

14 1

22

7.13 Data Management

7.13.1 Renal Registry 9,11 , 1 5 6 3,4,5,12,13,14

1

7.13.2 Clinical Audit 2,3,4,5,6,7,8,9,10,11

1,2,3,4,5,6,8

1,2,3 All 1,2,3,4,5,6

3,4,5,11,12,13,

1, 2

23

VIII Respiratory Nursing Sub-specialty Module 8.1 Health Assessment 8.1.1 Applied anatomy and patho-physiology, etiology in respiratory patient care 8.1.2 Screening, diagnosis and related investigation / assessment for respiratory diseases 8.1.3 Screening of the infectious disease and safe environment control in preventing nosocomial

infections 8.1.4 Screening of patients according to updated Government supported programs such as Nurse &

Allied Health Clinic 8.2 Establishment of Patient Centered Care Therapeutic relationship 8.3 Multi-disciplinary Collaboration such as case conference and pre-discharge plan 8.4 Management patients with: 8.4.4 Receiving Interventional Pulmonology such as bronchoscopy, pleuroscopy & endobronchial

ultrasound (EBUS) 8.4.5 Pneumonia 8.4.6 Asthma 8.4.7 Chronic Obstructive Pulmonary Disease 8.4.8 Respiratory Failure / Acute Respiratory Distress Syndrome 8.4.9 Bronchiectasis 8.4.10 Pulmonary Fibrosis / Interstitial Lung Diseases 8.4.11 Neuromuscular Diseases 8.4.12 Pleural Diseases including Tumour, Spontaneous Pneumothorax, Pleural Effusion and pleural

empyema 8.4.13 Lung Cancer 8.4.14 Pulmonary Tuberculosis 8.4.15 Extra-pulmonary Tuberculosis 8.4.16 Multidrug Resistant / Extensive Drug Resistant Tuberculosis 8.4.17 Novel Viral Infection 8.4.18 Critical Respiratory conditions Receiving Oxygen Therapy 8.4.19 Critical Respiratory conditions with Non-invasive Ventilation (NIV) or Invasive Mechanical

Ventilation (IMV) 8.4.20 Tracheostomy 8.4.21 Chest Drain, Pigtail Drain & Indwelling Pleural Catheter (IPC) 8.4.22 Sleep Breathing Problem 8.5 Pulmonary Rehabilitation Program 8.6 Health education to patients Receiving: 8.6.1 Inhaled Medications 8.6.2 Home Oxygen Therapy 8.6.3 Home Non-invasive Ventilation including BiPAP & CPAP 8.6.4 Home Invasive Ventilation 8.6.5 Outpatient Parental Antibiotic 8.6.6 Chronic Disease Self-Management, Exacerbation Management and Patient Empowerment 8.7 Nurse Led Clinic – planning, development and operation 8.8 Develop Smoking Cessation Program 8.9 Patient advocacy and End-of-Life Care 8.10 Facilitate change and adopt evidenced based practice in nursing care 8.11 Initiate improvement strategies in quality and risk management

24

8.12 Design and Framework of Respiratory Nursing Sub-Specialty Module The Respiratory Nursing Sub-Specialty Module is designed under the competency framework (appendix 2) of HKCMN. Below indicated the Sub-Specialty Module matching the competency framework:

Subject areas Domains

1 2 3 4 5 6 7

I. Health Assessment 1. Applied Anatomy & patho-

physiology, etiology for Respiratory diseases

1,2,3,4,5,8

2. Screening, diagnosis and related investigation / assessment for Respiratory Diseases

3,5,6,7 1,3,4,8 1 5

3. Screening of the infectious disease and safe environment control in preventing nosocomial infections

All 1,2,3,4,8 1,2,3 1,2,3,5 1

4. Screening of patients according to updated Government supported programs such as Nurse & Allied Health Clinic

All 1,2,3,4,8 1,2,3 1,2,3,5 1

II. Establishment of Patient Centered Care Therapeutic relationship

All All

1,3,4,5 2 1

III. Multi-disciplinary Collaboration such as case conference and pre-discharge plan

All All

1,3,4,5 2 1

IV. Management of patients 1. Receiving Interventional

Pulmonology such as bronchoscopy, pleuroscopy & endobronchial ultrasound (EBUS)

All 1,2,3,4,5,8

1, 2, 4, 5 1,2,4 1 5 1

2. Pneumonia All 1,2,3,4,5,8 1, 2, 4 1 5 1

3. Asthma All 1,2,3,4,5,8 1, 2, 4 1 5 1

4. Chronic Obstructive Pulmonary Disease

All 1,2,3,4,5,8

1, 2, 4 1 5 1

5. Respiratory failure / Acute Respiratory Distress Syndrome

All 1,2,3,4,5,8

1, 2, 4 1 5 1

6. Bronchiectasis All 1,2,3,4,5,8 1, 2, 4 1 5 1

7. Pulmonary Fibrosis / Interstitial Lung Disease

All 1,2,3,4,5,8

1, 2, 4 1 5 1

8. Neuromuscular Diseases All 1,2,3,4,5,8 1, 2, 4 1 5 1

9. Pleural Diseases including Tumour, Spontaneous Pneumothorax and Pleural Effusion

All 1,2,3,4,5,8

1, 2, 4 1 5 1

10. Lung Cancer All 1,2,3,4,5,8 1, 2, 4 1 5 1

11. Pulmonary Tuberculosis, Multidrug Resistant Tuberculosis, Extensive Drug Resistant Tuberculosis, Latent Tuberculosis & Extra-pulmonary Tuberculosis

All 1,2,3,4,5,8

1, 2, 4 1 5 1

12. Novel Viral Infection e.g. SARS, Mers CoV

All 1,2,3,4,5,8

1, 2, 4 1 5 1

13. Critical Respiratory Conditions Receiving Oxygen Therapy

All 1,2,3,4,5,8

1, 2, 4 1 5 1

14. Critical Respiratory Conditions with Non-Invasive ventilation (NIV) or invasive mechanical ventilation (IMV)

All 1,2,3,4,5,8

1, 2, 4 1 5 1

15. Tracheostomy All 1,2,3,4,5,8 1, 2, 4 1 5 1

16. Chest Drain, Pigtail Drain & Indwelling Pleural Catheter (IPC)

All 1,2,3,4,5,8

1, 2, 4 1 5 1

17. Sleep Breathing Problem All 1,2,3,4,5,8 1, 2, 4 1 5 1

V. Pulmonary Rehabilitation Program

All All 1,2,3,4,5 1, 2, 4 2 1

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VI. Health Education to patient Receiving:

1. Inhaled Medications All 1,2,3,4,5,8 1,2,3,4,5 1, 2, 4 1 5 1

2. Home Oxygen Therapy All 1,2,3,4,5,8 1,2,3,4,5 1, 2, 4 1 5 1

3. Home Non-invasive Ventilation including BiPAP & CPAP

All 1,2,3,4,5,8 1,2,3,4,5 1, 2, 4 1 5 1

4. Home Invasive Ventilation All 1,2,3,4,5,8 1,2,3,4,5 1, 2, 4 1 5 1

5. Outpatient Parental Antibiotic All 1,2,3,4,5,8 1,2,3,4,5 1, 2, 4

6. Chronic Disease Self-Management, Exacerbation Management and Patient empowerment

All 1,2,3,4,5,8

All 1, 2, 4 1 5 1

VII. Nurse Led Clinic All All 5,6 1,2,3,4,5,6 2,5 2,3 1

VIII. Develop Smoke Cessation Program

All 1,2,3,4,5,8

All 1, 2, 4 1 5 1

IX. Patient Advocacy and End of Life care

All 1,2,3,4,5,8 1 3 1,4 2,5,9 1

X. Facilitate change and adopt evidence based practice in nursing care

1,2,3,5

2,3,7

3,4,5,9,10

XI. Develop and foster patient safe environment and initiate improvement strategies in quality and risk management

3 2,3,4,8 3,4 1,2,3, 4,5,6

1,2,3,7

4,5,6,7,9 10,11 12,13

1,2

26

IX. Rheumatology Nursing Sub-Specialty Module

9.1 Clinical aspect of Rheumatology 9.1.1 Musculoskeletal system, immune system, pain perception and pathways 9.1.2 Screening, diagnosis, related investigation and nursing assessment for Rheumatic Diseases

a) Musculoskeletal examination b) Functional assessment c) Joint assessment d) Disease Activity Score (DAS 28) e) CDAI/ SDAI f) Bath Indices for Ankylosis Spondylitis (AS) g) PASI score h) SELENA-SLEDAI i) SLICC j) Biomarkers k) Autoantibodies l) Blood result interpretation m) Radiology examination: Magnetic Resonance Imaging, Computerized Tomography,

Musculoskeletal ultrasound n) Tissue Biopsy (Skin/ Muscle) o) Arthrocentesis p) Intra-articular injection q) Capillaroscopy

9.1.3 Clinical features, assessment and management of patients with: a) Inflammatory Arthritis - Rheumatoid Arthritis (RA), Spondyloarthropathy (SpA) b) Connective Tissue Disease (CTD)

Systemic Lupus Erythematosus (SLE) Scleroderma Idiopathic inflammatory myopathies (Dermatomyositis, Polymyositis)

c) Crystal deposition diseases: Gout, Tophaceous gout, Pseudogout d) Infection related arthritis: Septic Arthritis, Reactive Arthritis e) Metabolic bone diseases: Osteoporosis, Endocrine related arthropathy f) Degenerative joint disease: Osteoarthritis g) Uncommon Rheumatic Disorders

Adult Still’s Disease Vasculitis (Giant Cell Arteritis, Eosinophilic Granulomatosis with Polyangiitis,

Microscopic Polyangiitis, Takayasu Artheritis) Polymyalgia Rheumatica Fibromyalgia Behçet’s syndrome Sjögren’s syndrome Relapsing polychrondritis

9.1.4 Dermatological perspective in rheumatic diseases with distinct features: Lupus Erythematosus, Dermatomyositis, Scleroderma, Rheumatoid Arthritis, Vasculitis

9.1.5 Orthopaedic perspective in rheumatic diseases: operative management in hand, knee & hip and foot & ankle (e.g. Joint replacement, joint reconstruction)

9.1.6 Management of special situations in patient with rheumatic diseases: sepsis, operation, malignancy, pregnancy, vaccination, and disease flare up

9.1.7 Medications management in rheumatic diseases a) Analgesics b) Non-steroidal anti-inflammatory drugs c) Steroid therapy d) Conventional disease modifying anti-rheumatic drugs (DMARDs) and

immunosuppressants e) Bone protection agents

27

9.2 Biologic Care 9.2.1 Types of biologics 9.2.2 Patient assessment and screening for biologic therapy 9.2.3 Counseling for biologic therapy: financial issues, pregnancy, family planning 9.2.4 Delivery of biologic infusion 9.2.5 Education of self-injection 9.2.6 Safety monitoring 9.2.7 Data management on biologic registry 9.3 Patient Education and Counseling 9.3.1 Patient’s journey, stage of changes and coping strategies 9.3.2 Formulate and implement patient education incorporating patient’s physical, psychosocial, and

developmental needs 9.3.3 Identify and assist patient’s concordance to treatment 9.3.4 Patient empowerment and self-management 9.3.5 Educate and counsel patient and/or support system regarding medications, problem solving,

communication skills, stress management, and safety issues 9.3.6 Educate and advise in Multidisciplinary Team (MDT) approach including physiotherapy,

occupational therapy, dietary management, podiatry and social worker 9.4 Psychosocial care 9.4.1 Comprehensive psychological and social assessment 9.4.2 Psychosocial impact of rheumatic diseases 9.4.3 Acknowledge depression and recognize early signs associated with various rheumatic disease

processes 9.4.4 Effective communication and counseling 9.4.5 Psychosocial aspect and current social resources from Medical Social Worker’s perspective 9.5 Care of patients with telecommunication methods 9.6 Coordination and collaboration of care 9.6.1 Collaborate with physicians, nurses, dietitian, social workers, psychologists, occupational

therapists, physiotherapists, podiatrists and community agencies in planning appropriate management of patient problems

9.6.2 Explore and collaborate the community resources which provide psychotherapeutic services: Community Rehabilitation Network, Hong Kong Arthritis & Rheumatism Foundation

9.7 Develop nurse-led clinic 9.8 Develop care-pathway and care model on Rheumatic diseases 9.9 Develop and foster patient safe environment and initiate improvement strategies in quality

and risk management 9.10 Develop/review clinical care protocols and facilitate change by adoption of evidence-based

practice in Rheumatology care 9.11 Management and leadership skills

9.12 Design and Framework of Rheumatology Nursing Sub-Specialty Module The Rheumatology Nursing Sub-Specialty Module is designed under the competency framework (appendix 2) of HKCMN. Below indicated the Specialty Module matching the competency framework:

Subject areas Domains 1 2 3 4 5 6 7

9.1 Clinical aspect of Rheumatology

9.1.1 Musculoskeletal system, immune system, pain perception and pathways

3,4,5,6,7,11

2,3,5 --- --- --- 1

9.1.2 Screening, diagnosis, related investigation and nursing assessment for Rheumatic

1,3,4,5,6,7,8, 11

1,2,3,6 1,2 1,2,5 1 4,5,7 1

28

Diseases 9.1.3 Clinical features, assessment and management of patients with:

a) Inflammatory Arthritis – RA, SpA

All All --- --- 1,2,3,4 1 1

b) CTD – SLE, Scleroderma, Inflammatory myopathies

All All --- --- 1,2,3,4 1 1

c) Gout, Tophaceous gout, Pseudogout

All All --- --- 1,2,3,4 1 1

d) Infection related joint diseases: Septic Arthritis, Reactive Arthritis

All All --- --- 1,2,3,4 1 1

e) Metabolic bone disease – Osteoporosis, Endocrine related arthopathy

All All --- --- 1,2,3,4 1 1

f) Degenerative bone diseases: Osteoarthritis

All All --- 1,2,3,4 1 1

g) Uncommon Rheumatic disorders - Adult Still’s Disease - Vasculitis - Polymyalgia Rheumatica - Fibromyalgia - Behçet’s disease - Sjögren’s syndrome - Relapsing Polychrondritis

All All --- --- 1,2,3,4 1 1

9.1.4 Clinical evaluation for patient with inflammatory arthritis with different assessment tools

All 1,2,3,6 --- --- 1,2,3,4 2 1

9.1.5 Dermatological perspective in rheumatic diseases with distinct features: Lupus Erythematosus, Dermatomyositis, Scleroderma, Rheumatoid Arthritis, Vasculitis

All All --- --- 1,2,3,4 1 1

9.1.6 Orthopaedic perspective in rheumatic diseases: operative management in hand, knee & hip and foot & ankle

1,2,3,6,7,9,10,11

1,2,3,4,5,8

--- --- 1,2,3,4 1,3 1

9.1.7 Management of special situations in patient with rheumatic disease: Sepsis, operation, Malignancy, Pregnancy, Vaccination, and Disease Flare Up

All All --- --- 1,2,3,4,5,7

1,2,3,4,5,6,7,8

1

9.1.8 Medications management in rheumatic disease

All All --- 1,2,5 All 1,2,3,4,5,6,7,8

1

9.2 Biologic Care 9.2.1 Types of biologics 2,3,4,5,7,8

,9, 11

2,3,4,8 --- --- All 1,2,3,5,6,7,8

1

9.2.2 Patient assessment and screening for biologic therapy

All 1,2,3,4,5,6,8

--- --- All 1,2,3,5,6,7,8

1

9.2.3 Counseling for biologic therapy: financial issues, pregnancy, family planning

All 1,2,3,4,5,6,8

--- --- All 1,2,3,5,6,7,8

1

9.2.4 Delivery of biologic infusion

All All --- All All 2,3,5,6,7,8 1

9.2.5 Education of self-injection All 1,2,3,4,5,6,8

--- All All 2,3,5,6,7,8 1

9.2.6 Safety monitoring All All --- All All 1,2,3,5,6,8 1 9.2.7 Data management on biologic registry

9, 11 --- --- --- All 4,5,6,7 1

9.3 Patient Education 9.3.1 Patient’s journey, stage of changes and coping strategies

1,2,3,6,8,9 All 1,2 --- --- --- 1

9.3.2 Formulate and implement patient education incorporating

All All All 1,5 --- 2,3,5,6,7 1

29

patient’s physical, psychosocial, and developmental needs 9.3.3 Identify and assist patient’s concordance to treatment

All All 1,2 --- 4 --- 1

9.3.4 Patient empowerment and self-management

All All All 2,3,4,5,6 1,4,6 1,2,8,9,11,12

1

9.3.5 Educate and counsel patient and/or support system regarding medications, problem solving, communication skills, stress management, and safety issues

All All All 1 --- 2,3,5,6,7 1

9.3.6 Educate and advise in MDT approach including physiotherapy, occupational therapy, dietary management, podiatry and social worker

All All All 1,6 --- 2,3,5,6,7 1

9.4 Psychosocial care 9.4.1 Comprehensive psychological and social assessment

All 1,4,5,6,8 1 --- --- 3,8 1

9.4.2 Psychosocial impact of rheumatic diseases

All All 1 --- --- ---- 1

9.4.3 Acknowledge depression and recognize early signs associated with various rheumatic disease processes

All All 1 --- --- --- 1

9.4.4 Effective communication and counseling

All All 1 --- --- 2,3,8 1

9.4.5 Psychosocial aspect and current social resources from Medical Social Worker’s perspective

1,2,7,9,11 All 1,4,5 --- --- 8 1

9.5 Care of patient with telecommunication methods

All All All All All 2,3,5,7,8 1

9.6 Coordination and collaboration of care

9.6.1 Collaborate with physicians, nurses, dietitian, social workers, psychologists, occupational therapists, physiotherapists, podiatrists and community agencies in planning appropriate management of patient problems

All All All 1,6 1,4 9,10,11 1

9.6.2 Explore and collaborate the community resources which provide psychotherapeutic services: Community Rehabilitation Network, Hong Kong Arthritis & Rheumatism Foundation

All All All 1,5 1,4 9,11,13 All

9.7 Develop nurse-led clinic All All All All All 1,2,8,9,11,12

All

9.8 Develop care-pathway and care model on Rheumatic diseases

All 1,2,3,4,5,8

All All 1,4,6 1,2,8,9,11,12

All

9.9 Develop and foster patient safe environment and initiate improvement strategies in quality and risk management

All All 3,4 All 1,2,3,7 4,5,6,7,9,10, 11,12,13

All

9.10 Develop/ review clinical care protocols and facilitate change by adoption of evidence-based practice in rheumatology care

9 5 1,5,6 1,3,5,6 2,3,5,6,7 1,6,7,9,11,12,13,14

1,2

9.11 Management and leadership skills

All 7 All All 3,4,5,6,7 All 1,2

30

X Course Calendar The College accepts - Application for Associate Membership- every February. - Conduction of Membership Certification Examination (MCQ Examination) - every June. - Application for Ordinary Membership- every July. - Conduction of Fellow Membership Exit Assessment- every October. - Application of Fellow Member – every November.

XI Fellow Membership Exit Assessment 11.1 After completion of the Sub-Specialty Module and recommended by the mentors, the Ordinary

Members are eligible to attempt assessment stipulated by HKCMN for recommendation to the Hong Kong Academy of Nursing to be Fellow Members.

11.2 Assessment could be: case study and viva; or project and viva (pre-arrangement by Sub Specialty). 11.3 Assessment Panel is to assess the submitted case study/ project and will sit in the viva. Composition of the Assessment Panel:

- Fellow of the sub-specialty - invited physician of the sub-specialty - invited nurse expert.

11.4 Case study:

The candidate reviews the log book and selects a case for presentation as agreed by the mentor. The case study should cover the essential topics as stipulated by HKCMN. The word limit of the case study should be 2500 words+10%.

11.5 Project:

The candidate submits project outline which is approved by the mentor. The project could be evidenced based practice project, clinical guideline development or initiation of a change in practice. The word limit of the project paper should be 4000 words +10%. The project should be able to demonstrate at least two of the following: - Innovativeness or originality of the work - An impact to the practice of specialty nursing - A contribution to improve current practice in patient care and education - A contribution to research / new knowledge development in related specialty nursing

11.6 Viva

11.6.1 The duration of the viva session is one and an half hour and consists of two parts. 11.6.2 Part 1 case study/project : The Candidate is to present the gist of the case study/project to the Assessment Panel. Time limit of the presentation is 15 minutes. The members of the Assessment Panel will then raise follow up questions related to the case study/project to critically assess the candidates’ clinical competence and application of theory to clinical practice to ensure patient safety, and enhance quality of care. The duration of the viva on this part is not to be less than 45 minutes. 11.6.3 Part 2 EBP and Professional Nursing knowledge : The members of the Assessment Panel will assess the candidate’s proficiency in the aspect of linking evidence based practice to clinical practice, development of professional nursing knowledge through nursing research, contribution of nursing in the health care team and health promotion and protection of health to the community at large. The duration of the viva on this part is not to be less than 30 minutes.

31

11.7 The passing grade of Fellow Assessment is “Satisfactory”. 11.8 Eligibility for recommendation to the Hong Kong Academy of Nursing to be considered as Fellow Members.

- Holder of Registered Nurse (RN) Certificate issued by Nursing Council of Hong Kong and with valid Practicing Certificate

- At least 6 years accumulative specialty experience in the most recent 9 years. Part of the 6 years sub-specialty experience must be in the current 3 years.

- Ordinary Member of HKCMN and HKAN - Passed Fellow Assessment - Demonstrated evidence of clinical leadership and significant contribution to nursing

profession

- Achieved 60 Continued Nursing Education points for every 3 year cycle of which 45 CNE points are specialty related

- Recommended by 2 Fellows (Advanced Medicine) of PHKAN, then via the College to HKAN - Need to apply for Fellow Membership within 3 years upon becoming eligible, otherwise the

eligibility would lapse.

XII Award Fellow of Hong Kong Academy of Nursing (Medicine-Haematology) Fellow of Hong Kong Academy of Nursing (Medicine-Oncology) Fellow of Hong Kong Academy of Nursing (Medicine-Renal) Fellow of Hong Kong Academy of Nursing (Medicine-Respiratory) Fellow of Hong Kong Academy of Nursing (Medicine-Rheumatology)

32

XIII Appendix – 1

Core Module

Holder of Registered Nurse (RN) Certificate issued by Nursing Council of Hong Kong and with valid Practicing Certificate

Worked in Medical Nursing related specialty for at least an accumulative 4 years in the most recent 6 years (among the 4 years, the nurse must acquire a minimum of 1 year of subspecialty that he/she desired to take later)

500 theory hours: Generic (167); Advance (167) and Specialty (167) 5oo clinical hours: 50-100% supervised practice, 50% work placement; and complete not less than

75% of Log Book which demonstrated active participation in reflective learning The core module is to be completed within 4 years Completed Master Degree of Nursing or Health Care related

At least 4 years accumulative medical nursing related in the recent 6 years (among the 4 years, the nurse must acquire a minimum of 1 year of subspecialty that he/she desired to take later)

Self-declaration of NO Criminal Conviction or professional misconduct

Recommend by designated mentor Passed the Membership examination

Ordinary Member

Hong Kong College of Medical Nursing

Advanced Practice Nursing Certification Program

Road Map

33

Sub - Specialty Module

The Ordinary Member must acquire a minimum of 1 year in the subspecialty before he/she is eligible to take the sub-specialty training among the 10 sub-specialties below:

Advanced Medical Nursing, Haematological Nursing, Infectious Disease Nursing, Neurology Nursing, Oncology Nursing, Palliative Nursing, Rehabilitation Nursing, Renal Nursing, Respiratory Nursing and Rheumatogy Nursing

The Ordinary Member will complete the specialty Module in not less than three years The duration of elective sub-specialty education program (both theory learning and clinical

practice) should be a minimum of 1 year and a maximum of 2 years He/she is under the guidance of a designated mentor to:

Complete not less than 75% of the Log Book, but fulfill the mandatory items Complete not less than 2 case presentations/studies within the framework of Clinical Log

Sheet Lead/ active participate in CQI, research, mortality and morbidity meeting, journal club

At least 6 years accumulated medical nursing related specialty experience in the most recent 9 years

The 6 years specialty experience (of which 4 years are related to the subspecialty) must be in the current 3 years

Self-declaration of NO Criminal Conviction or professional misconduct

Recommend by 2 Fellows

Evaluation passed and recommended by the designated mentor

Take assessment as stipulated- case presentation or viva or project

Proof of significant contribution to the profession

Member needs to apply for Fellow Membership within 3 years upon becoming eligible, otherwise the eligibility would lapse

Approved by HKAN

Fellow

34

XIV APPENDIX 2

Hong Kong College of Medical Nursing

The Competence Framework of 7 Domains

The Advanced Practice Nursing Certification Program is designed under the competence framework

of the following 7 domains

Domain 1 Managing clients with complex healthy conditions

1 Manages complete episode of care for complicated health cases and

refers aspects of care to own and other professions

2 Provides case management services to meet multiple client health care needs

3 Plans and implements diagnostic strategies and therapeutic interventions

to help clients with unstable and complex health care problems regain

stability and restore health in collaboration with the client and

multidisciplinary health care team

4 Rapidly assesses client’s unstable and complex health care problems

through synthesis and prioritization of historically and immediately derived data

5 Selects, may perform, and interprets common screening and diagnostic

laboratory tests

6 Diagnoses and manages acute and chronic diseases while attending to the

illness experience

7 Diagnoses unstable and complex health care problems utilizing collaboration

and consultation with the multidisciplinary health care team as indicated by

setting, specialty, and individual knowledge and experience

8 Reviews medication regime and counsels clients concerning drug regimens, drug

side effects, and interaction

35

9 Assesses and adjusts plans for continuous management of client’s health

status by monitoring variation in wellness and illness

10 Obtains specialist and referral care for clients while remaining the primary care

provider

11 Monitors clients data base for follow up, consultation a, referral and outcome

Domain 2 Enhancing therapeutic nurse-client relationship

1 Demonstrates skills in promoting therapeutic interaction to effect clients’ change

in health behaviour

2 Provides guidance and counseling regarding symptom management

3 Provides emotional and informational support to clients and their families

4 Uses human skills to enhance effectiveness of relationship

5 Applies principles of self-efficacy /empowerment in promoting behavior change

6 Monitors and reflects own emotional responses to client interaction and uses as

data to further therapeutic interaction

7 Facilitates staff to debrief on overwhelming emotional and grief associated with

nurse-client relationship

8 Communicates a sense of “being present” with the client

Domain 3 Demonstrate effective leadership and team work

1 Coordinates human and environmental resources necessary to manage rapidly

changing situations

2 Leads hospital/community health education and promotional activities

3 Empowers staff to assume increasing responsibilities for complicated client care

with delegation, support and supervision

4 Provides leadership in the interdisciplinary team through the development of

collaborative practices or innovative partnerships

5 Demonstrate effective leadership skills and be able to exert influence in a group

6 Provides leadership in professional activities

36

Domain 4 Enhancing quality assurance and improvement

1 Leads the on-going process of setting and revising guidelines, protocols, standards

and contingency plan

2 Develops a tracking system within the practice to ensure that clients receive

appropriate preventive services

3 Monitors peers, self and delivery system through Quality Assurance, Total Quality

Management, as part of Continuous Quality Improvement

4 Manages complaints and monitors malpractice

5 Benchmarks various care programs with outcome measures and advise on clinical

management or recommend review of intervention as indicated

6 Initiates and implements quality improvement strategies and clinical audits in

collaboration with various health disciplines

Domain 5 Managing and negotiating innovative and effective approaches to care delivery

1 Employs appropriate diagnostic and therapeutic interventions and regimens for

specific client groups with attention to safety, cost, acceptability, efficacy and

cost-effectiveness

2 Suggests implementation of evidenced-based practice and facilitate changes

3 Uses evidence and rationale to leverage senior and other on decision making

4 Contributes to the development of overall client care delivery system and adopts

appropriate nursing models in system to achieve optimal outcomes

5 Re-engineers the work process

6 Establishes detailed implementation schedules, resource planning, achievement

indicators and monitoring mechanism to support the service development plan

7 Envisions change impacts. Be prepared to take reasonable risk to facilitate change

and open to innovation

Domain 6 Enhancing professional attributes of general and advanced practice

1 Applies principles of epidemiology and demography in clinical practice

2 Promotes and fosters ethical practice and advocacy for clients

3 Applies / develops a theory-base conceptual framework to guide practice

4 Attains self-advancement professionally through initiating and involving in

evidence-based practice and research activities

37

5 Masters the application of advanced health care technology in specific area and

shows knowledge on the evidence found

6 Critically evaluate and applies research studies pertinent to client care and/or

specialty practice management

7 Applies/conducts research pertinent to primary care and/or specialty practice

management

8 Demonstrates expertise on area (s) of nursing. Be a resource person for referrals

in this area

9 Interprets own professional strengths, role and scope of ability to peers, clients

and colleagues

10 Acts as role model and set exemplary standard of professional behaviors

11 Supports socialization, education, and training of novice practitioners by serving as

a preceptor, role model and mentor

12 Motivates and supports staff to be self-developing and achieves higher

professional goals

13 Interprets and markets the advanced practicing nurse role to the public and other

health care professionals

14 Participates in legislative and policy-making activities which influence advanced

nursing practice and health services

Domain 7 Enhancing personal attributes

1 Analyzes situation critically and draws relationship among issues

2 Maintains active membership in professional organization