Module 4: Research & LTC
109 4.3 Evaluation
The PEPPA Framework
A Participatory, Evidence-informed, Patient-Centred Process for Advanced practice nursing (APN)[1] role development
- Adaptation of two frameworks
- Shaped on the principles and values consistent with advanced practice nursing
- Engaging stakeholders as participants
- Planning and Implementation
- Ongoing evaluation and improvement
PEPPA Framework Toolkit:
- Designed to determine gaps between current roles
- Nine key steps for assessing need for an APN as well as developing, implementing and evaluating this role in the practice setting
Strengths of the PEPPA Framework:
- Engaging stakeholders in the process gives opportunities to establish the need and identify shared goals of a clearly defined APN role
- Promotes increased understanding of the APN role and optimal use of APN expertise
- Creates environmental conditions necessary to support APN role through planning strategies
- Provides the basis for prospective evaluation, and thus continued improvement of the APN role
- Limitations of the PEPPA Framework:
- Efforts and resources to implement may appear overwhelming
- Values often conflict with the bureaucratic and disease-focused culture of health care systems
- Strong administrative and organizational support that values patient-focused, multi-disciplinary, and goal-oriented care is required to overcome these barriers
- Application of framework heavily dependant on the quality of group function and leadership
- Lack of resources to support activities, lack of physician support, inability to access data to accurately determine needs and priority problems, lack of evaluation expertise, and frequent turnover in APNs
- Stakeholder reluctance
- Bryant-Lukosius & Dicenso, 2004 ↵