01/04/2017 Update on the education strategic programme Anne Trotter Assistant Director, Education and Standards 31 March 2017 Topics for discussion • Brief overview and context of education programme • Development of the future nurse standards for proficiency • Outline proposal for the future nurse technical and communication skills annexes 1
01/04/2017 Health, care and education policy contexts • Continuing economic pressures Increasing patient complexity • • Workforce and staffing challenges Introduction of new roles – e.g. nursing • associate and physicians associate • Introduction of new apprenticeship routes to nurse registration • Move from bursaries to loans What needs to change? • What do stakeholders want? • Critical thinkers, leaders, able to work safely in a variety of settings (knowledge of mental and physical health and illness) Confident and competent in terms of ‘technical ability’ • What is the view of the current position? (IFF • research) Actual pre registration standards – content not controversial, but not • future orientated • Vulnerability around learning in practice Insufficient clarity around technical skills at the point of registration • • Implications for: • Standards for learning and assessment in practice, four fields coverage, hours in practice, nature of preceptorship, use of simulation, new routes into nursing. 2
01/04/2017 Education Programme Quality Future Nurse Future Midwife Education assurance of Other standards Proficiencies Proficiencies Framework education Communications and engagement Education framework 3
01/04/2017 Current standards Comparisons Pre-Registration Nursing- current standards Comparison with other regulators NMC QAA HCPC GMC Ref Standard HCPC GDC current pro po sed Code Standards Requirem ents Accredited Prior learning 8 1 1 1 2 Assessment 18 6 5 5 4 13 3 Equality and diversity 6 1 4 1 1 1 Good Health and Character 4 2 2 4 5 Governance 1 2 5 Learning + assessment in practice 7 3 4 2 1 6 7 Managing interuptions 5 3 Practice Learning 22 1 10 6 4 3 2 8 9 Programme Content 15 1 5 5 5 10 Programme design and delivery 9 3 4 4 4 Programme length 6 2 11 12 Programme outcome 4 1 1 1 2 Progression 12 5 1 1 2 13 Protected learning time 5 2 1 2 1 14 15 Public protection 7 1 8 1 2 3 QA 4 3 4 3 2 12 16 none although Reference to EU Directives 7 1 1 ref to legal 17 compliance Selection and admission 8 1 4 6 2 18 19 Student engagement 0 1 Teaching and practice support 13 4 15 7 7 9 20 21 Theory-practice distribution 3 1 3 SUMMARY 164 10 77 49 48 13 50 87 Proportionate transformation 12 sets of 164 standards and requirements 12 sets of standards – 164 S/R 12 se12 sets of standards – 164 S/R12of standards – 164 S/R Proposal: a single education framework 4
01/04/2017 Education Framework- Justification for standards V8.5 External reports, working assumptions and design principles Legal/EU Francis Report IFF Evaluation Keogh Report Directive Health The NES Education profession Nursing Guernsey Framework IFF Keogh Shape of al and NHS Maternity Design IFF Legal/EU Francis report Extraordinary Standards evaluation Report Caring education Midwifery Review principles Evaluation Review Requirements investmen Strategy t review 2014-17 North Recommendation 5: T he Nursing and 5.2 Isolation: Wales Midwifery Council Shape of A lack of Paragraph 25: and the Royal Extraordinary multidisciplinary Enhanced importance of Caring S3.2 Students are College of working, outcome based multi- Review empowered and Action 8.5 Theme 1 Obstetricians and leadership, and requirements Focus on multi- disciplinary Greater good quality recommendation Gynaecologists Future proof and supported to become professional teams in the emphasis on teaching and 2: Enhance the should review pre- agile reflective and lifelong working; planning and inter- mentorship voice of the registration education Enables Health understanding roles delivery of learners working in inter- innovation with our professional programmes patient and the to ensure that it NHS and responsibilities healthcare- professional and multi- partners professional learning within the public promotes multi- through agency teams. hospitals Maternity professionalism and education contributed to education and that there are shared overall poor training reviews investment elements where care . practical and review sensible. Evolving and NES Nursing transforming to deliver NMC NMC NMC excellence in care: A and Midwifery Midwifery Nursing workforce plan for Design principles strategy nursing and midwifery proficiencies proficiencies in Northern Ireland 2015-2025 Education Framework high level pillars Pillar 1 Learning environment and culture Pillar 2 Educational governance and quality Pillar 3 Student learning and empowerment Pillar 4 Educators Pillar 5 Curricula and assessment 10 5
01/04/2017 Development of future nurse standards for proficiency Design principles: Standards for proficiency (1) We will separate standards for graduate registered nurses from the standards for institutions. The new standards will: • embrace the values set out in the Code • be outcomes focused and open to objective assessment be sufficiently future proofed (2030 graduates) • be accessible to the public • • be unambiguous, transparent and succinct 6
01/04/2017 Design principles Standards for proficiency (2) • Standards should reflect increasing requirement for higher order skills, knowledge and proficiencies • Standards should be specifically worded so that they are not open to interpretation, but be flexible in their application • New standards should acknowledge increasing fluidity across care settings, including mental and physical health • Standards need to acknowledge increased working in multi-disciplinary and multi- professional teams Design principles: Standards for proficiency (3) • A focus on the role of the nurse in the wider public health agenda • A stronger focus on clinical leadership and managing complex care Additional focus on dementia, frailty and end of • life care Standards that emphasise the importance of • care being research and evidence led • Focus on practice skills such as venepuncture, managing intravenous infusions, drug administration and parenteral nutrition to ensure consistency in “output” 7
01/04/2017 Future nurse proficiencies Demonstrate professionalism Coordinate Promote health care Draft Future nurse proficiencies Improve safety and Assess needs and quality of care plan care Lead nursing care and Provide and evaluate work in teams care Four fields of nursing • The four fields of nursing are currently set out in legislation and any changes to these fields would require a full public consultation. • We will hold a full public consultation on the new nursing standards in the summer, and there are no plans to include changes to the four fields in this consultation. • The specific programme requirements will still set out what is required of programmes leading to registration within each field. 8
01/04/2017 Future Nurse Annexes Future nurse annexes • States the technical/procedural and communication competencies that all newly qualified nurses must demonstrate across the life span. • It is expected that the demonstration of competence will reflect application to each of the current four fields of practice. • Demonstration will occur across a range of practice settings in order to meet the proficiency outcomes. 9
01/04/2017 Future nurse annex one (1) • Technical skills required for assessing, planning, providing and managing evidence based nursing care. • Procedural competencies for the assessment, planning, provision and management of evidence based fundamental nursing care. Procedural competencies required for • evidence based medicines management and prescribing. Use contemporary tools/approaches for the assessment of: Mental health status and diagnosis of signs of distress – .e.g. anxiety, depression, self-harm. Cognitive health status and diagnosis of signs of distress – e.g. confusion, fatigue, delirium. Behavioural health status and diagnosis of signs of distress – e.g. agitation. Physical health status and diagnosis of physical symptoms and signs of deterioration e.g. vital signs, ECG. 10
01/04/2017 Future nurse annex two: communication skills (1) • Underpinning communication skills. Skills for: • Communicating with those living with sensory impairments across the lifespan. Communicating with people with specific • mental, cognitive, physical and behavioural health challenges. Supporting people to manage their own • health care and decisions. Future nurse annex two: communication skills (2) Skills for: • Working with people to help them improve their health and prevent ill health. • Supervision, teaching and appraising others performance. • Developing, maintaining and managing Relationships. 11
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