Dr G Perfilieva Dr M Vallimies S O'Malley - Department of Health ...

Evidence generated through country case studies• WHO expert group established, May 2012• Draft template developed and discussed atthe WHO CIS CNOs meeting, St.Petersburg, Russia, October 2012• Draft manual consulted with externalexperts• Work on country case studies initiatedEU Chief Nursing Officers’ MeetingDublin, Ireland

Country Case Studies• The target group:– GCNMs and National focal points on N&M– Directors of WHO Collaborating Centres– Presidents of the NNMAs• Focus on:– Different population groups, health needs, levels of health care services– Reviewing roles of nurses and midwives within the country context• To be compiled into a WHO European compendium– Reflect the diversity of countries and country’s experiences in the region– Share information and learn from each other– Inspire and encourage the development and dissemination of good nursing andmidwifery practices– Demonstrate to policy makers the contribution of nurses and midwives– Stimulate policy recommendations based on evidence and develop an Action planEU Chief Nursing Officers’ MeetingDublin, Ireland

The template• Provides a tool:– to guide author/s in creating country case studies• GCNMs and national focal points are invited to lead, facilitate and coordinate contributionsfrom national experts in creating country case studies• WHO Collaborating Centres are expected to support and develop this work on the basis oftheir mission• Information can be collected from publications, service areas or via interviews withnurse/midwife managers, researchers, practitioners and teachers• A steering group of key stakeholders can be established at national level to support andguide the work• Case study requirements: in English between 500 – 1 000 wordsEU Chief Nursing Officers’ MeetingDublin, Ireland

The template structure Title and country of the case studyFoundationHow and why started?ProcessWhat was done?BenefitsWhat were theoutcomes?Driver for changeRole expansionInitiator of the service changeArea of health careStakeholdersEvidence-based practiceSkills and competencies developedManagement supportMultidisciplinary team supportAny other supportGuidelines and regulatory frameworkPerformance outcomesImproved quality of careProfessional climateMultidisciplinary team dynamicPersonal reflectionContact person: Name, e-mail address, position, institution and countryEU Chief Nursing Officers’ MeetingDublin, Ireland

Sample country case study:Respiratory Assessment Unit (RAU)St. James’s Hospital - Dublin, Ireland• Respiratory Assessment Unit (RAU)– Nurse and physiotherapist-led service– Seamless integrated care for patients with chronic respiratory disease• 3 Levels of care– Early discharge– RAU evaluation– Pulmonary RehabilitationEU Chief Nursing Officers’ MeetingDublin, Ireland

Filling in the templateFoundationHow and why started?Title and country of thecase studyDriver for changeRole ExpansionInitiator(s) of the servicechangeArea of health careStakeholdersEvidence-based practiceRespiratory Assessment Unit (RAU)St. James’s Hospital, Dublin – IrelandPressure on Hospital BedsAutonomous nursing role developed to:•Enable early discharge•Provide home care•Integrate management of disease•Provide health education and promotion programs•Collaborate with physiotherapistsNursing and Physiotherapy StaffAcute Hospital/Primary Care•Multi-disciplinary Team•Hospital Management•Patient/Family•Primary Care TeamInternational, National and Local GuidelinesEU Chief Nursing Officers’ MeetingDublin, Ireland

Filling in the templateTitle and country of thecase studyRespiratory Assessment Unit (RAU)St. James’s Hospital, Dublin – IrelandProcessWhat was done?Skills and competenciesdeveloped•Physical Examination•Taking and interpretation of arterial bloodgases•Diagnostic Imaging ordering and interpretation•Anaphylactic Training•Mantoux Testing and Spirometry•Cognitive Behaviour TherapyManagement support•Consultant•Senior Nurse Management•Professional Development SupportEU Chief Nursing Officers’ MeetingDublin, Ireland

Filling in the templateProcessWhat was done?Title and country of the case studyMultidisciplinary team supportRespiratory Assessment Unit (RAU)St. James’s Hospital, Dublin – Ireland•Nurses•Physiotherapists•Respiratory Consultants•Respiratory Technicians•Public Health Nurses•Community Intervention Team•Social Workers•Our Lady’s Hospice•General Practitioners/Primary Care TeamAny other supportGuidelines and regulatoryframeworkFinancial Support:•Further Education•Continuous Professional Development•Nurses and Midwives Act•Scope of Practice•Code of Ethics for NursesEU Chief Nursing Officers’ MeetingDublin, Ireland

Filling in the templateTitle and country of the case studyRespiratory Assessment Unit (RAU)St. James’s Hospital, Dublin – IrelandBenefitsWhat were theoutcomes?Performance outcomesImproved quality of careProfessional climate•Reduced length of stay•Less hospital admissions•Job satisfaction for staff•Autonomous Nurse Led Services•Effective utilization of staff skills and competencies•Cost savings•Holistic Patient Care•Improved Quality of Life•Patient Satisfaction•Less Hospital Admissions•Better Disease Control•Support for expanding scope of practice of nurses•Multi-disciplinary collaborationMultidisciplinary team dynamic•Close working relationships between Nursing Teamand Physiotherapy Department.•Expertise from the wider MDT utilised.EU Chief Nursing Officers’ MeetingDublin, Ireland

Filling in the templateTitle and country of the case studyRespiratory Assessment Unit (RAU)St. James’s Hospital, Dublin – IrelandPersonal reflectionDrive, fearlessness and perseverance.Practice analysed continuously in response to service needsSupport from Respiratory Consultants and Nurse Management facilitated nurse-led autonomous services.Contact person: Name, e-mail address, position, institution and countryMaria Kane, Clinical Nurse Manager 3Respiratory/TB Services St James’s HospitalEmail: mlawlor@stjames.ieEU Chief Nursing Officers’ MeetingDublin, Ireland

Evidence from IrelandEU Chief Nursing Officers’ MeetingDublin, Ireland

Conclusions• Effective utilisation of nurses and midwives skills is essential• Service needs must be the driver for changing roles and roleexpansion• Nurses and midwives are working in multidisciplinary teams• Nurses and midwives must work within their scope of practice• Commitment to maintain competence is crucial.EU Chief Nursing Officers’ MeetingDublin, Ireland

Engagement of experts in N&M intothe WHO workThe WHO Regional Office for Europe calls forexperts’ contributions in creatinga European compendium of country casestudies to demonstrate evidence on impactof good nursing and midwifery practices onhealth outcomes.EU Chief Nursing Officers’ MeetingDublin, Ireland