Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team


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Kathy Hardie & Angela White, Central Coast Local Health District delivered the presentation at the 2014 Assistants in Nursing Conference.

The 2014 Assistants in Nursing Conference focused on strategic nursing workforce planning and development of a suitable model of care for the AIN role, looking at a variety of implementation approaches from pilot sites and services who have established the role; addressing challenges around appropriate training, mentorship, scope of practice and role evaluation.

For more information about the event, please visit: http://bit.ly/asstnursing14

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Kathy Hardie & Angela White, Central Coast Local Health District - Integration of Assistants in Nursing as part of the nursing team

  1. 1. Certificate III Health Services Assistance   Central Coast Local Health District (LHD) has supported AIN qualifications for over 15 years   Commenced with Aged Care school based traineeships   With the introduction of Health Training Package 2007 it moved to Acute Care   This was the first introduction of AIN’s to the LHD
  2. 2. The Start   The Divisions of Aged Care and Rehabilitation were the first Units to introduce AIN’s   Overall concerns were of a third tier of workforce   “AIN’s are going to reduce the EN workforce”   “The AIN does all that I do so what is going to be my role now? “
  3. 3. Health Services Implementation Package   Assistants in Nursing working in the acute care environment   Released in August 2010   Established a role and scope of practice for acute care AIN’s   No differentiation between AIN’s and Undergraduate AIN’s
  4. 4. Implementation Package Included in the package:  Recommendation of units of study  Minimum clinical hours  Upgrades from Aged Care to Acute Care  NSW Health AIN position description  Clarity and consistency in employment in Public Health
  5. 5. Local Site Implementation   Implementation package was rolled out to all NUM’s   There was then development of: -  Scope of practice -  Job description -  Local policy frameworks -  Recruitment principles -  Clinical skills mapping for AIN’s
  6. 6. AIN Students   AIN HSC students were well received in the work place   They were no threat to staff numbers   But with the changing workforce and recruitment strategies   The introduction of Acute Care AIN’s as staff were not received well   SO WHAT NEEDED TO CHANGE?
  7. 7. Do Nurses like change?   Was this any different from the introduction of the EEN role?   Everyone is threatened by change   No one wants to change   Isn't there room for everyone?   Isn't there enough work for everyone?   Don’t all levels have something to give to their patient’s care?   ? Supernumerary role for AIN’s
  8. 8. Models of Care   Plan for change   Clarify ways of working   Identify change champions   Determine new and innovative models of patient care delivery   Consideration of the skills required at all levels   Overall patient centred care
  9. 9. Models of Care Champion Workshop   Nominated staff attended a full day workshop   Greater insight into scope of practice   Responsibilities and accountability of staff within teams   Role of Model of Care Champions   LHD Models of Care Implementation plan   Development action plans within the Unit/Ward
  10. 10. Nursing Practice Decision Flowchart   Supervision and delegation framework   Risk assessment approach   Asking the questions - Is it in my scope of practice? - Do I have current skills and knowledge? - Is there a policy and procedure to support me? - Is there a competency assessment?
  11. 11. Patient Allocation V’s Team Nursing Patient allocation -  Support decreased  Isolation  No teaching environment  Where is the supervision?  Can patient allocation work with 3 tiers of nurses?  All staff are to work under the RN  Can AIN’s be allocated patients?
  12. 12. Team Nursing   Provides support for all team members   Supervision and delegation by the RN/team leader   Supportive education and personal development   All staff supported e.g. TRN, casual staff   Every staff member has a role   Team approach to clinical decision making   Open communication between team members   Patients recognise that they have a team of staff who are caring for them
  13. 13. Did this work?   Some areas have embraced team work   Some are still under development   Some areas will never change   So baby steps   With education and support you will achieve the right team approach for your units
  14. 14. What is needed to make the change?   Strong leadership   A willingness to change   Everyone working together   Everyone knows each others role/competence level   Open communication   A plan of care for the shift   “Huddles”   Everyone works to a common goal
  15. 15. Integration of AIN’s   Started with the student AIN   Staff are more aware of student role   Ward areas have become aware of AIN scope of practice   Assimilation to the team model   AINs have moved into a casual or permanent staff member role   Student AIN’s do return to the LHD as EEN’s or RN’s   Career progression
  16. 16. Nicole’s Story
  17. 17. Faye’s Story
  18. 18. Jessika’s Story
  19. 19. Thank you Graduating class of 2013