Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in...

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Certificate III Health Services Assistance Central Coast Local Health District (LHD) has supported AIN qualifications for over 15 years Commenced with Aged Care school based traineeships With the introduction of Health Training Package 2007 it moved to Acute Care This was the first introduction of AIN’s to the LHD

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Kathy Hardie & Angela White, Central Coast Local Health District delivered the presentation at the 2014 Assistants in Nursing Conference. The 2014 Assistants in Nursing Conference focused on strategic nursing workforce planning and development of a suitable model of care for the AIN role, looking at a variety of implementation approaches from pilot sites and services who have established the role; addressing challenges around appropriate training, mentorship, scope of practice and role evaluation. For more information about the event, please visit: http://bit.ly/asstnursing14

Transcript of Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in...

Page 1: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

Certificate III Health Services Assistance

  Central Coast Local Health District (LHD) has supported AIN qualifications for over 15 years

  Commenced with Aged Care school based traineeships

  With the introduction of Health Training Package 2007 it moved to Acute Care

  This was the first introduction of AIN’s to the LHD

Page 2: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

The Start

  The Divisions of Aged Care and Rehabilitation were the first Units to introduce AIN’s

  Overall concerns were of a third tier of workforce

  “AIN’s are going to reduce the EN workforce”

  “The AIN does all that I do so what is going to be my role now? “

Page 3: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

Health Services Implementation Package

  Assistants in Nursing working in the acute care environment

  Released in August 2010

  Established a role and scope of practice for acute care AIN’s

  No differentiation between AIN’s and Undergraduate AIN’s

Page 4: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

Implementation Package

Included in the package:

 Recommendation of units of study

 Minimum clinical hours

 Upgrades from Aged Care to Acute Care

 NSW Health AIN position description

 Clarity and consistency in employment in Public Health

Page 5: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

Local Site Implementation

  Implementation package was rolled out to all NUM’s

  There was then development of:

-  Scope of practice

-  Job description

-  Local policy frameworks

-  Recruitment principles

-  Clinical skills mapping for AIN’s

Page 6: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team
Page 7: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

AIN Students

  AIN HSC students were well received in the work place

  They were no threat to staff numbers

  But with the changing workforce and recruitment strategies

  The introduction of Acute Care AIN’s as staff were not received well

  SO WHAT NEEDED TO CHANGE?

Page 8: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

Do Nurses like change?   Was this any different from the introduction of the

EEN role?

  Everyone is threatened by change

  No one wants to change

  Isn't there room for everyone?

  Isn't there enough work for everyone?

  Don’t all levels have something to give to their patient’s care?

  ? Supernumerary role for AIN’s

Page 9: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

Models of Care

  Plan for change

  Clarify ways of working

  Identify change champions

  Determine new and innovative models of patient care delivery

  Consideration of the skills required at all levels

  Overall patient centred care

Page 10: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team
Page 11: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

Models of Care Champion Workshop   Nominated staff attended a full day workshop

  Greater insight into scope of practice

  Responsibilities and accountability of staff within teams

  Role of Model of Care Champions

  LHD Models of Care Implementation plan

  Development action plans within the Unit/Ward

Page 12: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

Nursing Practice Decision Flowchart

  Supervision and delegation framework

  Risk assessment approach

  Asking the questions

- Is it in my scope of practice?

- Do I have current skills and knowledge?

- Is there a policy and procedure to support me?

- Is there a competency assessment?

Page 13: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

Patient Allocation V’s Team Nursing Patient allocation -

 Support decreased

 Isolation

 No teaching environment

 Where is the supervision?

 Can patient allocation work with 3 tiers of nurses?

 All staff are to work under the RN

 Can AIN’s be allocated patients?

Page 14: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

Team Nursing   Provides support for all team members

  Supervision and delegation by the RN/team leader

  Supportive education and personal development

  All staff supported e.g. TRN, casual staff

  Every staff member has a role

  Team approach to clinical decision making

  Open communication between team members

  Patients recognise that they have a team of staff who are caring for them

Page 15: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team
Page 16: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

Did this work?

  Some areas have embraced team work

  Some are still under development

  Some areas will never change

  So baby steps

  With education and support you will achieve the right team approach for your units

Page 17: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

What is needed to make the change?   Strong leadership

  A willingness to change

  Everyone working together

  Everyone knows each others role/competence level

  Open communication

  A plan of care for the shift

  “Huddles”

  Everyone works to a common goal

Page 18: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

Integration of AIN’s   Started with the student AIN

  Staff are more aware of student role

  Ward areas have become aware of AIN scope of practice

  Assimilation to the team model

  AINs have moved into a casual or permanent staff member role

  Student AIN’s do return to the LHD as EEN’s or RN’s

  Career progression

Page 19: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

Nicole’s Story

Page 20: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

Faye’s Story

Page 21: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

Jessika’s Story

Page 22: Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

Thank you

Graduating class of 2013