Salon 2 13 kasim 15.30 16.00 ged wi̇lli̇ams

1. Results of the 4th World-wide
survey of critical care nursing:
Implications for leadership
Ged Williams
Founding President,
World Federation of Critical Care Nurses.
Professor of Nursing, Griffith University, Australia.
Chief Nursing Officer, Al Ain Hospital, UAE.
g.williams@wfccn.org

2. Critical Acknowledgements
•Paul Fulbrook - Australia
•Ruth Kleinpell - USA
•Shelley Schmollgruber – South Africa
•Laura Alberto – Argentina
•All those who participated in the study (59)

3. First
World Wide Overview of Critical
Care Nursing Organisations and
their Activities
Williams G, Chaboyer W, Thorsteinsdottir R,
Fulbrook P, Shelton C, Chan D, Wojner A. 2001.
International Nursing Review. 48, Dec: 208-217.

4. Americas
Canada
USA
Mexico
Asia Pacific
Australia Korea
Japan India
Hong Kong Taiwan
Philippines New Zealand
2001
Euro-Africa
Britain Belgium
Denmark Greece
Germany Italy
Iceland Ireland
Norway Turkey
Slovenia France

5. International: Most important issues facing critical
care nurses across 23 countries of the world
(rating out of a possible 10)
• Staffing Levels 9.24
• Working Conditions 8.86
• Access to quality educational programs 8.76
• Wages 8.52
• Formal practice guidelines/competencies 8.38
• Work activities/roles 8.33
• Team work 8.29
• Extended/Advanced Practice 7.90
• Relationship with doctors 7.76
• Formal credentialling process 7.60
• Use of technologies 7.38
• Facilities & Equipment 7.24
• Relationship with other nurses 6.90
• Relationship with other health groups 6.76
Williams G. et al. 2001. World Wide Overview of Critical Care Nursing
Organisations and their Activities. International Nursing Review. 48, Dec: 208-217.

6. SURVEY RESULTS
6d). Which of the following activities or services that an international society could provide,
would be of most value to your organisation? Please indicate the level of importance you
would attached to such a service (1=not important, 10=extremely important)
Service and Activity Europe Americas Asia/Sth.Pac World
Website 9.64 10.00 8.00 9.19
Coordinate/Support in international
8.73 9.33 9.17 8.90
conference
Coordinate/Support international study
exchanges
8.55 9.33 9.33 8.86
Provide international
guidelines/principles relevant to
critical care practice
8.36 10.00 9.00 8.74
Coordinate/Support international
education
8.64 8.67 8.83 8.67
Coordinate/Support international
research projects
8.45 8.33 8.83 8.57
Journal 8.55 7.67 9.17 8.52
Make representation to national and
8.27 9.33 8.67 8.43
international bodies on issues of
health, human-society
Newsletter 7.45 7.67 7.67 7.48
Williams G. et al, International Nursing Review, 2000. 48, Dec.:208-217

7. 2001 - 8th World Congress, Sydney.
First Council of the WFCCN,

8. Journal - CONNECT
http://en.wfccn.org/connect_journal.php

9. Website –www.wfccn.org

10. International Conferences
• 2004 England
• 2005 Argentina*
• 2006 Philippines
• 2007 South Africa
• 2008 Mexico
• 2009 Italy*
• 2010 Philippines
• 2011 (skipped)
• 2012 Croatia
• 2013 South Africa*
• 2014 Turkey
• 2015 Korea*
• 2016 Australia
• 2017 Brasil*
• 2018 Serbıa
• 2019 Australıa*
*Conference with WFSICCM

11. International Council of Nurses
- Official Affiliate Member
Since February 2005

12. Second
World Wide Overview of Critical
Care Nursing Organisations and
their Activities (2005)
Williams G, Chaboyer W, Alberto L, et al. 2007.
Critical Care Nursing Organisations and Activities:
a second worldwide review.
International Nursing Review. Vol 54. 151-159.

13. Americas
Argentina
Bolivia
USA
Mexico
Chile
Columbia
Brazil
Canada
Peru
Venezuela
Asia Pacific
Korea China
Hong Kong Taiwan
Macau Sri Lanka
Philippines New Zealand
Australia Singapore
Japan
Europe
Iceland Ireland Hungary
Norway Turkey United Kingdom
Finland Croatia Cyprus
Sweden Slovenia Denmark
Belgium Greece Poland
Germany Switzerland Estonia
France Netherlands Saudi Arabia
Spain Italy
Africa
Botswana
Ghana
Malawi
Namibia
Tanzania
Uganda
South Africa
2005

14. SUMMATION 2005
• 51 countries represented
• Workforce and Education = most important issues
• Poorer countries want help to establish CCNOs
and education programs.
• Wealthier countries suggested research data
bases and more guidelines.
• National Assoc’s to continue: conferences, policy
guidelines and professional representation.
• WFCCN activities valued by respondents: Position
Papers, Guidelines, Conferences, Representation

15. Third
World Wide Overview of Critical
Care Nursing Organisations and
their Activities (2009)
Williams G, Bost N, Chaboyer W, et. al. 2011
Critical care nursing organizations and activities: a third
worldwide review.
International Nursing Review. 59: 73-80

16. Africa
Kenya
Malawi
Mauritius
Nigeria
South Africa
Sudan
Swaziland
Americas
Argentina
Bolivia
Brazil
Canada
Chile
Colombia
Costa Rica
Cuba
Mexico
Venezuela
Peru
USA
Uruguay
Asia/Pacific
Australia
Bangladesh
China
Hong Kong
India
Japan
Macau
New Zealand
Philippines
South Korea
Taiwan
Vietnam
Europe
Afghanistan
Austria
Belgium
Croatia
Denmark
Estonia
Finland
France
French Belgium
Federal Republic
of Germany
Greece
Greenland
Hungary
Europe
Iceland
Ireland
Italy
Norway
Russia
Serbia
Slovenia
Spain
Sweden
Switzerland
Switzerland Paeds
The Netherlands
United Kingdom
Middle East
Israel
Jordon
AKirnagbdiaom of Saudi
Oman
Turkey
United Arab Emirates
2009

17. Services/activities provided by National CCNOs (respondents) and
mean responses of importance attached to each
(1 = not important, 10 = very important)
2009 Results
Services Africa Americas Asia Europe/
Mid East
World
Professional representation 7.5 9.5 9.4 9.2 9.1
Practice guidelines 7.6 9.8 9.7 8.9 9.1
National conferences 7.3 9.6 9.2 9.2 9.1
Standards for educational courses 6.8 9.6 9.3 8.6 8.8
Workshops/education forums 7.8 9.4 8.7 8.6 8.7
Website 6.5 9.4 8.6 8.9 8.7
Training/skill acquisition course 7.0 8.4 8.8 7.9 8.5
Initiating/conducting research
7.7 8.8 8.5 8.2 8.4
studies
Local conferences 7.2 9.1 8.2 8.4 8.4
Credentialing process 7.2 9.1 8.5 8.3 8.4
Journals 6.7 9.0 8.3 7.9 8.1
Newsletters 5.5 8.4 8.5 7.9 7.9
Research grants 5.7 9.0 7.1 7.1 7.4
Study/education grants 5.3 9.2 6.9 7.0 7.3
Industrialization/union 6.0 5.6 6.8 6.1 6.2

18. Services/activities provided or intended to be provided by
WFCCN: awareness and importance attached to each
(1 = not important, 10 = very important)
2009 Results
Issue Provided Africa Americas Asia/
Pacific
Europe/
Mid East
World
Standards for professional
practice
61 (98.4%) 8.7 9.2 9.7 8.4 9.1
Standards for clinical
practice
61 (98.4%) 9.2 9.0 9.5 9.0 9.1
Website (www.wfccn.org) 61 (98.4%) 8.2 9.3 8.3 8.8 8.8
Initiate, conduct or lead
61 (98.4%) 9.0 9.2 9.3 8.2 8.7
research studies
Professional representation 61 (98.4%) 9.2 9.0 9.3 8.1 8.6
Journal (through CONNECT
60 (96.8%) 8.2 8.6 8.9 8.4 8.5
journal)
International Conferences 61 (98.4%) 9.5 9.2 8.3 7.8 8.3
Research Grants 61 (98.4%) 8.9 8.5 7.5 7.1 7.6
Study/education Grants 61 (98.4%) 8.8 8.3 7.3 7.1 7.6

19. 2001 2005
2009

20. HOT OFF THE PRESS (SPSS!)
Unpublished results of the
2013-14
World Wide Survey
of
Critical Care Nursing

21. Survey Design at a glance
• Survey Monkey – 5 sections = 31 questions
• Section 1 – Demographic questions
• Section 2 – Services provided by CCNO
(including questions re policies/procedures, journal/newsletter
• Section 3 - Priorities and concerns of Crit Care Nurses
(including expectations of the CCNO whether present or not)
• Section 4 – Expectations and priorities of National health
organisations (Policies and guidelines)
• Section 5 – Expectations and priorities for WFCCN

22. 2013-14 Survey Results

23. Respondent countries by wealth group
Low income = $400 - $5,800 (USD)
Middle Income = $5,900 – $18,600 (USD)
High Income = $18,700 – $64,000 (USD)
Central Intelligence Agency (2013): GDP per capita
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2004rank.html

24. 2013 – Critical care nursing issues
(shown by wealth group and total)

25. Mean responses for important issues for critical
care nurses by year of study 2001-2013
Issue 2001 2005 2009 2013
Teamwork 8.3 (7) 8.9 (2) 9.2 (1) 9.30 (5)
Staffing levels 9.2 (1) 8.9 (1) 9.0 (2) 9.36 (3)
Access to educational programs 8.8 (3) 8.6 (3) 9.0 (3) 9.34 (4)
Formal practice
guidelines/competencies
8.4 (5) 8.3 (6) 9.0 (4) 9.45 (2)
Working Conditions 8.9 (2) 8.6 (5) 8.9 (5) 9.46 (1)
Work activities/roles 8.3 (6) 7.9 (8) 8.7 (6) 9.05 (7)
Extended/advanced practice 7.9 (8) 7.7 (11) 8.7 (7) 9.04 (8)
Relationship with doctors 7.8 (9) 7.8 (10) 8.5 (8) 8.79 (12)
Relationship with other nursing
6.9 (13) 7.6 (12) 8.5 (9) 8.71 (13)
groups
Facilities and equipment 7.2 (12) 8.1 (7) 8.4 (10) 9.02 (9)
Use of technologies 7.4 (11) 7.9 (9) 8.4 (11) 8.91 (10)
Formal credentialing process 7.6 (10) 7.6 (13) 8.3 (12) 8.88 (11)
Wages 8.5 (4) 8.6 (4) 8.0 (13) 9.27 (6)
Relationship with other health care
groups
6.8 (14) 7.5 (14) 7.9 (14) 8.61 (14)

26. 2013 - Importance of CCNO services/activities
provided whether service exists or not.

27. Other facts of interest
• 43/59 (75%) were members of WFCCN
• 17/59 had a newsletter (12 on line)
• 20/59 had a journal or access to a journal
• 8/59 had workforce policies
• 9/59 had educational policies
• 13/59 had clinical policies

28. Most important
Guidelines Requested
• Overwhelmingly, the greatest needs identified were for
guidelines on critical care nursing education and
workforce.
• Other topics:
pediatric conditions tracheostomy management
sepsis management pain and sedation management
delirium management safety in the workplace
weaning from ventilation

29. Recommendation 1
•That WFCCN establish, in partnership with
other nursing and policy leaders, a prioritized
program of work to address the most critical
issues of workforce, education and clinical
practice standards that can be adopted or
tailored for CCNOs and national health
authorities.

30. Recommendation 2
• That critical care nurse leaders and CCNOs
actively support efforts to address
educational and clinical practice resource
needs of critical care nurses. This is
essential as the aging of the population,
increasing severity of illness of hospitalized
patients, and complexity of care will only
increase the demands for well trained and
adequately staffed ICUs to promote best
outcomes for critically ill patients.

31. Recommendation 3
• That the research team through WFCCN and
others conduct targeted, more frequent worldwide
surveys to maintain engagement and connection
with leaders so that input into future studies
results in a larger representation of countries and
needs across the world. We feel that a response
rate from 59 countries, predominantly western,
and affluent, remains insufficient to truly represent
the global needs of critical care nurses at this time.

32. Recommendation 4
• Investigation into communication
techniques to access more nurses more
effectively via means other than the
traditional newsletter and journal modalities
be explored, trialed and evaluated.

33. Recommendation 5
• National CCNOs need to continue to pursue
development of practice guidelines,
conferences and professional representation
at a national level. We also recommend that
in less affluent countries, emphasis be
placed on establishing CCNOs and assisting
in the development of education standards
and the provision of training programs.

34. Recommendation 6
• Greater efforts need to be made to assist the
development and growth of CCNOs in
developing economies. A goal of at least
one effective CCNO or CCNO branch of a
larger nursing/health organization in each
country of the world might be reasonable.

35. Recommendation 7
• This survey should be repeated in 4 years or
less to critically analyze the progress being
made against the work plan suggested in
recommendation 1.

36. “Never doubt that a small group of thoughtful,
committed citizens can change the world.
Indeed, It is the only thing that ever has.”
Margaret Mead
Thank You

37. Any Questions…??

39. WFCCN - Next Moves…

40. Middle East (5) /World (59): Most important issues
facing critical care nurses (rating out of a possible 10)
Middle East (5) World (59)
•Formal practice guidelines/competencies 9.60 9.45 (2)
•Team work 9.40 9.30 (5)
•Access to quality educational programs 9.20 9.34 (4)
•Facilities & Equipment 9.20 9.02 (9)
•Relationship with other nurses 9.20 8.71 (13)
•Work activities/roles 9.20 9.05 (7)
•Extended/Advanced Practice 9.20 9.04 (8)
•Formal credentialling process 9.20 8.88 (11)
•Working Conditions 9.00 9.46 (1)
•Relationship with doctors 9.00 8.79 (12)
•Staffing Levels 8.80 9.36 (3)
•Use of technologies 8.80 8.91 (10)
•Relationship with other health groups 8.80 8.61 (14)
•Wages 8.60 9.27 (6)

41. Services/activities provided by National CCNOs and
mean responses of importance attached to each
(1 = not important, 10 = very important)
Middle East (5) World (59)
•Standards for Educational courses 10.0 9.13 (7)
•Professional Representation 9.80 9.45 (3)
•Practice Standards/guidelines 9.80 9.39 (4)
•Initiate, Conduct, Lead research studies 9.80 8.91 (8)
•National Conferences 9.60 9.57 (1)
•Research Grants 9.60 8.39 (13)
•Website 9.60 9.46 (2)
•Credentialing or accreditation processes 9.60 8.52 (11)
•Study Grants 9.40 8.41 (12)
•Local Conferences 9.20 9.29 (5)
•Training/Skills acquisition courses 9.20 8.79 (9)
•Workshops/Education forums 9.20 9.20 (6)
•Journal 9.08 8.59 (10)
•Newsletter 8.60 8.34 (14)
•Travel Scholarships 7.80 7.84 (15)
•Industrial/Union Representation 7.00 6.80 (16)