title: Development of a curriculum for advanced nurse practitioners working with older people with frailty in the acute hospital through a modified Delphi process.
abstract: BACKGROUND
  advanced nurse practitioners (ANPs) are experienced nurses who undertake some activities traditionally performed by medical staff. There are four pillars of advanced practice: advanced clinical skills, leadership, education and research. ANPs are starting to specialise in the management of older adults with frailty in the acute hospital. However, the role and competencies required for this have not been well defined. This study aimed to establish an expert consensus on the role description and essential competencies for ANPs working with older people with frailty to develop a curriculum.
  
  
  METHODS
  a literature review and workshops including multi-professional and lay representatives generated a role description and a list of 69 competencies. A modified Delphi process was then conducted with three rounds involving a panel of 31 experts including representatives from the RCN, BGS Education and Training Committee, BGS Senior Nurses and Practitioners Group, Chartered Society of Physiotherapy Older People Network, College of Occupational Therapists Older People Specialist Section and lay representatives. Consensus on the statements was established by 70% panel agreement.
  
  
  RESULTS
  the role description reached 100% agreement within three rounds. Twenty-five essential competencies were agreed after Round 1, increasing to 43 after Round 2 and 49 after Round 3.
  
  
  CONCLUSIONS
  this Delphi study has allowed, for the first time, a national panel of clinical experts and lay representatives to refine and agree a set of competencies for ANPs working with older people with frailty. It is the first step towards ensuring consistency in the training of ANPs in geriatric medicine.
authors.affiliation: School of Health Sciences, University of Nottingham, Nottingham, UK.
authors.forename: Sarah Elizabeth
authors.initials: SE
authors.lastname: Goldberg
authors.affiliation: Corporate, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: Jo
authors.initials: J
authors.lastname: Cooper
authors.affiliation: Health Care of the Older Person, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: Adrian
authors.initials: A
authors.lastname: Blundell
authors.affiliation: Health Care of the Older Person, Nottingham University Hospitals NHS Trust, Nottingham, UK Division of Rehabilitation and Ageing, Medical School Queens Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK Present address: Medical School Royal Derby Hospital, Derby, UK.
authors.forename: Adam Lee
authors.initials: AL
authors.lastname: Gordon
authors.affiliation: Health Care of the Older Person, Nottingham University Hospitals NHS Trust, Nottingham, UK Division of Rehabilitation and Ageing, Medical School Queens Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK.
authors.forename: Tahir
authors.initials: T
authors.lastname: Masud
authors.affiliation: Health Care of the Older Person, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: Ravisankar
authors.initials: R
authors.lastname: Moorchilot
mesh_terms: D000367:Age Factors; D000368:Aged; D002983:Clinical Competence; D032921:Consensus; D003479:Curriculum; D003697:Delphi Technique; D004511:Education, Nursing, Graduate / Q000379:methods* / Q000592:standards; D016330:Frail Elderly; D005853:Geriatrics / Q000193:education* / Q000592:standards; D017408:Guidelines as Topic; D006760:Hospitalization; D006801:Humans; D009722:Nurse Practitioners / Q000193:education* / Q000592:standards; D024802:Nurse's Role; D016730:Program Development; D013663:Teaching / Q000379:methods* / Q000592:standards
keywords: Delphi technique; advanced nurse practitioners; aged; curriculum; frail older person