The Nursing and Midwifery Scope of Practice Framework

Summary

This project standardised the recruitment process and conducted training for nurses and midwives in Southern NSW Local Health District (SNSWLHD) to help them understand their professional obligations and maintain the skills required to safely undertake their role in the organisation.

Aim

To ensure all nurses and midwives in SNSWLHD understand their professional obligations in the delivery of safe and effective patient care.

Benefits

• Improves the delivery of safe and effective patient care.
• Enhances workforce satisfaction and retention.
• Allows the organisation to maintain a highly-skilled workforce with opportunities for continuing professional development.
• Ensures staff are aware of the framework that governs clinical practice.
• Improves recruitment processes by standardising job descriptions and training of new staff.

Background

The Nursing and Midwifery Directorate at SNSWLHD participated in a number of incident management reviews in 2014, which highlighted a lack of systems and governance in the professional development of nursing and midwifery staff.

Subsequent root cause analysis and clinical reviews identified that staff lacked a number of skills required in their role and did not understand the professional responsibilities associated with supervision of and delegation to other staff.

At the time, nurses and midwives’ understanding of continuing professional development was limited and they did not participate in training that would give them the skills they needed to maintain their role in the organisation. Position descriptions did not reflect the minimum skills required for each position, or reflect the framework that governs clinical practice.

Implementation

• A review of other local health districts’ recruitment practices was undertaken.
• Nursing and midwifery leaders were consulted, to determine opportunities and barriers to change.
• A procedure was developed that articulated the minimum requirements for recruiting nursing and midwives at SNSWLHD.
• Position descriptions were mapped to the Health Education and Training Institute (HETI) requirements for each role and implemented into the recruitment process.
• Support was provided to nursing unit managers and nursing managers during the recruitment of new staff.
• A training program was delivered to nurses and midwives when their scheduled permitted, with the aim of increasing their awareness of professional responsibilities associated with supervision of and delegation to other staff.

Project status

Sustained - the initiative has been implemented and is sustained in standard business.

Key dates

December 2014 – December 2016

Implementation sites

• Queanbeyan Hospital
• Goulburn Hospital
• Bega Hospital

Evaluation

A formal staff survey will be conducted in December 2016, to measure awareness of professional responsibilities in nurses and midwives. Incident management and compliance with mandatory training will also be measured, to determine the impact of this awareness on patient care.

Lessons learnt

It was clear that poor systems and reviews had led to a lack of understanding by nursing and midwifery staff on the professional framework that governs clinical practice and how this translates into their role within the organisation. It’s important to avoid making assumptions about the professional understanding of staff and instead gather data and feedback to determine the actions required.

Further reading

Nursing and Midwifery Board of Australia

Contact

Cherie Puckett
Nurse Manager Leadership and Development
Nursing and Midwifery Directorate
Southern NSW Local Health District
Phone: 0417 051 553
cherie.puckett@gsahs.health.nsw.gov.au