Dynamic in PHC competences Challenges and perspectives for

education and training

CNO meeting Cyprus Eur.Presidency

Oct.2012

Anne LEKEUX FINE

RENEWAL of PHC: Perspectives for N&M Education

°changing context : demographics,chronic and emerging diseases, medical advances/technology,specialisation,privatisation,trade in health services ,international migrant population….

° negative impact on education

° negative practice work environment

…….

Where are we going?

Working together

We teach, we care

3 Pillars

Objectives Activities Outputs Outcome

Interprofessional Collaboration Mobilize networdks and partnership to enhance the interprofessional collaboration in education and practice for improved population health •Establishing Health Professionals Global Network (HPGN) •Supporting virtual Communities of Practice •Piloting Framework for Action on interprofessional collaboration

•Interprofessional Collaboration models piloted •Policy recommendations

Health Care across the Life-course of the Population

Promote integrative strategies to improve access to health workers for people-centred care across the life-course of the population •Country-focused interventions for MDG 5 •Facilitating multi-country collaboration in Maternal & Newborn Health (MNH) •Establishing networkds & partnerships to support health workforce scaling-up for MNH

•Action plan on competent workforce for « skilled care for every birth » in pilot countries •Sub-regional joint planning & agreed monitoring system •More skilled health workers in MNH programmes

Strengthening Nursing and Midwifery

Strengthen the nursing and midwifery capacity to support Primary Health Care implementation •Implementing global Programme of Work in priority countries •Supporting innovations for transforming Nursing and Midwifery (N&M) education •Identifying good practice and success factors of people-centred care models •Providing continued support for N&M leadership & policy development

•Increase in N°of countries Strategic Directions (SDNM) •N° of Centres of innovation in N&M education •HRH Guide to support the development of people-centred care models

Improved capacity of Member States to implement transformative health workforce strategies and build partnership for effective health service delivery.

Now more than ever, the health of people worldwide depends on health professionals working together across boundaries of disciplines, professions and conventions to ensure the provision of equitable, patient-centred, possible efficient, and community driven health services

Concerted multidisciplinary and interprofessional approach in which each discipline identifies what they can contribute, and then works collectively towards a common purpose

WHO and its partners recognize interprofessional collaboration in education and practice as an innovative strategy for mitigating the global health workforce crisis and addressing global health goals within the context of health system strengthening and primary hearth care

UNIVERSAL COVERAGE

PUBLIC POLICIES FOR

PUBLIC HEALTH

PEOPLE-CENTRED CARE

INCLUSIVE LEADERSHIP

Participation

GAGNM 2010

To scale up collaboration with key stakeholders to effectively lead and facilitate

N&M worldwide have demonstrated significant leardership and innovative contributions

To continue to endorse community-based interprofessional collaborative practice

WHO and its supports are committed to mobilizing the vital and potential roles

To provide evidence-informed guidance and support

…

Timely and accurate date-informed advice in relation to N&M workforce, capacity and skill-mix

Crisis response and emergency preparedness, planning and implementation

Professional regulation and policy in relation to N&M and their inter-professional intersections

Service/care delivery quality, standards and patient safety

Inter-sectoral liaison, collaboration and networking

Educational programme standards, accreditation and funding

Deep contextual understanding of PHC, healthcare, N& M nationally and internationally.

Workforce planning and development

Strategic and operational planning

Research, epidemiology and evidence based healthcare

Strategic financial management

Networking and relationship building nationally and internationally

…

DEVELOP AND SUPPORT QUALITY MANAGMENT SYSTEM FOR N&M national service:

°Tools to calculate staffing Nbs PHC service

°Support for inexperienced leaders

°Stenghtening leadership and managment

°Career program: from novice to expert

°Services flexible and responsive to local need

Developing and selecting the best care delivery models ,standards and regulation

Identifying and mobilizing the appropriate staff/skill mix for delivery of people-centred care

Working on competencies required by nurses working in leardership roles in PHC

Providing care for vulnerable populations

Using of existing resources :

Norms and tools to support PHC

WHO Compendium of Primary care case studies

Also multimedia study cases (Ex. Virtual hospital –ICT european project)

Transforming norms and tools to practice

impact on practice / on education

Pushing nursing education to 2°&3°cycle

To teach to be creative ,proactive

To allow students to use new ideas

To give opportunities/time in the curriculum to be creative ,to work on innovation with pluridisciplinair approach

To build updated pedagogies and training strategies using reflexivity

…..

The big challenge’ll be to trusting people to innovate!

Entry level for N&M and CPD (continuing professional development) in order to fulfill new and expanding PHC roles (PHC interprofessional collaborative practice)

Increase equitable access to quality and comprehensive care by increasing resources to train and retrain registered community health N&M

Scaling up production categories of nurses within health human resource planning to support PHC demands (nurse practionner roles).

Incentivize and prepare N&M to work in high need PHC areas.

Scope of N&M practice maximized within PHC

PHC-specific competency-based curricula integrated into basic and ongoing N&M curricula

Work with training and regulation of nonprofessional community health worker group

Country-level health and related governance systems need to develop policies and supports that allow PHC renewal to become a reality

Resources be mobilized to support countries and the WHO in scaling up N&M education and practice

More advanced knowledge, skills ,evidence base practice,technologies as key success factor

A post graduate degree in nursing (Master’s degree) APN (Advancing Nursing Practice)

Strenghtening interprofessional education modules in PHC in pluridisciplinarity (to prepare better for close collaboration and teamwork)

Sufficient training in PHC to prepare N/M in the community and to work on reflexive approach

Testing new models involving new roles through local pilot projet

Providing greater flexibility to adapt new roles to local needs (more professional autonomy)

A skilled , motived health professional

supported with good health system /positive work environment

The advancement of teaching: Educating nurses – a call for radical transformation (P.Benner 2010)

The right skilled people delivered the right/safety care to population ‘ll bring the best quality !

….

Working together intra and inter-professional liaison

Educational institutions (control members, recrutement and

standard of new graduate, specialty education, undertake research)

With directors of N&M practice (staffing, skillmix, safety and quality,

workplace environnement, career structure, models of care …)

With Professional organisations

With Regulatory Authorities (registrations – accreditation, professional

standards, professional competence)

°engage and empower both staff and community

°build on existing local resources

°clear goals and expectations

°evidence-based interventions

°reliable and adequate funding and resources

°innovative thinking,especially about capacity to take on new roles

°improvment in MDGs

°access to PHC to all

°N&M engaged in policydevelopment,implementation, evaluation

°Policy assesment in EDUCATION , regulation , roles distribution….

Community program for Home care (B/M level existing in Europe),adapted knowledge

°work with key stakeholders to evaluate the scope of professional practice for N&M, quality insurance ,articulated research in PHC

°monitor prevention strategies for safety care

°update PHC guidelines /competences (clinical judgment/innovative thinking …)

Revitalization of PHC (crucial role of N&M)

Unique and timely opportunity to refocus the role of N&M in PHC renewal with impact from educational institutions

Impact on the transferability of learnings related to successful PHC models from one community and country to another

Today, more than ever, the commitment building the global partnership must guide our collective actions.

FINE PERSPECTIVE

Nursing Education Challenges

Anne Lekeux FINE

Let us learn from each other ,sharing our knowledge and good practices . Step after step ,to grow in our profession and to respond to the current needs in education and training according by PHC renewal . Go on to the modernity, quality and innovation in Nursing Sciences!

Working together

We teach, we care