|
|
||||||||||||||||||||||||
|
|
Overview of strategies and recommendationsRecommendationsThis Review was commissioned by two Commonwealth Ministers and supported by the State and Territory Health Ministers. However, it must be recognised that many other stakeholders have an interest in the outcomes of the Review and are also essential to the success of the Review. These include other portfolios such as Defence, Veterans’ Affairs, Employment and Immigration, as well as nursing and education organisations. Other players essential to the outcomes are the employers. Often the contribution of individual nurses is overlooked in reviews that focus on issues of system change and funding implications. We are acutely aware of the contribution of individual nurses to the health care of the Australian people. The energy, support, commitment and creativity of individual nurses is the only way the implementation ofnew arrangements and processes will make a difference and enable the significant successes already achieved to be consolidated. These recommendations have been based on the fundamental principle that, in order to provide a universal healthcare system that provides safe and quality outcomes, an adequate investment in nursing education and training is essential. This investment is primarily a public responsibility rather than a matter for the private market. The following seven themes provide the understandings and positions that form the basis of the report and its recommendations:
Recommendation 1—Implementation taskforce Commonwealth, State and Territory health and education and training ministers should establish a national implementation taskforce to action, monitor and report on the progress of implementation of the recommendations. Proposed responsibility: Commonwealth, State and Territory health and education and training departments (Relevant discussion Section 5.1.1) Recommendation 2—Establish a National Nursing Council of Australia Key to the development of Australian nursing is nursing leadership and national coordination. To achieve these outcomes: a) An independent National Nursing Council of Australia (NNCA) should be established. b) The body should be established, for five years in the first instance, to:
c) The NNCA and its secretariat should be funded by Commonwealth, State and Territory governments with in-kind contributions from nursing organisations. d) Membership should comprise nurse regulatory authorities, public and private sector nursing, nursing education at all levels, professional and industrial organisations, and representatives of Commonwealth, State and Territory health and education policy and funding organisations. e) The Chair of the NNCA should be a nurse appointed by the Commonwealth, State and Territory health and education and training ministers. f ) It is not intended that the NNCA undertake work already effectively undertaken elsewhere and it is envisaged that, to pursue health, education and training outcomes, the NNCA should create appropriate links with other national and international bodies. Proposed responsibility: Commonwealth, State and Territory health and education and training ministers, with details to be developed by the implementation taskforce (Relevant discussion Section 5.2.1) Recommendation 3—Nursing education and workforce forums State and Territory governments should establish nursing education and workforce forums to: a) facilitate collaboration between the education sectors and the health and community and aged care sectors, including both the public and private sectors b) address local and regional nursing education and workforce issues c) assist with the implementation of the recommendations of this Review. Proposed responsibility: State and Territory health and education and training departments (Relevant discussion Section 5.2.3) Recommendation 4—Nationally consistent scope of practice To promote a professional scope of practice for nurses and greater consistency across Australia: a) a nationally consistent framework should be developed that allows all nurses to work within a professional scope of practice, including the administration of medications by enrolled nurses b) to facilitate this development, all Commonwealth, State and Territory legislation and regulations that impact on nursing should be reviewed and reformed as required. Proposed responsibility: Implementation taskforce with the NNCA (Relevant discussion Section 5.3.3) Recommendation 5—National standards for nurse practitioners To promote a consistent national approach, the Australian Nursing Council Incorporated (ANCI) should be commissioned to establish national standards for nurse practitioners. Proposed responsibility: Commonwealth, State and Territory health ministers (Relevant discussion Section 5.3.4) Recommendation 6—National ANCI principles to underpin nursing legislation and regulation To ensure a more nationally consistent approach to nursing, State and Territory nursing legislation and regulations should be underpinned by nationally agreed principles. These principles should include requirements for: a) assessment against the ANCI competencies for initial registration of registered nurses and enrolled nurses b) audited self-reporting for continuing registration of registered nurses and enrolled nurses using indicators that demonstrate currency of competence including ongoing education. Proposed responsibility: ANCI in consultation with the NNCA (Relevant discussion Section 5.3.5) Recommendation 7—Care workers not covered by regulation To ensure quality and safety in the health, aged and community care sectors, all workers without relevant recognised training who are employed to provide direct care should have: a) a common national nomenclature b) a minimum competency level of Certificate III from the appropriate Community Services or Health Training Package c) an appropriate suitability check. As a matter of urgency, the Commonwealth, States and Territories should establish or utilise an appropriate system to ensure that compliance in relation to the minimum qualification and suitability checks for care assistants is achieved by 2008. Proposed responsibility: Implementation taskforce (Relevant discussion Section 5.3.6) Recommendation 8—Research and research training for nursing To build capacity in a vital discipline that has only been in the university sector for a relatively short period: a) immediate steps should be taken to ensure that the current level of postgraduate research scholarships and research training places for nurses are at least maintained, with the longer term target of doubling Research Training Scheme (RTS) commencement load by 2008. Proposed responsibility: Implementation Taskforce and Department of Education, Science and Training b) a dedicated pool of funding from new or existing sources should be made available over the next five years to provide research grant money and for cooperative research centres for nursing.
Proposed responsibility: Implementation taskforce (Relevant discussion Section 5.6) Recommendation 9—The image of nursing To develop and improve the image of nursing: a) the value, contribution and benefits of a nursing career should be promoted b) expert advice should be sought to develop a national marketing profile (brand) for nursing:
Proposed responsibility: NNCA with advice to governments and other employers Recommendation 10—Information on nursing To provide coordinated and ready access to information on nursing to the public and other stakeholders, the NNCA should: a) maintain an information base of recruitment and re-entry programs, assessments of their effectiveness and advice on best practice b) develop a web-based portal for Australian nursing. Proposed responsibility: The NNCA (Relevant discussion Section 6.1.2) Recommendation 11—Government and employer information on nursing To ensure that nursing is portrayed as a profession in government and employer information, all levels of government and other employers of nurses should: a) review their recruitment and promotion activities to ensure they reflect the professional status of nursing and the valuable social contribution made by nursing through its diverse roles and practice b) review their classification of ‘nursing’ to ensure it is consistent with the Australian Standard Classification of Occupations (ASCO) classification, in order to reflect the professional status of nursing. Proposed responsibility: Commonwealth, State and Territory governments, and other employers of nurses (Relevant discussion Section 6.1.2) Recommendation 12—Maximising education pathways To promote career transitions and opportunities for development in the education and training of care assistants, health workers, enrolled nurses, registered nurses, midwives, nurse practitioners, nurse educators and nurse managers, education providers should seek ways to: a) maximise the potential for Recognition of Prior Learning (RPL) and Recognition of Current Competency (RCC) in enrolment processes b) in consultation with local Indigenous communities, improve articulation pathways for Aboriginal and Torres Strait Islander peoples. Proposed responsibility: Education providers (Relevant discussion Section 6.3.1) Recommendation 13—Student nurse employment With a view to achieving national consistency, the NNCA should examine the financial benefits and experience that might accrue to student nurses (and the implications for the workplace) from their employment in the health workforce at their level of competence (but not as part of the requirements of their educational program). Proposed responsibility: The NNCA (Relevant discussion Section 6.3.6) Recommendation 14—Standards for transition programs To ensure consistency and quality in the development and delivery of transition programs: a) a national framework should be developed for transition programs to provide guidelines and standards for institutions b) State and Territory nursing registration boards should accredit transition programs c) employing institutions should be responsible for meeting the standards. Proposed responsibility: ANCI in consultation with the NNCA, State and Territory nursing registration boards and employing institutions Recommendation 15—Continuing clinical development of nurses To promote the ongoing development of nurses’ clinical competencies in the workplace, Commonwealth, State and Territory national health funding arrangements should dedicate funds to the provision of: a) clinical development support in healthcare settings for nurses at all levels and the necessary infrastructure for education and training in the healthcare system b) transition to practice programs for new nurses, both enrolled and registered, and for nurses returning to the workplace c) support for these developments, including preceptorship and mentoring. Proposed responsibility: Commonwealth, State and Territory health ministers (Relevant discussion Section 6.4.2) Recommendation 16—Continuing clinical development of nurses: aged care To promote ongoing development of nurses’ clinical competencies in their workplaces, Commonwealth, State and Territory aged care responsibilities and funding arrangements should: a) endorse and ensure continuing support for the standards and guidelines for residential aged care services in relation to the clinical education of nursing staff as outlined in the aged care accreditation standards b) endorse and encourage the provision of transition programs for new graduate nurses, both enrolled and registered nurses, in aged care organisations. Proposed responsibility: Commonwealth Minister for Ageing (Relevant discussion Section 6.4.2) Recommendation 17—Transition to workforce: funding The Commonwealth, States and Territories should establish a system to allocate dedicated funds to (public and private) health and community care institutions to assist registered nurses and enrolled nurses in making the transition into employment, including the transition into employment of those nurses who have completed a re-entry program. a) Allocations should attach to the individual employee or registrant (and should be made on their behalf ) to institutions whose programs have been accredited for transition b) Transition programs should be encouraged in areas such as mental health, aged care, community nursing, and rural health, as well as hospitals. Proposed responsibility: Commonwealth, State and Territory health ministers (Relevant discussion Section 6.4.2) Recommendation 18—Lifelong learning and nursing competency Given the challenging tasks undertaken by nurses and the rapid changes that can occur in technology, knowledge and skills, all nurses should be expected to undertake continuing education activities to maintain and enhance their professional competence and this should be taken into account in retaining registration or enrolment. To ensure this is possible: a) employers should develop strategies in their local areas to provide the opportunity for registered and enrolled nurses to keep their nursing competencies current so that they can retain registration b) employers could also provide opportunities to those not presently in employment to access appropriate fee-paying courses to maintain competency c) nursing organisations should develop educational material to support the maintenance of nurses’ competencies in relevant areas. Proposed responsibility: Employers, nursing organisations and individual nurses (Relevant discussion Section 6.5.1) Recommendation 19—Models of preparation To assure quality programs, undergraduate and enrolled nurse courses should continue to be accredited by State and Territory registration boards in accordance with national principles developed by the ANCI and endorsed by the NNCA. These principles should ensure that: a) graduates from these courses meet the ANCI competency standards b) quality assurance processes for course accreditation and the assessment of students are met c) there is ongoing evaluation of the curricula and teaching practice in the light of changes in nursing practice, research on learning, and the broader developments in professional and para-professional preparation. Proposed responsibility: ANCI in consultation with the NNCA (Relevant discussion Section 7.1.3) Recommendation 20—Nurse academics and teachers To ensure that students are exposed to current clinical practices, faculty practice should be: a) built into the workload of those nurses who teach nursing students in universities and the VET sector b) incorporated into annual performance appraisals. Proposed responsibility: Education providers (Relevant discussion Section 7.1.6) Recommendation 21—Enrolled nurse competencies To provide links to other training and to develop national consistency for the education and training of enrolled nurses: a) the ANCI and Community Services and Health Training Australia should meet as a matter of urgency to ensure the ANCI competencies for enrolled nurses are incorporated in existing or new Australian National Training Authority sponsored training packages b) in establishing the appropriate level of qualification, account should be taken of the training requirements for evolving models of care and changes in supervisory practice, including those related to medication administration and new enrolled nurse specialisations. Proposed responsibility: Implementation taskforce (Relevant discussion Section 7.3.1) Recommendation 22—Minimum level of qualification for registered nurses To ensure that registered nurses are appropriately prepared for their professional roles, the minimum level of qualification for entry to practice as a registered nurse should remain a university-based bachelor degree, with a minimum length equivalent to six full-time semesters. Proposed responsibility: Commonwealth Department of Education, Science and Training, and State and Territory nursing registration boards (Relevant discussion Section 7.4.1) Recommendation 23—HECS for undergraduate nursing To acknowledge the contribution that nurses make in the service of the community and the potential disincentive of increased course costs, all units that form part of undergraduate nursing courses required for initial registration should be classified at the minimum Higher Education Contribution Scheme (HECS) band. Proposed responsibility: Commonwealth Department of Education, Science and Training, and universities (Relevant discussion Section 7.4.4) Recommendation 24—Clinical education funding Since clinical education is an essential element of the preparation of all nurses and an area where the costs have increased to a point of being unsustainable, new quarantined funding over five years should be provided for clinical education in addition to the operating grant for undergraduate nursing courses. It should be administered through a new program, the Clinical Education Partnership Program. The program should be formally evaluated in the fourth year to assess its impact and identify any changes that may be required for its continuing operation. The program should meet the following criteria: a) promote State- and Territory-based cooperative arrangements between those sectors preparing nurses for initial registration and those employing them b) be acquitted in terms of delivering quality clinical placement outcomes (to defined minimum standards) c) prioritise partnership arrangements and contributions from all sectors involved in health and education d) promote innovative approaches to clinical education e) include some assistance to students, particularly for those who are disadvantaged by the high costs of attending clinical placements. Proposed responsibility: Commonwealth Department of Education, Science and Training (Relevant discussion Section 7.5.3) Recommendation 25—Commonwealth assistance for speciality and re-entry courses The maintenance of nursing specialities and re-entry programs are important in meeting labour market needs. To enable these needs to be met:a) an audit should be undertaken of the current postgraduate coursework scholarships, including those offered by the States and Territories b) using the audit outcome and advice from the Australian Health Ministers’ Advisory Council (AHMAC) on shortages in specialised areas of nursing, recommendations should be made to the Commonwealth on the number of additional scholarships to be funded and the specialties to which they should be allocated c) new scholarships should be offered for three years in the first instance, subject to review d) specialised nursing areas where small numbers of graduates are needed should be identified and opportunities investigated for the contracting of these courses on a national basis e) university-based units required for re-entry to nursing should be covered by a loans scheme. Proposed responsibility: Implementation taskforce (Relevant discussion Section 7.6.1) Recommendation 26—Remuneration for practice: postgraduate award course recognition To acknowledge the value to the workplace afforded by nurses who undertake postgraduate courses relevant to their practice, appropriate remuneration should be provided to registered nurses who have completed a formal postgraduate award course and who are applying the related knowledge and skills in their employment. Proposed responsibility: Commonwealth, State and Territory health ministers and other employers (Relevant discussion Section 7.6.2) Recommendation 27—Encouragement of inter-disciplinary and cross-professional approaches to education and practice To encourage further developments in models of care and the education that supports them, government policy, funding and decision making in the health, education and training sectors should promote and support team-based approaches in education and practice. Proposed responsibility: Commonwealth, State and Territory health and education and training ministers (Relevant discussion Section 7.8.2) Recommendation 28—Work organisation Because the nursing workforce (including trained care assistants) contains a range of experience and skills, and because it needs to adapt to an evolving care environment, work organisation throughout the health, aged and community care sectors should: a) constantly seek to achieve the most effective and efficient use of the total nursing workforce (including learning from best practice elsewhere) b) ensure that skills and expertise are matched to the work required in the particular workplace c) take account of the interrelationships with other health professionals d) ensure that nurses are encouraged to practise to their full professional capacity. Proposed responsibility: The NNCA and employers (Relevant discussion Section 8.2.1) Recommendation 29—Aged care nursing To ensure that residents of aged care facilities have access to quality nursing care and that nursing in the aged care sector is an attractive option for nurses, Commonwealth aged care responsibilities and funding arrangements should enable professional nursing time to be focused on residents in aged care facilities by separating professional nursing documentation from the funding tool. Proposed responsibility: Commonwealth Department of Health and Ageing (Relevant discussion Section 8.3.2) Recommendation 30—Workplace culture To develop a constructive workplace culture, management in all health, aged and community care sectors, in consultation with staff, should establish and implement a suite of policies that encourage: a) support for professional development b) a positive work environment in which staff feel valued and are able to make their full contribution c) multi-professional team work d) workplace safety and cultural sensitivity e) a work/life balance. Proposed responsibility: Commonwealth, State and Territory health ministers and other employers (Relevant discussion Section 8.3.5) Recommendation 31—Workforce planning and data Workforce planning is a vital component of future policy processes. It needs to be based on reliable valid data. Consequently the following are supported: a) AHMAC’s ongoing work on nursing workforce planning which should proceedas a matter of priority to determine:
b) The ongoing work of the Australian Institute of Health and Welfare (AIHW) to establish and analyse data on the nursing workforce (including action to improve its currency) should proceed as a matter of priority. Proposed responsibility: Implementation taskforce in consultation with AHMAC (Relevant discussion Section 8.4.6) Recommendation 32—Health workforce research funding Australia’s workforce planning needs to be based on an integrated view of the workforce, developed using quality research tools. At the same time, recognition of the unique contribution of particular professions, such as nurses, must be understood. To promote this approach: a) funding should be provided for further development of a robust methodology for all health workforce planning (including nursing), with consideration being given to the establishment of a research centre to undertake this work. Funding should be provided for five years in the first instance, subject to review b) the methodology employed should draw on overseas research to further develop nursing indicators that are applicable in the Australian context. Proposed responsibility: Implementation taskforce (Relevant discussion Section 8.4.6) Recommendation 33—Commonwealth funding for additional undergraduate university places An increased supply of registered nurses is essential due to current shortages and the rapidly ageing nursing workforce. An initial short-term measure to achieve this outcome should include the following actions: a) A benchmark for nursing commencement load based on the 2002 equivalent full-time student units (EFTSU) for non-overseas nursing commencements in each university (including direct-entry midwifery) should be set as the target for the following two years, with under-target load to be re-distributed to universities which have provided additional nursing EFTSU above the 2002 benchmark. The results to be reviewed after two years. b) An additional minimum of 400 EFTSU for undergraduate nursing commencements should be provided for two years, beginning if possible in 2003, on the basis that:
Proposed responsibility: Commonwealth Department of Education, Science and Training Recommendation 34—Expansion of opportunities in VET and VETin-schools States and Territories should expand opportunities for entry to enrolled nursing and occupations that do nursing work by: a) providing additional training places for enrolled nurses to replace those upgrading to registered nurse within the State/Territory, and to meet shortages of enrolled nurses b) promoting employment of student enrolled nurses through models of education and training such as traineeships c) working with the Commonwealth to expand traineeships in rural areas as an entry to care work and nursing d) supporting the expansion of VET-in-schools programs based on the Community Services or Health Training Packages e) offering workplace trainer and assessor courses to nurses and recently retired nurses willing to assist in training or supervision of student nurses or trainees, particularly those in rural areas. Proposed responsibility: Commonwealth, State and Territory ministers for education and training (Relevant discussion Section 8.4.9) Recommendation 35—Training places for Certificate III To ensure that those workers involved in direct care work in the health, aged and community care sectors achieve a level of at least Certificate III in the appropriate Community Services or Health Training Package by 2008, a strategy should be developed to expand workplace assessment and the number of training places for Certificate III in the appropriate training packages. Proposed responsibility: Commonwealth, State and Territory ministers for education and training (Relevant discussion Section 8.4.9) Recommendation 36—Nursing leadership and management For nursing leadership and management to be enhanced:a) governments should ensure improved representation of nurses on bodies which advise on both health and health education issues, so as to use more fully the expertise and knowledge of the nursing profession b) workplaces should recognise and support the development of future nurse leaders and managers, using initiatives such as:
Proposed responsibility: The NNCA (Relevant discussion Section 8.5.2) |
|
contact
details | search |
archive search | publications
| site map | subscribe Any comments or queries should be sent to: wwweditor@dest.gov.au This page was
last updated on
Tuesday, 26 August 2008
|
