The Changing Role of Nursing: Opportunities for Nurse-led Services for the Management of Chronic Disease and Diabetes in the UAE

There is little debate that current and future healthcare is, and will continue to be, dominated by the prevention and management of increasingly complex chronic health disease; the UAE is no exception. Preventive and disease management services directed at groups and individuals at risk of unfavourable health outcomes are core to the make-up of an effective health system. The burden of noncommunicable, chronic and diabetes-related diseases places a heavy strain on health service cost and service delivery requirements. The UAE is faced with the challenge of identifying and developing effective strategies for the prevention and management of the burgeoning prevalence of levels of chronic disease and diabetes, including the identification and development of appropriate health workforce and service development options. Nursing and other allied health professionals possess a broad range of professional competencies and skills to provide preventive and follow-up services in an effective and cost-efficient manner. The addition of non-medical led services has significant ability to strengthen traditionally designed health system

Partnership in Action: A Case Study in Nursing Workforce and Leadership Development in East Africa

Session presented on Saturday, July 23, 2016: East Africa suffers an inordinate burden of disease and does not have the numbers of suitably qualified nurses and midwives to address this challenge.\u27 Focussed efforts in nursing workforce capacity building are needed to build capacity within nursing education, practice and leadership. An enhanced nursing and midwifery workforce is needed across all disciplines with development required at all levels including upgrade of the existing workforce, development of speciality qualifications and enhancement of leadership capacity.\u27This presentation involves a case study in which university private-public partnerships have successful contributed to nursing capacity enhancement of nursing education, practice and leadership in the East African nations of Tanzania, Kenya and Uganda.\u27 Capacity building is not a quick-fix activity.\u27 It takes time and resources.\u27 Equally, the success of capacity building efforts is context dependent.\u27 One size does not fit all and capacity building initiatives must be tailored to the unique cultural context and regulatory environment of each participating nation.\u27 \u27This presentation outlines specific details of capacity building strategies developed and implemented along with a comprehensive range of partnerships which have contributed to capacity building efforts.\u27 Details are provided regarding the process of stakeholder consultation re workforce need, the range of programmes developed along with graduate numbers and progression to-date.\u27 A full description of the broad range of partnerships needed to successfully implement the strategies along with an outline of factors critical for successful collaborative enterprise.\u27 \u27\u27 The outcomes achieved are presented along with a description of the methods used to evaluate progress and measure success.\u27 Outcomes are measured in terms of graduate numbers, progression to higher degrees, progression to nursing leadership positions and placement into rural and remote settings.\u27 Lessons learned are outlined for the benefits of nurse educators, nurse executives and policy makers wishing to increase nursing workforce capacity efforts and impacts in a developing context

The leaking pocket: The implicit struggle for skilled health workers between private not-for-profit and public sector in Tanzania

Public health services in sub-Sahara Africa countries face severe health workforce shortages exacerbated by both outward migration and internal public to private sector migration—Tanzania is no exception. This review was conducted to characterize the extent of health workforce shortages in Tanzania, and the factors impacting on the shortage. The authors reviewed publicly available data to assess the extent of health workforce shortages within Tanzania and the range of ‘pull’ and ‘push’ factors contributing to the shortages. Findings highlight significant health workforce shortages in Tanzania. Pull factors, the advantages offered that \u27pull\u27 workers towards the new jobs and well as Push factors, those negative factors that push workers out of their jobs, such as poor pay, working conditions, and management and governance issues, were identified. The issue of health workforce flow from the public to private not-for-profit sector was particularly notable and the impact this has on the ability to provide an effectively functioning public health system in Tanzania. The authors conclude that opportunities exist for the private not-for-profit sector to take an active role in the production of skilled human resources for health in Tanzania

Difficult and frustrating? Caring for those with chronic and complex conditions

Caring for people with chronic and complex health needs has become an ever-larger part of everyday nursing. The World Health Organization has identified common and preventable risk factors that are the primary cause of chronic illness worldwide—hypertension, tobacco use, hyperglycaemia, physical inactivity, and overweight or obesity. Nurses now need an expanded range of skills and expertise that will enable them to work effectively with people whose chronic and frequently complex health issues may be seen as difficult and challenging. This article invites you to think about your experiences of caring for people with chronic and complex conditions. Before you read any further, take a moment to think about your response to some initial questions. How would you describe your attempts to work with people with chronic and complex health needs? Do you find yourself struggling to understand when your patient doesn’t appear to be following professional health advice? What do you hear your colleagues say about chronic illness

A single competency-based education and training and competency-based career framework for the Australian health workforce: discussing the potential value add

This brief discusses the policy implications of a research study commissioned by Health Workforce Australia (HWA) within its health workforce innovation and reform work program. The project explored conceptually complex and operationally problematic concepts related to developing a whole-of-workforce competency-based education and training and competency-based career framework for the Australian health workforce and culminated with the production of three reports published by HWA. The project raised important queries as to whether such a concept is desirable, feasible or implementable – in short what is the potential value add and is it achievable? In setting the scene for discussion, the foundation of the project’s genesis and focus of the study are highlighted. A summary of key definitions related to competency-based education and training frameworks and competency-based career frameworks are provided to further readers’ commonality of understanding. The nature of the problem to be solved is explored and the potential value-add for the Australian health workforce and its key constituents proposed. The paper concludes by discussing relevance and feasibility issues within Australia’s current and changing healthcare context along with the essential steps and implementation realities that would need to be considered and actioned if whole-of-workforce frameworks were to be developed and implemented

A framework for cyclical nursing curriculum review across multi-site and multi-country campuses

Cyclical curriculum review and continuous course improvement is an unarguable measure of quality nursing education. Higher education and professional regulators across the Middle East and North Africa (MENA) and African (Afro) regions are increasingly mandating cyclical review within accreditation and programme approval standards. Many nursing education providers in the region operate multi-site and multi-country campuses. A key challenge is to ensure that programmes keep pace with international standards in nursing education, and, that inter-campus drift does not occur in programme content and quality. Cyclical review offers a process whereby programmes can be updated to current best practice and consistent cross-campus standards can be maintained. The review process described in this presentation arises from a Aga Khan University project designed to review the status of courses within its post registration RN to BScN programme. The University operates four direct delivery sites in Kenya, Tanzania, Uganda and Pakistan and provides mentoring support to programmes in Upper Egypt and Mozambique. The project sought to assess currency of course content and develop a nursing course review framework for use by any educational provider involved in multi-campus programme delivery. The approach engaged an expert review team including internal and globally sourced external experts. The team involved subject experts and curriculum development and pedagoloical experts. Key foci of the review framework are described including; expected student outcomes, learning objectives, content inclusions, assessment items, and, teaching/learning resources. The review framework is of practical use to other educators involved in the review of course modules across multi-campus, multi-state, multi-emirate and/or multi-country settings

Health professionals in Kenya: strategies to expand reach and reduce brain drain of psychiatric nurses and psychiatrists

This paper highlights the extent of the brain drain in relation to human resources for health (HRH) that is currently challenging Kenya, and suggests strategies that have the potential to change current working environments and improve HRH retention rates. Governments in partnership with health professional bodies and regulators could improve the working conditions for psychiatrists and mental health nurses: by promoting career choices in mental health; by providing accessible professional development opportunities; and by easing workload pressures by expanding service reach through thoughtfully planned and delivered task-shifting to primary care. While these strategies have the potential to make a significant difference, the evidence suggests a brain drain will continue as long as working conditions remain sub-optimal and global HRH shortages persist

Collaborative task-sharing to enhance the Point-Of-Care Ultrasound (POCUS) access among expectant women in Kenya: The role of midwife sonographers

Unrealized maternal and child health goals continue to challenge Kenya where adverse outcomes remain high and diagnostic services are limited. The acute shortage of doctors and radiographers requires alternate human resources for health (HRH) with the ability to identify risk factors in pregnancy through Point-Of-Care Ultrasound (POCUS). A specialist radiologist and ultrasonography team partnered with midwives to adopt interprofessional task sharing and capacity building. Faculty from the Radiology Department of our hospital designed and implemented the project which was carried out at three outreach health service centres. Designing and implementing a training model to skill midwife sonographers with the capacity to accurately identify risk factors in pregnancy is an effective model to increase POCUS access. A collaborative task sharing model focused on training quality, validation of results, tracking of errors and specialist level clinical supervision yielded a safe and scalable model of HRH capacity building. Programme evaluation, verification of outcomes and dissemination of results were all monitored. The project was a successful HRH task sharing and interprofessional learning initiative involving task sharing a clearly defined suite of sonographer competencies with participating midwives. The programme increased POCUS accessibility at the three outreach clinics with proven outcomes in the early detection and referral of risk factors in pregnancy

Supporting the nationally mandated transition to competency-based nursing curricula in Egypt

Egypt has a substantive and rich history in nursing education with continuous evolution over many years. A government commitment to further enhance the capacity of the nursing workforce recently required all nursing curricula to be upgraded and presented in a competency-based format. In response to this directive, lead agencies in Egypt, including the Educational Development Fund and the Nursing Sector Group of the Supreme Council of Universities, have garnered internal and external nursing expertise to provide guidance in the curriculum reform process. The authors of this presentation are currently working in close partnership with several Egyptian nursing education providers supporting the transition to competency-based nursing education. Shifting from bio-medical style syllabi to competency-based curricula is a time intensive and multi-faceted process. Successful transition requires a base knowledge of the fundamentals of competency-based programme design and its associated pedagogies. An understanding of relevant definitions, curriculum development processes, mandatory curriculum inclusions, and assessment techniques are core requirements to the development processes. This presentation provides an oversight of these terminologies and processes. The presentation provides insights to policy makers and educators embarking on similar nursing curriculum reform and nursing workforce capacity development initiatives

Rising to the Challenge: Nursing Leadership via Nurse-Led Service Provision for Chronic Disease Management and Prevention

All nations are currently challenged by the increasing prevalence of non-communicable and chronic disease [1]. In Australia, by 2051, over 50% of the population over 50 will have a chronic disease [2]. In addition to increased levels of chronic disease, services will be stretched through workforce shortages, and government policies to provide greater access to services. Within the United States of America demand for primary care services will further increased by the passage and progressive implementation of the Affordable Care Act (ACA), which expands Medicaid coverage to millions of low-income Americans [3]. Given the increasing levels of disease burden, all staff, not just doctors, need to be viewed as part of the solution and encouraged to innovate and search for better and more affordable ways of delivering effective and appropriate care [4]. Globally, nurses are the largest and most accessible cohort within the health workforce. It is not surprising; therefore, that increasing reference to nurse-led services is present within the literature. This paper reports the findings of a focused literature review aimed at identifying the range of leadership skills and attributes required of nurses involved in the leading roles in the provision of nurse-led services and the management of nurse-led clinics. The implications for nursing education are highlighted and discussed