INSTITUTIONAL STRATEGY NURSING ASSOCIATION REPUBLIC OF MOLDOVA

2015-2020

I. Introduction

“Nursing Association of Republic of Moldova” (forwards Association / NARM) is a professional and scientific, non-governmental, non-profit and apolitical organisation, constituted by the free will of associated individuals with the aim to achieve the common goals determined by the statute.

The vision of NARM represents the community of nurses with clinical profile from Republic of Moldova, militating for protection of their rights, but also for offering the qualitative nursing services which will permit to improve the health condition of our population.

The mission of NARM is to assure leadership, knowledge and capacity needed for education and qualitative practice in nursing. The aims of NARM are:

To create the level of professional competence to aim at improvement of health conditions of patient, family and community; placing the stress from curative activity to the prophylaxis; having as final aim promotion of health strategy for everyone, assuring in this way a fundamental right of individuals;

To promote the quality of nursing services, to aim to protect the right of the population’s health through an educational system according to the European Union Standards;

To represent the profession to the authorities and population, as well as to the non-governmental, national and international organizations.

“The institutional strategy of Nursing Association Republic of Moldova for 2015-2020” (forwards The Strategy) is the mainly document on planning and strategic management of the Association for a period of time, as a reference for the central and branch levels, and determines the development objectives, establishing measures and priority actions for 2015-2020.

The document is based on the strategic development policies of the Ministry of Health in the health care system in the context of European Union (EU) standards. The initiatives in the Strategy are complex actions feasible in cooperation with public and private partners to develop nursing services according to real needs and expectations of the beneficiaries. The quality of the collaboration is essential to a successful implementation of the Strategy.

The actions outlined in the Strategy are based on the criteria stipulated in policy documents of the health sector and developed according to the requirements of the World Health Organization (WHO). In developing the Strategy were consulted the following strategic documents: The National Health Policy for 2007 - 2021, approved by the Government Decision nr. 886 from 06.08.2007; The development strategy of the health system in 2008-2017, approved by the Government Decision nr. 1471 from 24.12.2007; The Action Plan of the Ministry of Health, approved by the Order nr. 232 from 03.31.2015.

In a complex operational context in which political, economic, social and technological changes face common challenges, the most significant ones are dynamic data changes and general attitude towards the changes, perceived as threats.

From this perspective, developing a strategy to respond effectively to the needs of professional development of members, profession and institution development has been a participatory process, which was aimed to ensure objectivity, accuracy, relevance and a solid foundation for implementation.

In the process of finalizing the Strategy were involved approximately 700 members of the Association from 68 branches and 80 primary care organizations of which 148 are leaders of national and district authorities, including 552 nurses. The data collection was achieved by standardized questionnaire and problem / obstacles / barriers identification, needs, opportunities, and strategic development measuresfor 2015-2020. After analyzing the data from respondents and consultation with the leaders have been established strategic objectives, operational priorities and strategy implementation plan for 2015-2020.

II. Context

The current situationSince the establishment of the Nursing Association of Moldova in 1994, the Association activities

and projects were conducted according to the mission of the Association, progressively increasing the level of professional competence, leading to continuous improvement of practice and competence professionals to ensure patients' right to health.

The previous actions of the Association during 1994-2014 were focused predominantly onthe development and implementation of modern nursing, information and training of nurses about the new medical concept, continuous improvement of the legislative framework of the profession and contribution to the development of the profession on national and international levels. Through its activities, active presence and assumed responsibility of leaders and members, the Association has become a prestigious organization in Europe and an important factor in representing the professional interests of its members on national and international levels.

Also this period was focused on organizational development actions, structural strengthening of the association, updating the internal regulations according to the legislation of the EU and its members wishes.

The Association is currently characterized as a stable with great potential organization, a dialogue partner of the Ministry of Health on topics related to the development of the profession. The activities of the Association are highly appreciated internationally, in partnerships with similar organizations that are members of the European Forum of Nursing Associations of the WHO in collaboration with the European Federation of Regulatory Commissions of the profession.

The main tasks of organizational development are image profession, building national and international partnerships (particularly European ones) in professional development and image, improving the legal framework of the profession in order to ensure autonomy and independent activity, restructuring the national program of continuous medical education to meet the continuous professional development needs, and improving internal and external communication.

PartnersThe development opportunities of the Association are to develop and implement modern nursing,

development and expansion of home care services and palliative care, partnership building, leadership development, access to available European funds, human resources development programs on cultural changes, ensuring both attitudes and behaviors consistent with organizational aspirations and increasing the capacity of the Association to manage external factors changes.

The main partners are the Ministry of Health, World Health Organization, European Forum of Nursing Associations, European Nurses Confederation, Union “HEALTH”, National College of Medicine and Pharmacy "Raisa Pacalo", Centre of Continuous Education for Healthcare Professionals, NGOs, and medical institutions.

III. The aim and strategic objectives

The principles underlying the development and implementation of the Strategy are: Professional growth; Performance in professional processes and organizational development; Participation of the members in the development processes; Commitment to action on fundamental documents; Relevance to the establishment of professional development processes and organizational

development.

The Strategy goals are to increase organizational efficiency in development of the profession, image and prestige in society and representation of nurses through health policies. The strategy sets out the following strategic objectives for institutional development of the Association:

Legislative acts on the profession and efficiency in the area; Prestige of the profession and professionals, both medical and social sectors;

Functional capacity of the Nursing Association for an effective contribution to the implementation of modern nursing.

IV. Operational objectives and actions

Strategic objective 1: Strengthening the profession of nurse, efficiency increase in the professional area of the Association’s members.

Objective 1.1: Contribution to the legislation strengthening of the profession through initiatives, of any legislative act on the profession of nurse according to European standards for professional practice. To achieve this goal there are following actions:

Nr. Action Timeline Partner1. Proposals and recommendations to improve the process of

management on governmental level and medical institutions, the nursing process in the health care system

Ongoing Ministry of Health

2. Support to develop subdivisions of nursing and / or nursing specialists of the Ministry of Health and Health Departments

2015 - 2016 Ministry of Health / local public authorities

3. Proposals to improve the legislative framework and human resource policies in healthcare / nursing sector, and laws review to increase the professional level of knowledge of specialists

2015 - 2016 Ministry of Health

4. Laws and regulations on personnel according to European standards

2015 - 2016 Ministry of Health / National College of Medicine

5. Reserves of managerial personnel in nursing Ongoing Ministry of Health / National College of Medicine

6. Regulatory legal acts on the workload of nurses from different areas of activity

2015 - 2017 Ministry of Health / “Health” Union

7. Proposal and recommendations to develop mechanisms of moral and financial personnel retention

2016 - 2017 Ministry of Health

8. The procedure of licensing of nurses using base tests developed by the Nursing Association Moldova

2016 - 2017 Ministry of Health / National College of Medicine

9. Proposals to improve the remuneration process of nurses 2016 - 2017 Ministry of Health / Ministry of Labour

10. Necessary investments to ensure the infrastructure development of specialties in nursing

Ongoing Ministry of Health / local public authorities / National Company of Medical Insurance

11. National and regional database on medical technologies 2016 - 2017 Medical institutions 12. Jurisdiction between doctors and nurses, according to

professional standards2016 - 2017 Ministry of Health

13. Implementation of the modern nursing model in healthcare system

2017 - 2018 Medical institutions

14. Normative framework that will regulate the activity of nurses in clinical processes and prevention

Ongoing

15. Evaluation indicators system to assess the quantity and quality of services

2015 - 2016

16. A concept of qualification system and training of nursing personnel

2015 - 2016

Objective 1.2: Development of documents with reference to professional regulations (protocols and practice guidelines, professional standards, etc.) according to the Strategy of the Ministry of Health, directions of professional practice of European regulations or imposed by technological progress, profession or medical sciences. To achieve this goal there are following actions:

Nr. Action Timeline Partner1. Management models of nurses activities on all levels Ongoing Ministry of Health /

local public authorities2. Necessary documents on accreditation criteria in Nursing

care2015 - 2016 Ministry of Health /

National Council of Evaluation and Accreditation in Health

3. Professional nursing standards and protocols of nurses activities

Ongoing Ministry of Health / National College of Medicine

4. Emergency care services. New models of provision in health care services and nursing care

2017 - 2018 National College of Medicine

5. State educational standards in three areas: Nursing, Obstetrics and Midwifery, General Medicine

2017 - 2018 National College of Medicine

6. List of new specialties for nurses with higher studies according to professional standards

2017 - 2018 National College of Medicine

7. Educational standards according to professional standards 2017 – 20188. Quality criteria and integration of nursing care 2017 – 20189. The concept of professional nurses activity 2015 – 201610. Universal health care services centered on patient 2016 – 201711. Activity process of nursing personnel in primary care,

hospice and palliative careOngoing

12. Innovative programs and models in nursing Ongoing 13. Simple nursing techniques for the community Ongoing

Objective 1.3: Increasing professional education of nurses by reviewing and improving medical education programs, according to internal factors (nurses training needs, their expectations, dynamics and evolution of the profession, other factors) and external (national or European legislation, other factors). To achieve this objective there are following actions:

Nr. Action Timeline Partner1. The potential of human resources based on rational

planning, professional, continuous and advanced Ongoing Ministry of Health

2. Policies on human resources and professional educational system on different levels: baccalaureate, PhD, etc.

Ongoing Ministry of Health / Ministry of Education / National College of Medicine

3. State and local mechanisms on training process of nurses 2015 - 2016 Ministry of Health / National College of Medicine / local public authorities

4. National List of Nurses with their qualification features 2015 - 2016 Ministry of Health5. Competence and level of responsibility of medical

institutions that have practice training of students2016 - 2017 Ministry of Health

6. Level of teachers’ competence from Medicine Colleges in medical computer technologies

Ongoing National College of Medicine

7. Process of training of computer technologies Ongoing 8. Online education system and other methods to train health 2017 - 2018 National College of

care professionals Medicine9. Quality control system in professional process on all levels 2017 - 2018 National College of

Medicine10. Informational system to support the educational process,

new programs for students2017 - 2018 National College of

Medicine11. Software programs in medical educational institutions Ongoing National College of

Medicine12. Online library for nursing personnel 2015 - 2016 National College of

Medicine13. Scientific research in nursing Ongoing National College of

Medicine14. Experimental technological activity in nursing Ongoing 15. Experimental system of research and innovation for

nursing personnel Ongoing National College of

Medicine

Strategic objective 2: Increasing the profession image and health care professional in medical and social sectors.

Operational objectivesObjective 2.1: Building strategic partnerships. To achieve this objective there are following actions:

Nr. Action Timeline Partner1. Best practices and models to retain the nursing personnel

through excellent working conditions Ongoing Medical institutions

2. Professional participation in social programs Ongoing 3. Professional status in nursing, social protection Ongoing 4. Public health care, medical and social, diagnosis, nursing

programs: “Diabetes”, “Tuberculosis”, “Pregnancy without risk”, “Anti-AIDS/HIV”, “Blood pressure prophylaxis”, “The elderly”, “Children’s health”, “Healthy nutrition”, “Diseases caused by stress”, etc.

Objective 2.2: Building partnerships with international professional associations. To achieve this objective there are following actions:

Nr. Action Timeline Partner1. Partnership in medical area with governmental and non-

governmental international organizations and foundations (WHO, UNICEF UNAIDS, etc.)

Ongoing WHO, UNICEF UNAIDS

2. Partnership in social area with international organizations and foundations

Ongoing

3. Direct partnership with medical and educational international organizations in nursing care

Ongoing

Objective 2.3: Strengthening the Nursing Association in professional area through programs that raise the image and the profession of a nurse, both national and international level. To achieve this objective there are following actions:

Nr. Action Timeline Partner1. Participation at international projects: Leadership,

Tuberculosis prophylaxis, etc. Ongoing

2. Participation at international research, technological research programs of health care area

Ongoing

3. National Nurses Conference. Scientific research in nurses’ Ongoing

activity. Objective 2.4: Local and external communication through values, activities and professional outcomes of members. To achieve this objective there are following actions:

Nr. Action Timeline Partner1. Development of possible technologies. Ongoing2. Informative data base for all health care institutions in the

system. 2015 - 2016

Strategic objective 3: Capacity development of the association.

To achieve this objective there are following actions:

Nr. Action Timeline Partner1. Legal regulations on the association (statute, etc.) Ongoing 2. Management system 2015 - 20163. New legal regulations on NGOs Ongoing 4. Continuous education programs Ongoing 5. Evaluation program on strategic objectives of the

association2016 – 2017

6. Reporting system on strategic objectives of the association 2016 - 2017

Strategic and operational objectives will be achieved through annual plans to implement this strategy which each branch will determine, according to the operational context of local and national priorities, or local events.

To implement the Strategy it is important that this operational plan to be reviewed annually and adjusted according to the priorities caused by internal or external factors.

V. The outcomes

Strategic objectives The outcomesTo develop a frameworkon the profession andefficiency in the professional area of association’s members

- Updated legislation according to the aspirations and professional needsof nurses; - Local updated legislation;- Performance, efficiency and progress in all primary, regional and national structures.

To raise the prestige of the profession and professionals in health care and social areas

- Membership of national and international structures;- Partnerships and collaboration with relevant organizations of professional area;- Progress in image of the profession and professionals: health care and social area;- Promoting successful practices, research-based evidence.

To strengthen the capacity development of Nursing Association for an effective implementation of modern nursing

- Quality services;- Performance, efficiency and progress in the nursing process;- Implementation of Nursing Plans;- Individual Nursing care Plans developed on hospital and community levels;- Effective communication skills.