Good morning. I am going to talk about the university's nursing clinic.
The nursing clinic was established primarily to meet the needs of our primary health care nurse practitioners, or PHCNPs. One goal was to give them more clinical practice time. We also wanted to improve the professional exam success rate. This clinic has allowed us to offer student practitioners a learning environment developed and shaped not only by PHCNPs, but also by partner physicians who want to contribute to the training of our NPs, in a very important pedagogical environment.
This has also enabled us to develop a clinical training environment that supports testing of an innovative approach, in that the clinic very accurately reflects nurses' work in the Quebec health care system. The NPs, or nurse practitioners, find the same operating methods in the clinic as they would find as student trainees in a medical clinic. This also means that our NPs are quickly exposed to the roles and functions they are going to have to perform as soon as they begin their training placements.
In the NP program, there are three courses that relate to the practical application. These courses prepare our students to deal quickly with decisions and with certain pathophysiological problems they have to resolve. They must also apply pharmacological and non-pharmacological treatment and develop their clinical supervision process in dealing with a real clientele.
The program includes two courses in which there is integration training. Our students can now do those placements at our university clinic, since it was recognized as a training centre in June 2012. We need students at various levels to apply the physician-nurse-NP partnership process.
In terms of innovation, in September, we developed an exam preparation course so that NP candidates for the exam or practitioners who have unfortunately failed the professional order exam on one or two tries can come to the clinic and do a 10-day integration placement and a preparatory placement for taking or retaking the exam.
In terms of the service description, the target clientele in the first phase is employees of UQTR and their spouses and children, retired employees of the hospital and their spouses, and all students in the university communities. The clinic is open one day a week. A physician is present in the clinic at all times, along with nurse practitioners at various levels, either observing or on training placements, or students who have already completed their courses and are doing exam prep. We see an average of 24 patients a day, or about four patients an hour. The patients are seen by both NPs and the partner physicians.
In terms of supervision, as I explained earlier, there is always the student NP/partner physician pair. For the intervention steps, the initial patient evaluation is done by the student in the examination room. Immediate supervision is provided by the physician and the qualified NP, by video. We have a camera system in each examination room and a common room where the physician and supervising NP observe and evaluate the practice of the student with the patient being treated. The student NP then consults with the supervisors. They discuss the clinical case and determine the treatment plan. The supervisor and the student return to the examination room to meet with the patient, complete the evaluation and determine the treatment plan, or at least discuss it with the patient.
There are four stations available for real-time viewing of the patient examinations. This also means that at the end of the day's work, we can review the clinical cases using the recordings. For confidentiality reasons, the recordings are destroyed each day. Only one person has access to them, to avoid duplication or breaches of confidentiality, among other things.
I neglected to mention that patients at the university clinic sign a document stating that they consent to be seen not only by a partner physician or supervising NP, but also by students. The consent form is essentially identical in all clinics at the UQTR campus. The second phase, implementation, involves integrating undergraduate students into the clinical practice. For example, some students could do triage.
In conclusion, this innovative project focuses on clinical training for our NPs. It strongly encourages collaboration between partner physicians and NPs, as well as multidisciplinary collaboration, since we work with the various clinics on campus. There is also collaboration with network partners, since we do a lot of patient referrals.