Advanced Practice
The third in the series of acute care toolkits from the Royal College of Physicians aims to improve the care of the frail older patient.
Patients who are admitted to hospital believe that they are entering a place of
safety, where they, and their families and carers, have a right to believe that
they will receive the best possible care. They feel confident that, should their
condition deteriorate, they are in the best place for prompt and effective
treatment.
Yet there is evidence to the contrary. Patients who are, or become, acutely
unwell in hospital may receive suboptimal care. This may be because their
deterioration is not recognised, or because – despite indications of clinical
deterioration – it is not appreciated, or not acted upon sufficiently rapidly.
Communication and documentation are often poor, experience might be
lacking and provision of critical care expertise, including admission to critical
care areas, delayed.
http://www.nice.org.uk/
As nursing practices continue to expand, develop and become more advanced, practitioners need to keep abreast of their professional and 
legal obligations to the patients under their care. An expression of these roles has found some nurses undertaking the responsibility of verification of death.
This is an information sheet that will look at :
• some of the causes of acute onset of breathlessness in the acutely unwell patient,
Hospital at Night Advanced Nurse Practitioners (ANP) emerged in Ayrshire & Arran in 2006