Office of the Nursing & Midwifery Services Director … of the Nursing & Midwifery Services Director 2015 Annual Report HealtH Service executive Office of the Nursing & Midwifery Services

Office of the Nursing & MidwiferyServices Director

Clinical Strategy and Programmes Division

Office of the Nursing & Midwifery Services Director 2015 Annual Report

HealtH Service executive

Office of the Nursing & Midwifery Services Director

2015 Annual Report

HealtH Service executive

Office of the Nursing & MidwiferyServices Director


contentstable of contents

Abbreviations .................................................................................................2

Foreword ......................................................................................................3

Introduction ...................................................................................................4

Purpose ........................................................................................................4

Role and Function ........................................................................................4

Organisational Structure of ONMSD .............................................................5

Goal 1 .........................................................................................................6

Policy Development and Consultation

Goal 2 ........................................................................................................7

Provision of Safe Quality Care

Research and Evidence Based Practice

Goal 3 .........................................................................................................12

Practice Development

Goal 4 ........................................................................................................14

Leadership and Innovation

Continuous Practice Development

Capacity Building

Goal 5 .........................................................................................................19

Corporate and Clinical Governance

Summary of Quantitative Data ......................................................................21

Appendix 1.....................................................................................................23

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2

list of abbreviations

AMP Advanced Midwife Practitioner ICT Information Communication Technology

AMAU/AMU

Acute Medical Assessment Unit/Acute Medical Unit

IMEWS Irish Maternity Early Warning Score

ANP Advanced Nurse Practitioner IV Intravenous

BOM Board of Management KPI Key Performance Indicator

CAWT Co-operation and Working Together LEO Leading an Empowered Organisation

CBAS Caring Behaviours Assurance System MEWS Maternity Early Warning Score

CCNE Centre of Children’s Nurse Education MDT Multi-Disciplinary Team

CEO Chief Executive Officer MN-CMS Maternal and New born Clinical Management System

CHO Community Health Organisation NAES National Adverse Events Study

CMM Clinical Midwife Manager NCEC National Clinical Effectiveness Committee

CNM Clinical Nurse Manager NFR National Financial Regulations

CNME Centre of Nursing and Midwifery Education NLIC National Leadership and Innovation Centre

CN/MSp Clinical Nurse/Midwife Specialist NIGSIP National Immunisation Group for School Immunisations Programme

COPD Chronic Obstructive Pulmonary Disorder NMBI Nursing and Midwifery Board of Ireland

CRGN Community Registered General Nurse NMPD Nursing and Midwifery Planning and Development

CVAD Central Venous Access Device ONMSD Office of the Nursing and Midwifery Services Directorate

DCU Dublin City University OPD Outpatient Department

DoH Department of Health PCCC Primary Continuing and Community Care

DoNM Director of Nursing/Midwifery PEWS Paediatric Early Warning Score

DPHN Director of Public Health Nursing PHN Public Health Nurse

EBP Evidence Based Practice PIC Person in Charge

FETAC Further Education and Training Awards Council

PMAV Professional Management of Aggression and Violence

HAA Health Amendment Act PPPG Policies, Procedures Protocols Guidelines

HCAI/AMR

Health Care Associated Infection/Antimicrobial Resistance

QQI Quality and Qualifications Ireland

HCV Hepatitis C Virus RANP Registered Advance Nurse Practitioner

HEI Higher Education Institute RCNME Regional Centres for Nursing and Midwifery Education

HETAC Higher Education and Training Awards Council

RNID Registered Nurse Intellectual Disability

HIQA Health Information Quality Authority RPN Registered Psychiatric Nurse

HSE Health Service Executive


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Foreword

Dear Colleagues,

It gives me pleasure to publish the Office of the Nursing & Midwifery Services Director 2015 Annual Report. I am extremely pleased to look back at a year of great progress, achievement and advancement within the professions of Nursing and Midwifery in the HSE. This report demonstrates the achievements and outputs in 2015 set out under the goals in the Health Services Executive National Corporate plan 2015-2017.

The ONMSD’s role is to provide strategic leadership and workforce development supported by quality education and training to strengthen safe clinical evidenced based practice, ensure consistency and standardisation, avoid duplication, and support legal and regulatory requirements at regional and local level. The ONMSD function supports economy of effort in that the work undertaken has relevance and applicability to the delivery of health care to all patients nationally and across all services. The advantage of this collective approach is that the Nursing & Midwifery resource and expertise undertakes these activities on a once off basis that otherwise would be replicated within services and would result in multiple non standard interpretations and applications in each statutory and voluntary service across the region.

The ONMSD works across all the divisions of the HSE and in collaboration with the Chief Nursing Office in the Dept of Health and the Nursing & Midwifery Board of Ireland. The Office works in partnership with the Directors of Nursing and Midwifery, the Nursing and Midwifery Planning and Development Units, the Centres of Nursing and Midwifery Education and our stakeholders. This partnership working has contributed significantly to an open, transparent and learning culture within Nursing and Midwifery services. Nurses and Midwives have innovated, provided governance, demonstrated leadership through embracing change, leading teams and developing clinical capacity to meet the current and future needs of the Nursing & Midwifery professions and the healthcare community in a changing landscape and economy.

I wish to acknowledge the contribution and engagement of all Directors of NMPDU’s, Centres of Nursing & Midwifery Education and their staff and all the organisations and stakeholders who we work with on an ongoing basis.

________________________ Mary Wynne Interim Nursing and Midwifery Services Director & Assistant National Director Office of the Nursing & Midwifery Services Director Clinical Strategy and Programmes Division


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introductionThe 2015 annual report outlines the contribution and activities of the Office of Nursing and Midwifery Services Director (ONMSD) within the HSE. Our work reflects and is consistent with the values and goals of the HSE Corporate Plan 2015-2017, the Health Services People Strategy 2016-2018 and supports the work of the Integrated Care Programmes Charter, 2015. The 2015 annual report also outlines the purpose, role and function of the ONMSD.

Purpose of the Office of the Nursing and Midwifery Services Director The purpose of the Office of Nursing and Midwifery Services (ONMSD), Health Service Executive (HSE) is to strategically lead and support nurses and midwives to deliver a safe, high quality person centred healthcare in the HSE that enables people to improve their quality of life and wellbeing. The ONMSD is situated within and accountable to the HSE Clinical Strategy and Programmes Division (CSPD).

ONMSD Role and Function The ONMSD is led by a Director, supported by a leadership team, Nursing and Midwifery Planning and Development Units and Centres for Nursing and Midwifery Education regionally.

The ONMSD:

t provides professional guidance and expertise at a corporate level and to health service providers locally.

t provides a focal point for nursing and midwifery within the public health system and is the critical professional link between the Department of Health, Office of the Chief Nurse, the Nursing and Midwifery Board of Ireland, the HSE Directorate and its Divisions, Higher Education Institutes, Directors of Nursing and Midwifery and other stakeholders.

t provides expertise that is pivotal to the analysis, application, implementation and evaluation of legislation and health policy to the nursing and midwifery resource within health services nationally. This comprises an analysis of legislation, national and international policy and wider literature as well as nursing and midwifery specific data and identifying key actions necessary for the implementation of policy in every location where care is delivered.

t supports the Clinical Strategy and Programmes Division by providing individual staff resources leading on specific aspects of programmes as well as the collective contribution of the ONMSD to the integrated care programmes. The ONMSD has a key enabling and leadership function in realising this contribution.

t supports Quality Improvement (QI) by providing individual staff resources to the Quality Improvement Division leading on specific QI projects as well as the collective contribution to QI education, practice, project development, research and resources.

t collects and analyses data nationally that informs and supports decision making pertaining to nursing and midwifery related factors. This results in the application of an integrated evidence based standardised approach nationally by nurses and midwives within services.

t is a budget holder and provider for design development and delivery of continuous professional development for nurses and midwives incorporating education, clinical and leadership development, research, innovation and advancing clinical practice.


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Organisational structure of the Office of Nursing and Midwifery Services Director

NMPDU & CNE Staff

NMPDU & CNE Staff

NMPDU Area Director Dublin North East

NMPDU Area Director West

NMPDU Area Director South

Director NMPDU Director NMPDU

National Lead Medicinal Prescribing

National Lead Midwifery

National Lead Public Health Nursing

National Lead Clinical Governance

National Lead National Clinical

Programmes

NMPDU & CNE Staff

NMPDU & CNE Staff

NMPDU & CNE Staff

NMPDU & CNE Staff

Director NMPDU West

Director NMPDU North West

Director NMPDU South East

Director NMPDU South

NMPDU & CNE Staff

NMPDU & CNE Staff

National Lead Leadership

Regional Prescribing Team

National Leadership Team

Admin Support

Director ONMSD

General Manager NMPDU Area Director Dublin Mid-Leinster

Director NMPDU Dublin Sth, Kildare & Wicklow

Director NMPDU Midlands

Business Manager

Directors of Nursing for some

programmes

National Lead Medicines Mgmt

National Lead X-ray Prescribing


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Goal 1

Promote health and wellbeing as part of everything we do so that people will be healthier

We want people to live fulfilled lives and to be as healthy as they can. We want the health service to have a positive impact on the health and wellbeing of everyone living in Ireland. We will support people to be as healthy as they can by promoting healthy lifestyle choices.

Policy Development and Consultation

Business Priority Brief Description of Activities / OutputsAnalysis, consultations and review of National Documents, Policies and Guidelines, for example:

Nursing and Midwifery Board of Ireland (NMBI)

Health Service Executive (HSE)

ONMSD/NMBI

Department of Health

Health Information and Quality Authority (HIQA)

National Clinical Programmes

To determine the future role of the Registered Nurse Intellectual Disability (RNID)

t Scope of Nursing & Midwifery Practice Framework (January)t Exploratory workshop to explore the potential components of a professional

competence scheme to be operated by NMBI (March) t NMBI Advanced Practice Nursing Standards and Requirements

(September)t NMBI Advanced Practice Midwifery Standards and Requirements (October).

t Consultation and contribution to development of National Suicide Strategyt Contribution to developing National Standards for Suicide Prevention.

t ONMSD Nursing & Midwifery Strategyt Medicines Management Standards for Nurses and Midwives.

t NCEC - Consultation Proposed Prioritisation Process - National Clinical Guidelines.

t Draft Information Governance and Management Standards for the Health Identifiers Operator in Ireland (April 2015)

t HIQA Corporate Plan (November).

t National Skills Strategy (November 2015)t Irish Hospice Foundation and UCC – development of guidance documents

to support healthcare staff working with people with dementia from all care settings in addressing specific aspects of dementia palliative care

t Consultation Feedback on Guidance Document No. 4 (Pain Assessment and Management), No. 5 (Medication and Dementia – Palliative Assessment and Management) No.6 (Management of Hydration and Nutrition), No. 7 (Ethical decision making in end-of-life care for the person with dementia) – November.

t Collaboration and consultation process completed to inform a national strategy and policy along with foundation work for an elearning programme.


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Goal 2

Provide fair, equitable and timely access to quality, safe health services that people need

We must make it easy for people to access the services they need. These services must compare with the best other countries have to offer and be safe and available to people in the right place and when they need them.

Provision of Safe Quality Care

Business Priority Brief Description of Activities/ Outputs

National Nursing and Midwifery Quality Care Metrics

t Standardised and consistent approach to the national implementation of Nursing and Midwifery Quality Care Metrics

t Developed and launched a Guiding Framework for Implementation and a suite of Standard Operating Procedures for Acute Hospitals, Midwifery, Children’s, Public Health Nursing, Older Person Services, Mental Health and Intellectual Disability Services

t Supported the development and implementation of new Nursing and Midwifery Quality Care-Metrics to measure the quality of care delivered in services, across eight national work-streams in conjunction with the eight NMPD Directors and the regional Project Officers

t Worked with National ICT and Procurement to secure the electronic platform (Test Your Care)

t Enabled the roll-out of hand held technology to support care measurement at the front-line of care

t Contributed to the development of organisational quality profiles in conjunction with the Quality Improvement Division

t Contributed to National Implementation Group, HSE/HIQA Maternity and other forums as requested.

Productive Ward t Provided support and facilitated continued roll-out within existing and new Productive Ward Quality Improvement programme sites through the provision of advice training and licensing

t Evaluated and reported the impact and implementation of the Productive Ward Initiative in two distinct phases.

Caring Behaviour Assurance System for Ireland (CBAS – I)

t Concept tested Caring Behaviours Assurance System - Ireland (CBAS-I) in four hospitals within SAOLTA University Healthcare Group

t Undertook an evaluation of the process of implementation to inform the future roll out of the programme.

Key Performance Indicators (KPIs) for Nursing/Midwifery

t Contribute to the development of appropriate infrastructure to enable reporting of outcome indicators - pressure ulcers and falls.

Co-ordination of Services for Survivors of Thalidomide

t Engaged with key stakeholders including Survivors of Thalidomide, Support Groups, Disability Unit DoH, HSE Primary Care Teams and Beaumont MDT on the implementation of an MDT assessment process

t Continue to support individual survivors with HSE Primary Care Teams and Beaumont MDT members and other services as appropriate in conjunction with the DoH on implementing recommendations of MDT assessed needs

t Continue ongoing communication and liaison with Head of Operations and Service Improvement, Disabilities Services, HSE and the Disabilities Unit, DoH.


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Older Persons Services t Scoped appropriate tool for early detection of patient deterioration in residential care settings. Pilot completed and evaluation report completed for dissemination across services in 2016

t Developed an eLearning programme to support care planning for older people

t Supported services in response to HIQA inspection reportst The roll out of National Dementia Education Project. Target reached for

upskilling staff across all areas in Dementia Awareness education t Practice improvement projects linked to post-graduate educationt Acknowledged World Elder Abuse Day via the delivery of a multi-agency

information/awareness workshop entitled “Ethics in Safeguarding Vulnerable Adults: A multi-agency approach”.

Public Health Nursing Supported practice development in community settings:

t Child and Family Health Needs Assessment Frameworkt Postnatal depression screening training for PHNst Adult and paediatric continence training for PHNs and community nursest Education on management of lymphoedemat Teamwork model of public health nursing service delivery t Management of Long Term Conditions Integrated Caret The introduction of professional supervision for community settingst The establishment of Nurse Practice Development Co-ordinator posts in

community nursing t Designed and co-ordinated the delivery of a professional development

programme for PHNs and CRGNs.t Service Improvement Framework for Public Health Nursing Services - The

establishment of a national steering group and work streams to progress the implementation of the framework for Public Health Nursing.


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Mental Health Nursing t Supported the implementation of the recommendations from the Vision for Psychiatric/Mental Health Nursing report through the national steering group and regional implementation groups

t Hosted a national mental health conference in Dublin Castle ‘A Vision for Psychiatric/Mental Health Nursing; From Diagnosis to Dialogue………’ to evidence and showcase initiatives and best practice in mental health services nationally

t Supporting the development of a Recovery Colleges in mental health services

t Developed a risk assessment and safety planning framework supported by an eLearning programme for adult mental health services

t Published and implemented a National Clinical Supervision framework for nurses working in mental health services

t Completed an Education and Training Needs Survey of nurses working in Child & Adolescent Mental Health services to inform commissioning of skills and competency nursing education programmes

t Commissioned research to inform the development of a professional education programme for nurses and midwives working with women and mothers in the area of Peri-natal Mental Health Care

t Established a national steering group to develop national nursing guidelines and a professional development education programme for nurses and midwives caring for children, adolescents and adults with an eating disorder in all locations of care

t Developed strategies to increase and diversify access routes to train as RPNs i.e. post-graduate nursing registration programmes and graduate entry programmes

t Guided, advised and supported the review and delivery of PMAV Instructor education through HEI/HSE Steering Group.

t Coordinated and supported master classes in mental health nursing.

Intellectual Disability t HSE disability services preparation for HIQA inspectionst Response to HIQA inspection reportst Needs analysis for professional practice of nursest Shaping the future of intellectual disability nursing in Ireland – National

Studyt The development of nurse governance structurest Continuing education and professional development opportunities for

RNIDs t HSE Disability Services to respond to the findings and recommendations

of ‘Our Home, Our Say’ Report (2015) as it relates to resident engagement in service delivery

t Development of an Assisted Decision Making (Capacity) Assessment/Capacity Tool: Based on the Assisted Decision Making Capacity Legislation.


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Maternity Services t Supported Maternity services to implement practice improvements in response to investigations

t OPD project for maternity services t Developed governance structure and professional support for self-

employed community midwives working within the home birth servicet Project managed the development of a Clinical Governance framework for

Home Birthst Co-ordinated and supported midwifery master classes, including coping

with secondary traumatic stress and medication managementt Supported the National Review of Maternity Workforcet Supported quality improvement through midwifery leadership programme

through participation on advisory group.t Supported and contributed to the development and implementation of

electronic health record for maternal and child health servicest Provided support for the Domino Service.

Children’s Services t Established and supported a forum for children’s nurses who care for the child and adolescent patient with mental health problems

t Participated on National Senior Children’s Nursing Networkt Participated on Joint Nursing Executive for the three children’s hospitalst Provided support to services and Centre for Children’s Nurse Education

(CCNE) in relation to contribution to and planning for the National Children’s Hospital

t Contributed to the review of Children First Strategyt Participated on the Children First Education Strategy sub group.t Review of National guideline for the use and management of a CVAD

(Central Venous Access Device) for children in the community and the development of a national elearning education programme to support implementation of national guideline.

Acute Hospital Services t Supported development and implementation of a Professional Practice Model of Nursing through the Careful Nursing Project

t Supported the development of a bespoke evidence based care planning system for an acute service using an international standardised nursing language classification system and developed a systematic means of measuring the nursing contribution to each patient’s care

t Commissioned a literature review to evaluate nursing documentation across nine hospitals in one hospital group; identified resource requirements to enable nursing documentation standardisation across the hospital group

t Supported quality and safe care through the Hospital at Night Projectt Supported Critical Care Outreach Initiativet Supported Emergency Response System Initiativet Explored options available for the introduction of a standardised nursing

terminology system for integration in HSE ehealth strategyt Supported national casting programme for acute and orthopaedic services.


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research and evidence Based Practice

Business Priority Brief Description of Activities / Outputs

Regional Ethics and Health Research Committees

t Professional representative on regional ethics and health research committees

t Contributed and advised on health research applications t Supported nursing and midwifery colleagues with ethics approval

applications.

Building Research Capacity t Supported research capacity and expertise in nursing and midwifery through research and innovation funding

t Enabled RANPs to conduct researcht Chair of a Research Capacity Working Groupt Supported regional library services to provide electronic library resources

to HSE nursing and midwifery staff through innovation funding t Promoted LENUS as a repository for nursing/midwifery researcht A survey was undertaken to identify research and Evidence Based Practice

requirements with nurses and midwives t Enabled the development of nurse/midwife researchers through sponsored

research masters initiative whereby nurses/midwives are supported with a 2 year bursary to undertake service-identified research

t Nursing and Midwifery REACH (Research Excellence Across Clinical Healthcare settings). The research role, profile, skills, experience and research output of clinical nursing and midwifery staff is enabled and further developed through the implementation of this initiative

t Development of research strategy document for nursing and midwifery.

Nursing & Midwifery Quality Care Metrics

t Supported Metrics Project Officers who are actively undertaking researcht Established the research framework to enable the development of new

Quality Care-Metrics using a robust methodology.

Quality Improvement Collaborative

t Qualitative descriptive research study undertaken to explore the patient and family/carer experiences of the Pressure Ulcer to Zero collaborative.

Productive Ward Evaluation t The National Evaluation of the Productive Ward initiative was undertaken in two distinct phases.


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Goal 3

Foster a culture that is honest, compassionate, transparent and accountable

We will provide health and personal social services with care and compassion. This includes being honest and open with our patients, those using our services, the public and our staff

Practice Development


Older Persons Services t Dementia education and awareness programmest Safer medication practicet End-of-life caret Up-skilling nurses in residential care to support admission avoidance to

acute hospital and facilitate early discharget Establishment of a virtual ward model to provide more effective care to frail

elderly in the community.

Public Health Nursing Services t Supported integrated team working and practice developmentt Community nursing PPPG developmentt Developed a child emotional and mental health module as part of the roll

out of national Best Health for Children trainingt Designed and co-ordinated the delivery of a professional development

programme for PHNs and Community RGNs t Development of a framework for the introduction of clinical supervisiont The establishment of Practice Development Co-ordinator roles in PHN

services.

Mental Health Services t Implementation of the clinical supervision framework for nurses working in mental health services nationally

t Developed and Implemented a risk and safety planning framework for mental health nursing with an eLearning educational programme to inform staff working in the area of suicide and self-harm

t Implementation of evidenced based guidelines for risk assessment and safety planning in mental health nursing

t Development of national nursing guidelines to support nurses develop skills and competencies to care for children, adolescents and adults presenting with eating disorders

t Commissioned research to inform the peri-natal educational requirements for nurses and midwives to deliver care to women and mothers with mental health difficulties and developed a blended learning education programme

t Commenced the development of a national framework to include nursing guidelines and a professional development education programme for nurses and midwives working with children, adolescents and adults with an eating disorder in all locations of care.


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Intellectual Disability Services t Supported professional colleagues and senior managers in establishing senior nursing governance structures

t Contributed to the Regional Standards Reference Groupt Developed capacity assessment tool and education programme and

supported implementationt Provision of support for frontline intellectual disability nurses in developing

and sustaining evidence-based practices.

Midwifery Services t Supported midwifery practice development initiatives t Supported the development of maternity clinical care pathwayst Supported service initiatives including the Maternal and New-Born Clinical

Management System (MN CMS)t Supported hypno birthing practitioner trainingt Improved care for mothers and babies through increasing midwifery and

nursing research activity t Supported multidisciplinary education sessionst Scoped the peri-natal educational requirements for midwives to deliver

care to women and mothers with mental health difficultiest Provided support for the Domino Nursing Services.

Acute Services (incorporating Children’s Services)

t Facilitated and supported DoNMs and nurse/midwife practice development co-ordinators to identify practice development and educational priorities

t Active member of the Hospital Group Nurse/Midwife Practice Development Forums

t Supported plans to address priorities and competency gapst Supported and implemented innovation and practice development projects

as recommended by national clinical programmes t Facilitated innovation and practice development projects aligned to the

priorities of the Quality and Patient Safety Directorate t Created Critical Care Foundation and post graduate courses through

supporting the role of a Clinical Facilitatort Provision of children’s medication management and generic prescribing

workshops.


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Goal 4

Engage, develop and value our workforce to deliver the best possible care and services to the people who depend on them

Our staff are at the core of the delivery of healthcare services – working within and across all care settings in communities, hospitals and healthcare offices

leadership and innovation


Leadership and Management Development

t Director of Nursing and Midwifery and Senior Nurse and Midwife Managers Leadership and Management Programmes

t Front Line Manager Leadership and Management Programmest Clinical Nurse/Midwife Managers 2 Leadership and Management

Programme QQI People Management Certificatet Regional Leadership Programmes (LEO)t Programme for Clinical Nurse/Midwife Specialists (CN/MSps) designed,

developed and provided for Acute, Disability, Palliative Care and Mental Health Services

t Accredited multidisciplinary blended education programme in Palliative care assessment

t A bespoke Skills Enhancement Programme for front line managerst Established coaching networks and coaching resources to support nursing

and midwifery stafft Facilitated the establishment of ANP/AMP postst Implementation of Clinical Leadership Competency e Portfolio for frontline

nurse and midwivest Leading in uncertain times programme for nurses in ID and Mental Healtht Action learning facilitator training for nurses to understand the principles

and framework of action learningt Mentor Facilitator training for nurses and midwivest Commissioned the following Master classes: business case development

for DON/M, quality improvement in practice, health care commissioning for senior nurses and midwives

t Future Nurse Midwife leaders Programme and Quality Colloborativet Leaders for Compassionate Care Programmest Delivering Quality Improvement through Midwifery Leadershipt Delivering Quality Improvement through Primary Community and

Continuing Caret Development of a set of workbooks that will support organisations providing

specialist palliative care to meet the national standards on Safer Better Healthcare

t A multidisciplinary education programme to develop skills in Palliative care assessment to meet the requirements of the HSE Palliative Care Needs Assessment Guidelines.

Supporting the development of hospital groups and community healthcare organisations

t Future Nurse Leaders Programme for Medical and Maternal / Child Health Directorate aligned to a Quality Improvement multi-disciplinary collaborative

t Development of collaborative working relationships with Group Chief Nurses, Chief Officers in CHO Areas and Area Managers.


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ICT Innovations and Promotion Provided expertise and support in the implementation of ICT to aid nursing and midwifery initiatives:

t E-Learning programme development, review and quality assurance e.g. peripheral intravenous cannulation, venepuncture, pain management, anaphylaxis eLearning programme, clinical decision making, standard precautions

t Contributed and supported the implementation of the National Maternal and New-born Clinical Management System (MN CMS)

t Contributed to National E-Rostering framework, procurement and implementation

t Contributed to the Virtual International Practice Development Conference on International Nurses Day

t Contributed to the development of E-learning training programme for Standard Infection, Prevention and Control

t Led on the development of an eLearning education programme for pronouncement of death by registered nurses

t On-line discussion forumst Examination of tele-health options for services and cross border

partnerships, e.g., FOLD (Provides apartments and houses for older people and families)

t Establishment of Nursing and Midwifery elearning governance group to implement governance arrangements for the review and maintenance of elearning programmes for nurse and midwives on HSELand.

Support National Leadership and Innovation Initiatives

t Evaluation and dissemination of learning as appropriate from funded initiatives through the NMPDUs

t Led on networking with DoNM to enable sharing and sustainability of quality initiatives.

Examination and Evaluation of the clinical and cost effectiveness of generic Self-Management Support Interventions for Chronic Diseases

t Supported HIQA Expert Advisory Group in the review of available literature and Systematic Reviews of Randomised Control Trials for asthma; diabetes; COPD and cardiovascular disease and publication of final report.

Cross Border Collaboration t Established a cross border senior nurses and midwives forum for sharing and collaboration and awarded the All-Ireland DOH Chief Nursing Officers Award for Excellence in Cross Border Nursing.


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Continuing Professional Development


Establish education and competency development needs for nurses and midwives

t Identified designed and delivered Continuous Professional Development programmes to meet the education and competency development needs of nurse and midwives.

Delivery of Learning Events via the RCNME (HSE and Voluntary)

Through the BOM governance structure:t Monitored delivery and uptake of programmest Prepared quarterly reportst Programme accreditation from NMBIt Programme evaluation.

Enable professional development via ICT

t Use of video-conferencing and live streaming facilities and learning platform.

Nurse & Midwife Medicinal Product Prescribing

t Supported Health Service Providers in implementation of initiative and the Higher Education Institutions in delivery of education programme

t Review of Existing systems and Processes in partnership with NMBIt Developed a secure web-based nurse midwife prescriber databaset Development of the Seasonal Influenza Vaccine Protocol, and revision

of the Anaphylaxis Management Protocol in partnership with the National Immunisation Office

t Development of a discussion document that facilitates a national review of nurse prescribing in specialist palliative care with a view to further rollout nationally.

Nurse Prescribing Ionising Radiation

t Progressing the 12 recommendations from the review of Medical Ionising Radiation

t Final stages of alignment of the database to the NIMIS systemt A one day programme delivered for Emergency Medicine ANPs to enable

them to prescribe for children.

Development of Guidance Resource Documents

t Guidance for Anaphylaxis Programme, Information for Healthcare Professionals

t Guidance for Venepuncture and IV Cannulation in respect of difficult venous access – for all staff

t Guidance Framework for the Professional Development of Registered Nurses working in Adult Critical Care Units

t Cognitive Behaviour Therapy Programmet National Restraint Policy (HSE 2010) – Development of updated education

programmet Guidance for Implementation of Nursing and Midwifery Quality Care-

Metrics and supporting standard operating procedurest National Policy for Verification of (Expected) Death by Registered Nursest A Strategy for AMAU/AMU Nursing t Reviewed and updating of ‘Guideline for Central Venous Access Device in

Children in the Community’t Clinical Supervision framework for nurses in Mental Health Servicest Best Practice principles for Risk assessment and safety planning for

nurses working in mental health services.

CNME Database Development t Supported implementation of the national CNME database following the testing phase.


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Some ExamplesMaster Class Series/Seminars/Conferences

t Nursing and Midwifery Quality Care-Metrics t Open Disclosuret Positive Risk Management and Crisis Interventiont Quality and Patient Safetyt HIQA Standardst Advocacy t Eating disorderst Leading on Quality & Patient Safety for Nursing & Midwiferyt Implementing the HCA National Early Warning Score in an Acute Hospitalt Exploration of the relationship between positive patient experiences in

acute hospital settings and person centred care activitiest Dementiat Pain Management in the Older Persont Coaching for Performancet Resilience Management & Leadership t Clinical Supervisiont Branding Nursing in the Healthcare Environment t Meaningful Activities for People with Dementia using a Montessori

Approacht Clinical Education Day (Midwifery)t Team Working (Midwifery)t The Preferred Drugs Initiativet Team Buildingt Fearless Communicationt Quality Improvementt Legal Aspects within the Professionst Coping with Secondary Traumatic Stresst Recovery Colleget Mental Health.

National Cancer Care Education Programme

Delivered the National Community Oncology Programme:t Community Nursing Oncology Module (HETAC Level 9) – over 6 monthst Nursing Education Programme for Registered Nurses Working in an

Inpatient Setting (3 days)t Nursing Education Programme for Practice and Community Nurses (2

days).

National Dementia Programme t Roll out of National Dementia Education Project.

Mental Health t Supported national addiction training programmet Developed psychosocial interventions training modules (HETAC Level 8)

and facilitated national roll outt Developed cognitive behaviour skills for practice (HETAC Level 8) and

facilitated national rolloutt Developed eLearning programme in risk and safety planning in adult

mental health servicest Development and national implementation of Best Practice Guidelines in

Risk Assessment and Safety Planning in Mental Health Nursingt Supported services in implementing clinical supervision.

Intellectual Disability Services t Provided continuing professional development opportunities for RNIDs.


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Immunisation Protocols t Supported the National Immunisation Group for School Immunisations Programme (NIGSIP)

t Developed, reviewed and updated medication protocols for National Immunisation Programme

t Participated on the National Immunisation Group.

Clinical Supervision for Nurses and Midwives

t Introduced clinical supervision for nursing and midwifery in mental health, acute/general, specialist palliative care and public health nursing

t Clinical supervision implemented for peer groups that included the development of a policy and an educational programme to train supervisors

t Sustainability plan developed, which incorporated the identification of further sites including disability and older persons nursing.

National Project for Pronouncement of Death by Registered Nurses

t Blended Learning Education Programme developed to support nurses in the implementation of the policy.

Capacity Building

Business Priority Brief Description of Activities / OutputsNursing & Midwifery Turnover t Compilation of national turnover report on an annual basis.

Nursing & Midwifery Role Development

Clinical Nurse/Midwife Specialists

t Promoted, supported and facilitated the development of CNSp/CMSp posts in response to service need:

t Implementation of interim approval processt Advisory role to the National Recruitment Service regarding CNSp/CMSp

applications.

Nursing and Midwifery Role Development

Advanced Nurse/Midwife Practitioners

t Promoted supported and facilitated the development of ANP/AMP posts in response to service need

t Advisory role to NMBI’s working group on advanced practice.

Workforce Planning t Compilation of census data for nursing/midwiferyt Older person services skill-mix project t Out-patient renal dialysis dependency measurement projectt Developed framework to support skill mix decisionst Contributed to workforce planning for National Clinical Care Programmes t Workforce planning review in National Intellectual Disability Servicest DoH Taskforce on Staffing and Skill Mix in Nursing Hospital Evaluationt Development of a range of access routes into mental health nursing.

QQI (FETAC Level 5) HCA programme

t Sponsorship QQI (FETAC Level 5) HCA programmet Delivery of QQI HCA programmet Development and delivery of delegation workshops.


Goal 5

Manage resources in a way that delivers best health outcomes, improves people’s experience of using the service and demonstrates value for money

We are working to provide the safest, and most efficient health care system possible for the people in Ireland. Working together with all health care providers and government departments we will use all the resources in the health service in the most efficient and effective way possible to provide quality care and a good experience for those using the service

corporate & clinical Governance


Develop Office of Nursing and Midwifery Services (ONMSD) Nursing and Midwifery Planning and Development (NMPD)/Centre of Nursing and Midwifery Education (CNME) Annual Business Plans

t Monitored targets/outcomes of the 2015 Business Plans and produced an annual report for circulation and publication as appropriate.

ONMSD/ NMPDU/RCNME Governance

t Office administrationt Financial Resource Managementt Human Resource Managementt Performance reviews.

Financial Governance and Budgetary Management

Pay

Non Pay

Ensured compliance with National Financial Regulations (NFR) in the administration and monitoring of:t Pay expendituret Nursing and midwifery innovation funding t Centre of nursing and midwifery education fundingt Continuing nurse/midwife education fundingt Post graduate education funding (circular 020/2014)t Sponsorship of public health service employees scheme – circular

009/2010t QQI healthcare assistant fundingt Allocation and monitoring of funding to support national clinical care

programmest Allocation and monitoring of funding to support productive wardt Allocation and monitoring of funding to support nursing and midwifery

metrics.

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ONMSD Governance and Policy Development

t ONMSD Strategy Development Groupt ONMSD Budgetary Management Groupt ONMSD Communication Governance Groupt ONMSD www.HSELand.ie Governance Groupt National PCCC Quality and Leadership Advisory Groupt National Midwifery Quality and Leadership Advisory groupt National Leadership and Innovation Centre Strategic Planning Groupt National Advisory Group National Project for Pronouncement of Death by

Registered Nursest National Working Group National Project for Pronouncement of Death by

Registered Nursest ONMSD Vision for Psychiatric /Mental Health Nursing Strategy Group.t ONMSD Vision for the role of the RNID groupt NOCA Board of Governorst Consultant Applications Advisory Committeet Florence Nightingale Foundation group established ‘Leaders for

compassionate care steering group’t Joint HSE/Forum steering group: Clinical Programmes and Clinical

Directors t Pilot Planning and Implementation Group Taskforce & Steering Group for

Taskforcet National Quality Improvement Programmet NMBI Practice Development Consultative Committeet Serious Reportable Eventst Strategy & Programmes –Senior Management Team.

Stakeholder Communication

Internal Communication

National

Ensured efficient and effective communication governance structures are in place:t Maintained and monitored systems for team communicationt Led, supported and participated in local and regional and national Directors

of Nursing and Midwifery Forumst Developed and maintained linkages with all divisions of the HSE ,community

healthcare organisations and acute hospital groups, staff organisations, professional bodies, HIQA, Mental Health Commission, higher education institutes etc.

Acute Coronary Syndrome Acute Medicine Anaesthetic Asthma COPD Critical Care Diabetes Emergency Epilepsy Heart Failure iMEWS/ MEWS/PEWS Mental Health Older Persons Paediatric & Neonatal Transport Medicine

t Provided support and input to national clinical programmes – through service planners, lead nurses, interest groups, working groups etc

t Participated on programme working groups to strategically influence the development of national models of care and supported implementation

t Developed, procured or commissioned education to support national clinical programme implementation provided through HEIs/NMPDs/CNMEs, for example: Stroke Education Foundation Programme and MSc Epilepsy etc.

National DPHN Vision Document Group

t Supported and strategically contributed to developing the National DPHN Vision Document (Document on hold).

Hepatitis C – Persons with acquired HCV

t Worked with key stakeholders to determine appropriate support and home care needs of individuals with acquired HCV.

total

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Workforce DataCNS’s total 1,172

ANP’s total 145

CNS’s 2015 only 103

ANP’s 2015 only 31

ANP Posts in Development 2015 55

Education and TrainingFootfall CNME’s 2015 44,926

Total no of programmes delivered CNME’s 2015 1,717

New programmes developed 2015 158

QQiNumber of HCA Programmes delivered 11

Number Qualified 211

Policy Document DevelopmentHome Birth Strategy 1

QC-M SOP/Guidance Document 9

Emergency Medicine Workforce Planning Framework (in collaboration RCSI)

1

Acute Medicine Nursing Strategy 1

E-learning/HSElandNew programmes developed 2015/ currently under development 2015 10

Numbers of Post-reg. Programmes sponsoredSponsorships 2015 (total) 1,549

Certificates 2015 5

Postgraduate Diplomas 2015 622

Degrees 2015 59

Masters 2015 355

PHd’s 2015/Doctorate of Nursing 2015 31

Special purpose award/standalone modules 452

Diplomas 2015 25

research and innovation initiatives sponsoredTotal Number of Research and Innovation Projects sponsored 290

Category of project sponsorship: -

Developing clinical capacity 35

Quality Improvement & Patient Safety Initiatives 83

Number of Research Studies funded 13

Staff development 19

Service development 17

Summary of Quantitative Data NMPDs 2015


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NMPD Publications and Presentations 2015Number of presentations 116

Number of Conferences presented at 47

Number of Publications 33

Leadership programmes outside of NLICNumber of programmes delivered 35

Number of participants attended 493

Quality Improvement & Patient Safety InitiativesQC-M (Locations) 500

CBAS (Participants) 56

Other 11

Practice Development initiatives supportedPHN - child & family health needs assessment training 7

PHN - new PPPG’s develped - 47

Practice Development Co-ordinators 3

Documentation Project 2

District Hospitals - new PPPG’s developed 9

Meaningful Activities with people with dementia using a montessori approach

3

Continuing Practice/Professional Initiatives supported 105

NLIC Leadership ProgrammesLeaders for Compassionate Care programmes x 6 180 CNM2’s

Masterclsss: Health Care Commissioning 200 Senior Nurses and Midwives

Clinical Leadership Competency ePortfolio (CLCeP) 3000 nurses and midwives have acccessed the resource to date

Future Leaders Development Programme x 2 60 DONM/ADONM

Leading in Uncertain Times: Facilitators preparation programme 67 nurses and midwives in ID and mental health services

Action Learning Facilitator Training 50 Nurses and Midwives

Mentoring Facilitation Training 50 Nurses and Midwives

Masterclass Healthcare Commissioning 200 senior nurses an midwives

Masterclass Business Case Development 200 DONM

Masterclass Quality Improvement in Practice 420 frontline nurses and midwives

Delivering Quality Improvement through Midwifery Leadership 60 Nurses and Midwives

Delivering Quality Improvement through Primary Community and Continuing Care Leadership

80 Nurses and Midwives

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Appendix 1 Some Examples Research Projects/Publications and Reports

Research Projects a. An Exploration of Preparedness and Competence of Practising Nurses and Midwives in Quality Improvement and Safety

B. asepsis techniques research – Studies explored the knowledge and practice of healthcare workers regarding aseptic technique in acute and community settings. Studies complete and action plan developed to address findings. Integrated Steering Group (Acute and Community, NMPD and HEI) governing the action plan implementation.

c. Development of Clinical Dashboards for Reporting in Acute Hospitals

D. EMBRACES- ID (Early Monitoring of Breast and Cervical Cancer Signs & Screening in Intellectual Disabilities)

e. Empowerment in Irish Epilepsy Services. A System Study Utilising Critical Social Theory

F. Exploring the Detection and Care of Infants with Developmental Dysplasia of the Hip

G. HSE Intellectual Disability Services Preparation for HIQA - Level of understanding of service users within the HSE North East residential disability services of the underlying principles of the National Standards for Residential Services for Children and Adults with Disabilities. Report complete and launched by Mr. Tony O’Brien, CEO HSE in July 2015. Action plan developed to address findings, through collaborations between Disability Services, Service Users and NMPD.

H. Person Centred Care & the Patient Experience - An exploration of the relationship between positive patient experiences in acute hospital settings and person-centred care activities.

i. Physical Activity Promotion for Rehabilitation and Recovery Mental Health Service Users in the South East of Ireland

J. Physical Health Needs of Children with an ID - An exploration of the physical health needs of children and adolescents with an intellectual disability.

K. The Development of a Conceptual Framework of Compassion Fatigue and the Examination of the Role of Emotional Intelligence and Self-sacrificing Behaviours in the Development of Compassion Fatigue in Oncology Nurses

l. Using a Case Study Design to Explore Nursing Workforce Policy Implementation in the South East of Ireland

M. Using a mixed methods approach to examine survivorship in colorectal cancer

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Publications/Reports Barry, M. & Nugent, L. (2015) Pressure ulcer prevention in frail older people. Nursing Standard, 30(16), 50-60.

Clarke, V. and Mulligan, D. (2014) Evaluation of Regional Leadership and Management Development for Senior Nurse Managers in the HSE North East Region. HSE North East NMPD

Comer, M. (2015) Rethinking reflection-in-action: What did Schön really mean? Nurse Education Today, 36, pg. 4 - 6.

Gallen, A. (2015) Quality care in nursing and midwifery. World of Irish Nursing, 23(9), pg. 60 - 61

Health Service Executive (2015) Core Infection Prevention and Control Knowledge and Skills: A Framework Document. HSE Quality Improvement Division and the HCAI/AMR Committees, (NMPD member of HSE DNE HCAI/AMR Committee Subgroup).

Health Service Executive/ Royal College of Physicians in Ireland (2015) Guidelines for hand hygiene in Irish healthcare settings: Update of 2005 guidelines January 2015. HSE (NMPD member of Guideline Development Group).

Kyle, G., McLoughlin, R., Browne, V. & Greene, C. (2015) British Journal of Healthcare Assistants, 9(6), pg. 288 - 294.

Nolan, A., Kennedy, S., O’Malley, A., Kirwan, M., Hughes, A., Barry, A., Goodwin, V., Cunningham, A.M., Coyne, H., & Nugent, L. (2015). Mothers’ voices: results of a survey of public health nurse-led breastfeeding support groups. Primary Health Care, 25(7), 26-31.Nursing and Midwifery Planning and Development Unit/ Dundalk Institute of Technology (2015) Our Home Our Say; Research Report of the level of understanding of residents within HSE North East residential disability services of the underlying principles of the National Standards for Children and Adults with Disabilities. Health Service Executive 2015

Parlour, R., Slater, P. & Breslin, L. (2015) Evaluating Nursing and Midwifery Metrics: Providing Evidence to Support Change and Renewal in Healthcare Services in Ireland. International Journal of Research in Nursing, 6(1), pg. 1 - 10.

Rodger, D., Neill, M. O., & Nugent, L. (2015). Informal carers’ experiences of caring for older adults at home: a phenomenological study. British Journal of Community Nursing, 20(6), 280-285.

White, M. (2015) How Effective is Productive Ward? Nursing Times, 111 (8), 22-25

On Line Library Resources t Supported the provision of online and midwifery journalst Collaborative working with HSE Library, nationally and locally.

Nursing and Midwifery Research Newsletter

t Nursing and Midwifery Research Group Newsletter was produced and circulated in May 2015.

Conference Presentations t Three projects were presented by NMPD Officers at the 16th Healthcare Interdisciplinary Research Conference Trinity Collage Dublin in November 2015: The HSE NMPD Clinical Nurse/Midwife Specialists Development

programme Adopting a LEAN approach to stores supply in a primary care setting Findings from an Evaluation of a Regional Leadership and Management

Development Programme for DON,ADON/M, CNM/CMM3 and PICs (December 2013-May 2014)(HSE-North East NMPD, 2015)

t Presented Quality Care Metrics, to the Irish Pain Nurses and Midwifery Conference and the Clinical Governance Group for Home Births.

Notes:

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Notes:

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