Progress Report on Post SARS Nursing Service Direction and Development

1. 1 Progress Report on Post SARS Nursing Service Direction and Development  Presented by Dr Susie LUM, SEM(N) at MSDC On 28 June 2004

2. 2 Impacts of SARS on Nursing Profession Change Response Crisis Management Competences of ICU Nurses and Infection Control Communications and Caring

3. 3 Lessons Learnt From SARS Create new roles of nurses and new ways of doing things Nursing leadership/preparedness for facing future challenges/crisis Critical manpower assessment and development of new skill mix

4. 4 Six Major Achievable Goals Ensure Infection Control Competence and Build ICU Reserve and Training Facilitate Nursing Manpower and Deployment Enhance Service Management and Communication Standardize Nursing Care Delivery Model Review Current Patient Care Procedures Facilitate Community Nursing Service

5. 5 Ensuring IC Competence & Building ICU Reserve An ICN subcommittee been formed in 4Q 03 10 more out of 40 to be recruited to improve ICN ratio Already appointed 900 Infection Control Link Infection control trainings for new recruits and all nursing specialty been provided Already reviewed and updated all high risk patient care procedures

6. 6 (a) Nursing Infection Control Training 650 nurse be enhanced in coming 5 years In 2003, 286 nurses attended respective infection control trainings in different levels As at 23 April 2004, 307 nurses been sponsored to undertake local infectious disease control trainings

7. 7 (b) Nursing Intensive Care Training To achieve target goal that 70-80% of serving intensive care nurses are provided with the specialty trainings To achieve target goal that 10% of total nursing workforce for each cluster are instituted as a training reserve

8. 8 Three Levels of trainings from April 2003 to March 2005 Level A (Post Registration Certificate) � 125 nurses trained Level B ( Preparatory Course) � 539 been trained in 2003/2004 and 160 of non ICU nurses attend this course in 2004/2005 Level C ( Advanced Critical Care Nursing)- 95 already trained in 2003/2004 and some more to be trained in 2004/2005

9. 9 (2) Nursing Manpower and Strategies Recruit for Contingency Collaborate with private hospitals, universities and Department of Health Relieve the manpower demand Consolidate deployment plans

10. 10 (a) Recruitment for Contingency Recruited 487 RN in 2003/2004 and 400 RN to be recruited in 2004/2005 Recruited 3-5 agency nurses/other part time nurses in April 2004 Compiled a central registry of all retired nurses who could work in HA during contingencies 65 retired staff in both general stream and psychiatric stream list prepared to rejoin HA list of 78 HA staff (VER) been ready---special approval required)

11. 11 610 TUNS available for management consideration 277 already recruited to work on Saturdays and/or Sundays Explore skill mix changes i.e. TSA in OT Other sources of supply to be explored (e.g from Macau or PRC)

12. 12 (b) Collaboration with External Stakeholders Discussions on manpower deployment, contingencies and risk with various providers been initiated

13. 13 Reduction of non-essential /urgent nursing services Redeploying of support workers and general grade staff to take nursing administrative work and/or non-nursing duties

14. 14 HR Guiding principles on shift duty and leave arrangement been promulgated Plans on service prioritization and reorganization; voluntary deployment; rotation and inter-department and inter-hospitals communications been formulated Intra-cluster deployment been initiated HAHO to centrally coordinate when crisis emerge and to take step up measures

15. 15 (3) Enhancing Service Management & Communication Communication plans formulated and implemented Senior nurses and the managers already attended a 3.5 days Commissioned Program on Leadership for Change including Crisis Mgt, surveillance for Hospital-acquired Infections in Nov 2003 Frameworks for Clinical Leadership been developed and 300 more nurses targeted to be trained in 2004/2005

16. 16 (4) Standardizing Nursing Care Delivery Model Already conducted reviews of the current nursing care delivery and practices in 686 wards in 38 hospitals in 3Q 2003 To endorse new principles to streamline care processes and workflow, to minimize cross infection and physical contacts ; and to make major recommendations at various platforms and forums

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18. 18 (5) Reviewing Current Patient Care Procedures Already reviewed and updated high risk patient care procedures in September 2003. Evidence-based Practice Seminar already conducted by Joanna-Briggs Institute in early May 2004 for the nursing profession and possibly in early 2005; and promotion of EBP in active progress 21 specialties guidelines been developed, and 16 been ready for promulgation and others to be finalized in 2004

19. 19 (6) Community Nursing Services 51 nurses and 35 allied health professionals already attended a certificate course on Community Based Health Care Various clusters have worked out collaborative model with outreaching teams Integrated model of FM/CNS to manage episode problems to be piloted in HKW,KW and KE 5 Health promotion/teaching packages been ready for dissemination 11 Home Care Protocols to be developed by 4Q 04

20. 20 Long term targets Enhance IT support for effective reporting and documentation and pilot in KWC 04/05 Reengineer workflow to streamline care process in 04/05 Review nursing manpower situation Evaluate effectiveness of the proposed care delivery Enhance competencies of 650 nurses in infection control in coming 5 years

21. 21 Build up a training reserve of 10% of total nursing force for each acute hospitals in coming 3 years Achieve 70-80% of serving intensive care nurses with formal ICU nursing in coming 3 years Develop an information technology system to monitor and initiate ad hoc staff movement during crisis in 04/05

22. 22 Success is based on Creative use of untapped human energy Make people as our partners Engage them meaningfully either in improving the present operation of the organization or creating its future Blanchard 2002

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