OPPORTUNITY!! TRANSFORMING CRITICAL CHALLENGES INTO POWERFUL OPPORTUNITIES FOR NURSING EDUCATION

1. OPPORTUNITY!!TRANSFORMING CRITICAL CHALLENGES INTO POWERFUL OPPORTUNITIES FOR NURSING EDUCATION Hester Klopper(PhD; MBA; RN) Professor and Head School of Nursing Science Chairperson: FUNDISA

2. OVERVIEW OF THE PRESENTATION • Introduction • Challenges • Globalization • Changing legislation landscape • Theory-Practice integration • Workforce issues • Leadership • Opportunities

3. INTRODUCTION • IGNITE • To cause to burn • To set fire to • Subject to great heat, especially to make luminous by heat • Arouse the passions of; excite • CHANGE • Embrace or force

4. CHALLENGE ONE: GLOBALIZATION • WHA 59.27: Strengthening nursing and midwifery • Islamabad Declaration on Strengthening Nursing and Midwifery, 4-6 March 2007 • All people should have access to competent nurses and midwives who provide care, supervision and support in all settings. • A coordinated, integrated, collaborative, sustainable approach to planning, policy and health care delivery is necessary to strengthen nursing and midwifery services and acknowledge that countries in crisis or conflict have unique needs. • Urgent attention is needed in three key areas: • scaling up nursing and midwifery capacity • skill mix of existing and new cadres of workers • positive workplace environments.

5. CHALLENGE ONE: GLOBALIZATION • World Health Organization • Nursing and Midwifery Strategic Directions 2002-2008 • Nursing and Midwifery Strategic Directions for 2010-2015 (SDNM) • Global Standards for Initial Education in Nursing and Midwifery • Global Programme of Work 2008-2009 (GPW) Nursing and Midwifery contribution to primary health care

7. What we know… • WHO study … nurse density is primary driver for lower levels of HIV rates (even when medical drdensity is higher) • In acute care settings … nurses with baccalaureate or higher level education, mortality rate and failure-to-rescue is 5% lower • Midwives handle 75% of world’s births

8. CHALLENGE TWO: CHANGING LEGISLATIVE LANDSCAPE • Nursing Act, 2005 - Act No. 33 of 2005 • Scope of Practice • Qualifications - competence • SANC role - accreditation • Higher Education Qualifications Framework, 5 October 2007 • SAQA – Qualifications expire Nov 2010

9. CHALLENGE THREE: THEORY-PRACTICE INTEGRATION • Disease profile of SA • HIV/AIDS • Cerebrovascular disease • Ischaemic heart disease • Lower respiratory infections • Violence • Tuberculosis • Diarrhoeal diseases • Road traffic accidents • Diabetes mellitus • Chronic obstructive pulmonary disease • Three-fifths of world older population in developing countries - GERONTOLOGY • Curriculum impact

10. CHALLENGE THREE: THEORY-PRACTICE INTEGRATION • Evidence – based (scholarship) • Clinical role of RN • Interprofessional Education (CNA) • Population Health Approach • Person-centred health care, Access • Respect and trust • Quality care and services • Communication

11. CHALLENGE FOUR: WORKFORCE ISSUES • Estimated shortage of almost 2.3 million doctors, midwives, nurses and support workers worldwide • 57 countries have critical shortages – 37 in SSA • Sub-Saharan Africa has only 4% of health workers but 25% of the global burden of disease • The Americas have 37% of health workers but only 10% of global burden of disease

12. STATISTICS • Global health workforce, by density • Estimated critical shortages of doctors, nurses and midwives, by WHO region

15. WORKFORCE CHALLENGES • Adequacy – Which model? What evidence? (RN4CAST) • Increased production – ‘calculated risks’ • Age profile • Reasons for shortages: • Salaries • Limited career ladder • Poor work conditions • Increased work loads • Shortage of nurse educators

16. Distribution of Registered Nurses and Midwifes

17. CHALLENGE FIVE: LEADERSHIP • National Nursing Directorate • Chief Nursing Officer • Office of Nursing Policy

18. OPPORTUNITIES • Education and Training: • Curriculum to meet the disease profile of SA • “Programmatic” and policy approach • Increase number of nurse educators • RN to accept teaching and mentoring role and re-introduction of clinical preceptors • Capacity development of nurse educators • New modalities of delivery • Access flexibility – “millennium babies” • Interprofessional Education

19. OPPORTUNITIES • Health System Strengthening • Access – more personnel - Nursing Act provides for Enrolled Midwife • Access to information by staff • Nurse-led research – provide evidence • Engage in policy • Workplace Environments • Review of the implementation of the ILO convention • Immunization of health care workers • Career opportunities • Violence elimination • Restoration of image of profession

20. IMAGE OF NURSING PROFESSION

21. OPPORTUNITIES • Leadership (Talent management) • Nursing Education Provincial Directorates • JOINT effort • Partnerships • NEA-FUNDISA partnership • Global Alliance for Nursing and Midwifery (GANM - WHO) • Health Professionals Network (WHO) • International Alliance for Nursing Educators (IANA - STTI)

22. CONCLUSION • Start the fire of change • Arouse the passion • Ignite the profession

23. THANK YOU BAIEDANKIE KE A LEBOGA NGIYABONGA Hester.Klopper@nwu.ac.za