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
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? “
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
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
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
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?
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
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
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
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?
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?
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
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
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
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
Nicole’s Story
Faye’s Story
Jessika’s Story
Thank you
Graduating class of 2013
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