Towards a Shared Concept for Community Nursing

1. Towards a Shared Concept for Community Nursing Catherine Whitty National Practice Development Co-ordinator PHN Services

2. Developments in Community Nursing • Practice Development • Service Challenges/Strengths/Opportunities • Current national service developments

3. National Practice Development Post • Established March 2017 within ONMSD • Key purpose is to facilitate the: • promotion of safety and quality standards • expansion of excellence in practice • development of a national standardised approach • promotion of person centred cultures

4. What is Practice Development? Practice development is a continuous journey of developing, and innovating in care settings, so that patients/residents, families and the team engage with each other in person-centred ways. This engagement is brought about by teams developing their knowledge and skills and changing the culture of care. It is helped to happen by the team working with systematic and continuous processes of development and evaluation that involve and include the views, experiences and needs of patients/residents, families, the team and others. (Dewing, McCormack & Titchen, 2014)

5. Challenges to Current Practice • Increased demands for the service • Staffing levels to meet current demand • Changing demographics • Earlier hospital discharges • Greater complexity of care needs • Chronic Disease Management • Patient Safety and Quality Standards • Requirement for Integrated Systems • Infrastructure • Economic recession

6. PHN Service Strengths • Population Health Expertise • Self Care Focus • Provision of care throughout Life Cycles • Community Health Promotion Model • Domiciliary

8. Service Opportunities • Development of primary care • New infrastructure • Planned ICT developments • Specialist post development • Child health services/Nurture

9. What’s happening?

10. Manage for best outcomes, positive patient experience and value for money • Development of a national framework for Quality Improvement • Established January 2018 • Support of ONMSD and Community Operations • All CHO regions and grades within service represented • Head of Service and HEI Rep

11. Quality Improvement Group Work • ADPHN Development Programme -Depend and Value Workforce • KPI on Tissue Viability Services - Best Outcomes & Value for Money • National Mission Statement & Philosophy - Transparency, Positive Patient Experience • Breastfeeding: BOAT - Promote Health & Wellbeing

12. Manage for best outcomes, positive patient experience and value for money • Primary Care Activity Metrics • Child Health Activity Metrics • Electronic Caseload Management System

13. An honest, transparent, compassionate and accountable service • Discharge of Patient PPPG • Referral of a Patient to the PHN Service PPPG

14. Equitable and timely access to a quality safe service Safe Administration of Medication Project • Standardised national request form for prescribers to include; • Essential demographic, medical, medication and prescriber details • Review Mechanism • Standard for auditing

15. Promote Health & Wellbeing • Developmental Screening – ASQ-3 • Sleep Management Preschool Children • BOAT

16. Future Developments • Enabling Person Centred Cultures • Maternal Postnatal Record • Exemplars from practice for expansion?

17. “New Horizons…” An opportunity to; • Create a shared vision • Develop the strength of collective • Question and challenge • To support access and equity of service for all clients

18. You cannot swim for new horizons until you have courage to lose sight of the shore. William Faulkner