PDF Creating Change in Nursing and Midwifery Clinical Practice Engagement

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CREATING CHANGE IN NURSING AND MIDWIFERY CLINICAL

PRACTICE ENGAGEMENT

Samantha Gent, RN

Clinical Nurse Educator – Practice Development Centre for Education and Training (CET)

Ballarat Health Services (BHS)

Diploma of Applied Science (Nursing), Bachelor of Applied Science (Nursing), Graduate Certificate in Critical Care Nursing, Graduate Certificate in Education (Tertiary), Diploma of Project Management, Certificate IV TAE, Bachelor of Health Care Professional Honours (Clinical Redesign) in progress

[email protected]

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BALLARAT

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Ballarat Health Services - BHS

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Nursing and Midwifery Workforce

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Bedside Nursing & Midwifery Clinical and Committee Engagement

• Variable levels of committee and clinical

engagement within nursing and midwifery

• Minority represent the majority bedside nurse and midwife to

– Influence clinical practice

– Drive change in clinical practice

– Deliver evidence based – best practice care

• Changes in practice not readily sought

• Difficult to imbed changes into practice and culture

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Clinical Practice Committee

• Nursing and Midwifery Practice Development Committee

– NMPDC – the committee

• Historical existence at BHS

• Traditional format

– Narrow focus

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BHS Executive and Board

Patient, Safety and Innovation Committee - PSIC

Nursing and Midwifery Advisory Council - NMAC

Nursing and Midwifery Practice

Development Committee - NMPDC

Recommendations seeking amendments, approval and action are sent to:

• BHS Operational Governance

Committees

• National Standards Committees

NMPDC MEMBERSHIP Nursing Community

Midwifery Nurse Practitioners

Acute Graduates

Mental Health Clinical Nurse Consultants Subacute Residential

Nurse Unit Managers Administration

Governance & Risk Management

DON Education Ex officio CNMO Ex Officio NMPDC

information disseminated to ward based staff via forums, ward

meetings, flyers, emails and memos

Residential

Subacute

Acute

Community Mental Health

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Aims of the Nursing and Midwifery Practice Development Committee

• Improve clinical practice

• Follow up on recommendations on issues relating to patient care

• Communicate any change in practice

• Clinical issues referred to NMPDC will be actioned

• Review and approve clinical governance documents

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Committee Effectiveness Survey 2016

• Purpose

– to obtain feedback from NMPDC members to

better understand how to build and support the

function of the committee

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What did the members say?

To be honest I am unsure if my attendance makes a difference overall

Participants arrive with no

preparation

This committee has very minimal impact

upon patient care which is unfortunate

and disappointing

Lines of communication

appear unclear

I can’t help but feel there are too many hours

wasted in this

way Some ward

areas never attend

Many hours spent reading and reviewing governance documents

without any clinical knowledge

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Problem = Solution

https://blog.medicalsolutions.com/clinical-corner-2/clinical-corner-enlc-compact/

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Where to begin – stay the same or change?

https://hearingsolutionstriangle.com/wp-content/uploads/where-to-begin.jpg

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http://journalismthatmatters.org/experienceengagement/2015/10/09/creating-communities-of- practice-visual-maps-by-nitya-wakhlu/

CoP

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Cultivating Communities of Practice – CoP - Communities

• Ability for all nurses and midwives to have the opportunity to enhance their practice and

profession

• Model that has liked minded people sharing their ideas, clinical expertise and

understanding

• Improve relationships across a broad,

geographically spread organisation

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Immersing the Individual

• CoP place value on the individual in a diverse, complex and ever

changing health care system

• BHS nurses and

midwives are change agents in becoming

members of the CoP to improve bedside care

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Communities of Practice - CoP

• CoP

– CoP framework (generic) – Code of Conduct

– Individual CoP aims and working guides established

• Communities of Practice – Clinical Inquiry

– Workforce Enhancement – Innovation Hub

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2018 – Where are we at now?

• Infancy stage of the CoP

– Socialising the frameworks to the broader nursing and midwifery workforce

• Staff using CoP language

• BHS Standards committee have reviewed and approved Governance documentation

• IT Platform – Basecamp in pilot

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CoP

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Clinical Engagement is having

Communities of Practice

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Thank You

Questions?

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References

• Australian College of Nursing (ACN). Nurse leadership. Canberra: ACN; 2015.

• Gesme D, Wiseman M. How to implement change in practice. J Oncol Prac. 2010

Sep;6(5):257-9.

• Governance and Risk Management Unit (GARMU). Nursing and midwifery practice development committee members

evaluation: standard 1 governance and safety in health care. Ballarat: Ballarat Health

Services; 2017.

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References

• TED: Simon Sinek - "The Golden Circle" Clip [podcast on the Internet]. Place unknown: Ted Talks; c2009 [cited 2012 May 9]. Available from:

https://www.youtube.com/watch?v=l5Tw0PGcyN 0

• University of Tasmania. CAM554 clinical redesign in a global context: topic notes [Internet]. Hobart TAS: University of Tasmania, Faculty of Health;

2017 [cited 2017 Dec 17]. Available from http://www.utas.edu.au/mylo