Nursing Workforce Transition Project

1
Nursing Workforce Transition Project

• Paula Stephenson
• Director Nursing Midwifery Education
• October 2007

2
Nursing Workforce Transition Project

• Objectives
• To address the current and projected nursing
  workforce deficit (one part of strategy)
• To reduce vacant nursing positions to enable
  financially accountable provision of nursing
  services
• To increase the number of Division 2 RNs working
  in acute care (aim 20 across SH)
• To establish an Acute Care Transition Program for
  Division 2 RNs
• To maximise the scope of practice for Division 2
  RNs

3
Nursing Workforce Transition Project

• September 2006
• Submission to DHS for funding of project- RN Div
  2 ESOP
• February 2006
• Submission successful
• March 2006
• Appointment of Project Manager
• May 2006
• Commencement of Acute Care Transition Program
• 26 Div 2 RNs commenced full time employment in
  acute med/surg and specialty wards

4
Nursing Workforce Transition Project

• Project Initiation
• Engage clinicians, managers
• Source general med/ surg wards with EFT deficit
  to take part in ACTP
• Source existing acute care competencies - (Div 2)
  and individual programs
• Preceptorship/ mentorship for clinicians
• Initial evaluation tools/ reports
• Site working parties

5
Nursing Workforce Transition Project

• Key Activities
• ACTP curriculum/ program developed to incorporate
  acute post basic module (Chisholm)
• Nursing Workforce Transition Project Resource
  Manual for ward staff
• Staff briefings- NUMs and clinicians
• Identification and briefing of preceptors
• Inclusion of concepts of delegation and
  supervision, responsibility and accountability
  into preceptor program and education of NUMs

6
Nursing Workforce Transition Project

• November 2006
• First ACTP completed (90 retained)
• Commenced second ACTP (24 participants)
• February 2007
• Nursing Workforce Transition Project completed
• May 2007
• Second ACTP completed (80 retained)
• Commenced third ACTP (11 participants)
• November 2007
• Third ACTP to finish
• Fourth ACTP to commence (8 participants)

7
Nursing Workforce Transition Project

• Evaluation
• Professional development for Div 2 RNs (pre/
  post)
• Survey of clinical learning environment and
  supervision (mid/ post)
• Nursing staff survey (pre/ post)
• Patient satisfaction survey (pre/ post)
• General perceptions of ACTP
• Nursing workforce data

8
Nursing Workforce Transition Project

• Findings
• Improved skill level and confidence over time of
  RN Div 2
• Patient satisfaction unchanged
• Modest improvement in level of acceptance of role
  of RN Div 2
• Perceptions of increased workload of RN Div 1
  due to supervision requirements
• Preceptorship model needing improvement
• Need for further development of RN Div 2
  reflective abilities and critical thinking

9
Nursing Workforce Transition Project

• Outcomes
• 7.59 June 05
• 5.83 March 06
• 8.82 Dec 06

10
Nursing Workforce Transition Project

• Outcomes
• 12.05 Sept 05
• 16.10 June 06
• 15.35 Feb 07

11
Nursing Workforce Transition Project

• Benefits
• Establishment of a program of ongoing education,
  professional development and employment for RN
  Div 2s
• A strategy to develop a sustainable and skilled
  nursing workforce
• Reduced nursing vacancies and financial
  accountability
• A greater ability to provide better health for
  our community
• A better match of skills and resources to patient
  needs

12
Nursing Workforce Transition Project

• Limitations
• Resistance to change by Div 1 RNs
• Lack of familiarity with delegation, supervision,
  responsibility and accountability
• Lack of resource and commitment to change in some
  areas
• Existence of differing care models not conducive
  to two tiers of nursing

13
Nursing Workforce Transition Project

• Other Initiatives
• Revision of generic PDs for RN Div 1 2
• Development of Models of Care Toolkit
• Action learning sets for managers
• Development of SH guidelines on scope of
  practice, delegation and supervision
• Nursing and Midwifery Scope of Practice Committee

14
Nursing Workforce Transition Project

• Future Directions
• New Health Training Package- Cert IV, Dip, Adv
  Dip
• Reduced Vacancies in med/ surg areas
• Skill mix in specialty areas
• Opportunities for Div 2s in specialty areas
  periop, renal, maternity, emergency

15
Acute Care Transition ProgramCareer Pathways for
Division 2 Registered Nurses (Div 2 RNs) at
Southern Health

• Aims
• Increased employment opportunities for Div 2 RNs
• Enhanced theoretical knowledge and practical
  skills in acute nursing
• Professional development and career diversity for
  Div 2 RNs
• A skilled, balanced and
• sustainable nursing workforce
• Reduced nursing vacancies

• Method/ Approach
• Endorsement by Executive Director Nursing and
  Midwifery, Nursing Executive, Nursing Education
  Research
• Project manager funded through DHS Enhanced Scope
  of Practice Project
• Accredited education module in collaboration with
  Chisholm Institute
• Recruitment and selection of Div 2 RNs
• Orientation and employment on wards
• Preceptor model to support program participants
• Competency assessments, tutorials and debriefing

• Benefits achieved/ Outcomes
• Employment of 24 full time Div 2 RNs (May 06)
• Greater ability to provide better health for our
  community
• Development of our people
• Exciting initiatives to better match skills and
  resources to patient needs
• Twice yearly programs to provide employment,
  ongoing education and professional development

The Future We are committed to consolidating
career pathways for Div 2 RNs. The ACTP is an
entry point into acute nursing and we aim to
further enhance the Div 2 RN role in all areas.
With extended scope of practice (medication
administration) and planned changes to the Cert
IV Nursing curriculum, we have embraced a unique
opportunity to lead advancements in Division 2
nursing in Victoria.
Find out more laura.milligan_at_southernhealth.org.a
u or paula.stephenson_at_southernhealth.org.au