The contribution of nurses in future proof health care
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The contribution of nurses in future proof health care
EFPC Conference 9-10 September, 2013, Istanbul
Marieke J. Schuurmans, PhD, RN
Chair Nursing Science University Medical Center Utrecht/Professor Care for Older People University of
Applied Sciences Utrecht
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2033
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DEMOGRAFIC MILESTONE
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• Demographic changes• Changing patterns of health and disease• Increasing expectations of service users• Increasing need for choice• Shift to care close to home• Increased opportunities in treatment
and care• Increase in technology and
communication• Lasting social inequality
Front line Care Report by the Prime Minister’s Commission on the Future of Nursing and Midwifery in Engeland (2010) http://cnm.independent.gov.uk
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Extraordinary challenges in health care
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NURSINGThe unique function of the nurse is to assist the
individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible“
V. Henderson, 1966, p15
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FUTURE OF NURSING REPORTS
Nurses are at the heart of deliveringthe high quality, compassionate care that everyonewants.
They play a key role in determining the qualityof health and social care and enabling people tomake personal choices in a range of health, social andcommunity settings.
They are also vital in improvingpublic health, health promotion and illness prevention– crucial elements of future health care.Front line Care Report by the Prime Minister’s Commission on the Future of Nursing and
Midwifery in Engeland (2010) http://cnm.independent.gov.uk
Nurses are the largest and most flexible component of the health care work force
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NURSES CAN
• Improve the quality of care through the chain (across settings)
• Improve care systems• Address patient safety• Remove barriers to high quality care• Reduce health inequalities• Analyse health issues• Establish creative and effective
cooperation (partnerships)M. Hill (2010)
Bridge the gap between coverage and access, coordinate increasingly complex care for a wide range of patientswww.thefutureofnursing.org/iom-report
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1 NURSING CARE SHIFT FROM HOSPITAL TO HOME
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SELFMANAGEMENT IS IT!
CHANGE OF PARADIGM
SELF MANAGEMENT
2 TRANSITION FROM PROVIDING CARE TO ENHANCING PATIENTS ABILITY TO SELFMANAGE
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HEALTH
The ability to adapt and self manage in the face of social, physical, and emotional challenges. BMJ, 2011
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FRAME WORK..rather than patient dependency ‘causing’nursing action, nursing actions can cause patients to become more or less dependent (Miller, 1984)
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3 INDEPENDENT WITHIN A TEAM
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4 FOCUSSING ON RESULTS
PREVENTION
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DAILY FUNCTIONING & QUALITY OF LIFEDiseases that have strong negative
correlation with the ability to:• self care• move/transfer• have contacts with othersMost negative influence quality of
life (Netuveli et al, 2005, 2006)
Limitations in daily functioning 4x more impact on quality of life than disease itself (Netuveli et al, 2005)
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POPULATION BASED
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5 CLINICAL REASONING
EVIDENCE BASED
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6 TECHNOLOGY
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CARE INNOVATION
FIRST DO NOT HARM
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7 PARTNER IN POLICY
Leadership & partnership
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8 GENERALISTS & SPECIALISTS
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9 NURSING = BACHELOR
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3 Nursing education: can we all agree that a bachelor’s degree should be the minimum level for entry into practice?
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FUTURE
THE FUTURE IS ALWAYS DIFFERENT THAN THE PAST COULD IMAGINE(P. Schnabel, 2007)
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THE FUTURE IS NOW