Week 4- professional practice 2

Workforce

• CCI indicates that WA will be 150 000 workers short of requirements by 2017 o Current demand modeling suggests that by 2014/2015, WA health will require approximately 13,300 nursing and midwifery FTE to meet the anticipated demand • Ageing nursing workforce o Average age is 44.3 • Increase in part time workforce o Average of 32hours per week • Attrition of nurses from the profession • Spike in retirement

Social, cultural and environment influences:

• Consumer expectation/partnership • Ageing population • Lifestyle (reduced physical activity, obesity) • Financial (wages, employment, and the financing of healthcare) • Increasing rates of illness and disease (chronic illness such as diabetes, heart disease, mental illness, dementia) • Environmental (natural disaster, climate change) • Political (policy initiatives such as health promotion, illness detection and prevention) • Conflict (war, terrorism) • Technology (procedures, pharmacology, gene therapies)

Contemporary nursing and midwifery practice:

• Contemporary nursing and midwifery practice occurs in diverse settings ranging from tertiary level acute-care hospitals to remote community clinics • Professional nurses and midwives are required to provide the best possible patient care that is contemporaneous, timely, ethical, and resource (human, financial and material) efficient .

What has changed in Nursing:

• Expanded or new nursing roles (e.g. extended practice-nurse roles, nurse practitioners) • Models of practice delivery used in midwifery and other nurse- practice areas • Practice change that promotes and supports a multidisciplinary team approach to patient care • Appropriate use of unregulated caregivers • Promotion of 'evidence-based practice' • Development of 'continuity of patient care'.

Patient satisfaction with the services provide and the patient perception of care:

• Key principles of patient centered approaches include: o Treating patients, consumers, carers and families with dignity and respect o Encouraging and supporting participation in decision making by patients, consumers, carers and families o Communicating and sharing information with patients, consumers, carers and familiies o Fostering collaboration with patients, consumers, carers, families and health professionals in program and policy development, and in health service design, delivery and evaluation.

Safety and quality issues are directly linked to financial performance

• Length of stay as an important measure • Activity based funding • Increase focus on' never events' • Open disclosure as an important principle • A culture of safety and quality • How do we develop a culture of patient safety and quality care? o Reporting culture - report incidents o Learning culture- learn from incidents that have been reported o Flexible culture- make appropriate changes with recommendations from those working in the area to prevent incidents reoccurring o Just culture- focus on the system not individuals

Accountability for managing and leading the staff responsible for providing the patient care.

• Nursing leaders drive accountability in their staff • High performing units have accountable leaders • The key to success is the passionate commitment to as new vision of the organizations future and their ability to share that vision with all employees • Prioritorise what is important • Identify and develop talent • Influence other people

Nursing in 2016:

• Patient centred • Heavily regulated o Licensing and accreditation o National standards • Financially driven • Technology focused • Highly skilled workforce • Specialization • Consumer focused • Employee engagement

Nursing and midwifery:

• The focus is no longer just on the process of how care is delivered, but on the outcomes of that care (patient centred or patient focused care) • Providing care according to specific standards associated with better outcomes. New indicators, which are specifically sensitive to nurse's intervention. • Patient satisfaction with the services provide and the patient perception of care. • Accountability for managing and leading the staff responsible for providing the patient care • Safety and quality issues are directly linked to financial pressure • Workforce shortages • Technology and design for efficiency

Technology and design for efficiency:

• The health environment nurses operate in is changing, and nursing roles have, and are, continuing to evolve to match the environment. There is an ongoing trend for increasing hospital admissions, reduced lengths of stay, increased acuity and greater use of technology. • More care and more complex care is being provided in the community, additional aged care beds are being opened and nurses are taking on more roles and more diverse roles. • As well as providing care, the nursing role encompasses health promotion and prevention, education and management and for nurse practitioners, extends to providing primary care by assessing and managing clients- including providing referrals and prescribing medications.

What did we learn from Florence?

• The importance of nursing education and the science that underpins it. • Evidenced based care • Holistic care • Hospitality as a core nursing value • Light ventilation and warming • Noise • Environment • Nutrition • Bed and bedding • Cleanliness of rooms • Personal cleanliness • Recommendations to the family and friends to the sick • Observation of the sick

Strategic priorities:

• To be a recognized leader in the Australian health sector for the provision of high quality health care. • To significantly increase our investment in information, analytics and technology • Increased agility in responding to changes in our environment and in implementing our plans • Deeper partnering with key stakeholders • Capital optimization • The focus is no longer just on the process of how care is delivered, but on the outcomes of that care. • Providing care according to specific standards associated with better outcomes. New indicators which are specifically sensitive to nurse intervention. • Falls, pressure ulcers, medication errors, patient ID.

Nursing in 1985

• Transitioning from apprentice style education to Uni based • Team nursing • Hierarchical structure • Technology was being introduced • Simpler approaches to care • Accreditation was new