QUALITY AND QUANTITY IN NURSING CARE IN PRIMARY CARE IN CROATIA July 2003 June 2006

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QUALITY AND QUANTITY IN NURSING CARE IN PRIMARY
CARE IN CROATIA July 2003
June 2006

• Croatian participating organisations
• Ministry of Health
• Ministry of Education and Science
• Nursing Chamber
• Health Inssurance
• Health Centre Split-Dalmation county
• Home Care Institutes in Split
• GP ambulatories and pediatrics
• Clinical Hospital Split
• Nursing College at Medical Faculty Split
• Participating organisation from the Netherlands
• NSPOH

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Split-Dalmatian county Surface 14.045 km 2
Inhabitants 465.177
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Grad SPLIT Sjedite Splitsko-dalmatinske
upanije Broj stanovnika 187.599Povrina 79,33
km2
SPLIT
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Overall objectives of the project

• Optimize the nursing system in primary care
• Contribution policy making on quantity and
  quality in nursing care
• Contribution to the development of the curriculum
  for nurses
• Project goal
• To give tools and knowledge to set and maintain
  standards and criteria for good nursing practice
  and rational nursing management

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Main results achieved

• Validated and accepted instruments to manage and
  monitor quantity and quality in nursing care
• Insight in the required quantity and quality in
  nursing care in Health Centre
• Knowledge and skills to plan, to realize, to
  evaluate and to adjust the number of nurses
• Results out of the project are incorporated
  within the curriculum for nurses
• HC Split can function as an education centre on
  quantity and quality in nursing care
• Dissemination of the project results among
  nurses, nurse managers and policy-makers
• Accepted nursing documentation for Community
  nurses and Home Care Institutes
• Accepted Croatian-Model to assign nursing care at
  home incorporated in the law
• Accepted competencies for registered nurse by
  Nursing Chamber
• Performed research on Prevalence of Ulcer
  Pressure in county Split

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Main obstacles during the implementation of the
project

• Expected
• Resistance from nurses in the begining, GP
• Time limitation to execute the proposed
  activities in the project
• Unexpected
• Resistance from home care institutes
• The idea that the position of community nurse
  can be taken over by home care nurse
• Time needed to develop and test documentation, to
  define competencies which are indispensable for
  quality of nursing care
• Time needed to execute extra education programs
  for nurses

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The concept of primary care in CRO

• Health protection on primary level includes
• To follow the health status of inhabitants and to
  suggest measures for protection and promotion of
  the health of the population,
• To prevent and to detect illness and also cure
  and rehabiliation of ill persons,
• Specific prevention protection of children and
  youngsters special in primary and middle schools,
  high schools and universities in own region,
• Health protection of women,
• Prevention health protection risk groups and
  other inhabitants according to programs of
  preventive health protection,
• Counseling, health education, health promotion,

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• Hygiene-epidemiologic protection,
• Protection, detection and treatment of tooth and
  mouth illness with rehabiliation,
• Health rehabiliation of children and youngsters
  with physical and mental disorders,
• Visits of community nurses, home care and medical
  treatments at the patients home,
• Occupational health,
• Emergency medical help,
• Palliative care,
• Protection of mental health.

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The strong defenders of primary care

• Ministry of Health
• GP Association

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Further development of primary care Helpful
international support

• In my country the Law of Health Protection is
  in the process of finalizing and because of this
  procedure I can not go into
• details on this matter and there for I can
  also not say in concrete which international
  support will be helpfull and or on our priority
  list.

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The nurses from the Health Center Split and
Croatia would like to thanks again to Ministry of
Foreign Affairs of the Netherlands foundation
MATRA to make it possible to execute the
project in the nursing profession.