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

Impacts of SARS on Nursing Profession

Change Response Crisis Management Competences of ICU Nurses and Infection Control Communications and Caring

3

Lessons Learnt From SARSCreate new roles of nurses and new ways of doing thingsNursing leadership/preparedness for facing future challenges/crisisCritical manpower assessment and development of new skill mix

4

Six Major Achievable GoalsEnsure Infection Control Competence and Build ICU Reserve and Training Facilitate Nursing Manpower and Deployment Enhance Service Management and Communication Standardize Nursing Care Delivery ModelReview Current Patient Care ProceduresFacilitate Community Nursing Service

5

(1) Ensuring IC Competence &

Building ICU Reserve

An ICN subcommittee been formed in 4Q 0310 more out of 40 to be recruited to improve ICN ratioAlready appointed 900 Infection Control LinkInfection control trainings for new recruits and all nursing specialty been providedAlready reviewed and updated all high risk patient care procedures

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 levelsAs at 23 April 2004, 307 nurses been sponsored to undertake local infectious disease control trainings

7

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

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

Microsoft PowerPoint Presentation

9

(2) Nursing Manpower and Strategies

a) Recruit for Contingency b) Collaborate with private hospitals,

universities and Department of Health

c) Relieve the manpower demandd) Consolidate deployment plans

10

(a) Recruitment for Contingency Recruited 487 RN in 2003/2004 and 400 RN to be recruited in 2004/2005Recruited 3-5 agency nurses/other part time nurses in April 2004Compiled a central registry of all retired nurses who could work in HA during contingencies

a) 65 retired staff in both general stream and psychiatric stream list prepared to rejoin HA

b) list of 78 HA staff (VER) been ready---special approval required)

11

610 TUNS available for management consideration277 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)

Microsoft PowerPoint Presentation

12

(b) Collaboration with External

Stakeholders Discussions on manpower deployment, contingencies and risk with various providers been initiated

(c) Relieving Manpower Demand Reactivating continuous night duty

wherever possibleDeferring planned annual leave and non

essential in service training Encashment of annual leave

13

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

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 formulatedIntra-cluster deployment been initiatedHAHO to centrally coordinate when crisis emerge and to take step up measures

(d) Deployment Plan

15

(3) Enhancing Service Management & Communication

Communication plans formulated and implementedSenior 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

Microsoft PowerPoint Presentation

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 2003To 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

Microsoft PowerPoint Presentation

17

The approach on care delivery “Vertical Nursing” being piloted in QMH and be rolled out to other hospitals in 2004/2005; Further exploring if the frameworks could be carried out

Microsoft PowerPoint Presentation

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 progress21 specialties guidelines been developed, and 16 been ready for promulgation and others to be finalized in 2004

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 teamsIntegrated 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

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

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

Success is based on Creative use of untapped human energyMake people as our partnersEngage them meaningfully either in improving the present operation of the organization or creating its future

Blanchard 2002

23

Thank You