Call for full rollout of nursing framework

Pilot project shows benefits for nurse retention, patient outcomes

The Irish Nurses and Midwives Organisation (INMO) has called for the fully funded national rollout of a pilot project which demonstrated real results in the retention of nurses, the reduction of agency staff, and more positive patient outcomes.

The union’s call follows the launch yesterday by Health Minister Simon Harris of ‘A Framework for Safe Nurse Staffing and Skill Mix in General and Specialist Medical and Surgical Care Settings in Adult Hospitals in Ireland’.

The framework, piloted in Beaumont Hospital, Our Lady of Lourdes Hospital, Drogheda, and St Colmcilles Hospital, Loughlinstown, will provide the structure through which hospitals can determine the number and type of nurses needed on ward around the country.

Mr Harris said: “It will allow us to determine the appropriate number of nurses and healthcare assistants [HCA] required for each ward, based on the number of patients and their particular needs, rather than solely on the ward size.”

It is recommended that the nurse/HCA grade mix is 80%/20%, once a safe nurse staffing level exists and is subject to the outcomes of the current national HCA review.

Mr Harris said piloting the framework has shown “significant benefits”, including improved quality of care, shorter hospital stays, and increased patient satisfaction. Staff had reported an increase in job satisfaction and there had been a sustained decrease, up to 95%, in the use of agency staff, said Mr Harris. Moreover, a “promising trend in relation to reduced mortality rates” had begun to emerge.

INMO general secretary Phil Ní Sheaghdha said success of the framework would require “real investment”.

“The provision of optimal care and hope to patients and the nurses who care for them is now a real possibility,” she said.

“This requires real investment in attracting nurses to work in Ireland and retaining those that are leaving, pay remains the single area not addressed, and the framework requires full rollout without delay.”

The framework, which advocates an “invest to save” model, recommends that a seed investment fund be provided to commence incremental implementation across Model 4 (tertiary) hospitals, in tandem with the rollout of a national ICT system for workload measurement, once the HSE has developed an implementation plan, which should be supported by local pilot implementation teams.

It says implementation should be reviewed mid-2019.

The framework is the fruit of the work of the Taskforce on Staffing and Skill Mix for Nursing which began its work in September 2014 in the wake of an increasing number of high-profile health inquiry reports such as the UK Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (2013), which found 1,200 patients had died unnecessarily, and the Hiqa Tallaght Hospital Report (2012), which found, inter alia, that patients’ lives were put at risk because they were being treated on trolleys in corridors. The taskforce was also responding to an increasing body of research evidence linking components of the nursing resource to patient outcomes.



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