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Credentialling – what is it, who benefits and can we afford it?
AUSTRALIAN CRITICAL CARE
The 23rd Australian and Zealand Scientific Meeting on Intensive Care: conference abstracts (Part 2) aliS u r a n c e in arti0fil.l syringe pump error
Introduction: quality assurance (QA) activities within a paediatric intensive care unit (PICU) had revealed ongoing problems with the delivery of medications via syringe pumps. The majority of errors related to incorrect programming and failure to follow unit policy and procedure. Study objectives: to identify the causes and effects of medication delivery errors related to syringe pumps and make recommendations to limit these errors. Methods: search and review of local AIMS-ICU Q A reports over a 2.5 year period to identify error types. A focus group comprising all levels of nursing staff within the PICU was formed to address these errors.
Within Australia, the move toward credentialling advanced practice nurses is closely linked to the quest of advanced specialist practitioners for recognition of the contribution they make to nursing and health care, as well as the need to ensure that nurses providing those services have the required knowledge and skills. Intensive care nurses are well-placed to take advantage of this move and lead the clinical challenge for recognition. It will be important to develop flexible and nationally consistent advanced practice education that involves all stakeholders and which will promote the development of an identifiable body of advanced practice knowledge. However, many questions remain unanswered. Should Australian nurses implement credentialling? What level of credentialling is most appropriate and which model is appropriate for the Australian nursing context? How can credentialling best be implemented to advance the Australian nursing profession? This presentation details the progress to date, in Australia, of the credentialling process, describes the arguments for and against the concept, particularly with reference to intensive care nursing, and attempts to answer some of these questions.
Results: 54 reports relating to syringe pump errors were identified. Analysis of these revealed major error types, including incorrect programming (50 per cent), incorrect set-up (12 per cent), line faults (19 per cent), and faulty equipment (19 per cent). The focus group identified problems associated with the current policy on syringe pump infusions and education of staff as contributing factors to syringe pump errors. This resulted in review of the current policy on, and inservice education of nursing staff in, syringe pump use. Conclusion: this project demonstrates the importance of QA activities in improving the quality of care delivered to patients. Since syringe pump errors are potentially life-threatening, identification and correction of ongoing problems are essential for patient care.
WHO
Credentialling - what is it, benefits and can we afford ~t
Credentialling is not new. With the rights and privileges of professionalism come the obligations to develop and demonstrate the highest level of expertise required to provide a particular service (Styles 1987). Self-regulation to assure quality in performance and service is at the heart of a profession's relationship with the public and is the hallmark of a mature profession (Donabedian 1976). Significant change in the credentialling of nurses is occurring with increasing frequency as a r e d t of the growth of professional nursing, the health-care reform movement and societal expectations.
nd bereaved families in the ediatric intensive care unit GA Paterson, P Sanderson d JH Jeffrey Women's and Children's Hospital Adelaide, South Australia Bereavement follow-up and care has anecdotally been forfeited in our paediatric intensive care unit (PICU), due to its busy, highly demanding environment. A survey in 1997 revealed that staff required more knowledge and support when caring for a dying child and that previous bereavement follow-up had been conducted in a haphazard manner. Our literature search revealed protocols on how other PICUs managed death but there was minimal information on supporting staff. From this, our objectives were directed at isolating the needs of families and PICU staff, to assist them through the grieving process.
A poster was placed within the unit, inviting interested staff members to participate in a bereavement workshop. One third of respondents requested further bereavement education and participated in lectures by a multidisciplinary team. Knowledge drawn from these lectures, combined with experience, led to the 'PICU Bereavement Program', which includes a bereavement package, grief counselling for staff and family and telephone follow-up at 3, 6 and 12 months. Specific dates were highlighted, including the deceased child's birthday and the anniversary of hisher death.
VOLUME 12 NUMBER 2
JUNE 1999
The 23rd Australian and Zealand Scientific Meeting on Intensive Care: conference abstracts (Part 2) aliS u r a n c e in arti0fil.l syringe pump error
Introduction: quality assurance (QA) activities within a paediatric intensive care unit (PICU) had revealed ongoing problems with the delivery of medications via syringe pumps. The majority of errors related to incorrect programming and failure to follow unit policy and procedure. Study objectives: to identify the causes and effects of medication delivery errors related to syringe pumps and make recommendations to limit these errors. Methods: search and review of local AIMS-ICU Q A reports over a 2.5 year period to identify error types. A focus group comprising all levels of nursing staff within the PICU was formed to address these errors.
Within Australia, the move toward credentialling advanced practice nurses is closely linked to the quest of advanced specialist practitioners for recognition of the contribution they make to nursing and health care, as well as the need to ensure that nurses providing those services have the required knowledge and skills. Intensive care nurses are well-placed to take advantage of this move and lead the clinical challenge for recognition. It will be important to develop flexible and nationally consistent advanced practice education that involves all stakeholders and which will promote the development of an identifiable body of advanced practice knowledge. However, many questions remain unanswered. Should Australian nurses implement credentialling? What level of credentialling is most appropriate and which model is appropriate for the Australian nursing context? How can credentialling best be implemented to advance the Australian nursing profession? This presentation details the progress to date, in Australia, of the credentialling process, describes the arguments for and against the concept, particularly with reference to intensive care nursing, and attempts to answer some of these questions.
Results: 54 reports relating to syringe pump errors were identified. Analysis of these revealed major error types, including incorrect programming (50 per cent), incorrect set-up (12 per cent), line faults (19 per cent), and faulty equipment (19 per cent). The focus group identified problems associated with the current policy on syringe pump infusions and education of staff as contributing factors to syringe pump errors. This resulted in review of the current policy on, and inservice education of nursing staff in, syringe pump use. Conclusion: this project demonstrates the importance of QA activities in improving the quality of care delivered to patients. Since syringe pump errors are potentially life-threatening, identification and correction of ongoing problems are essential for patient care.
WHO
Credentialling - what is it, benefits and can we afford ~t
Credentialling is not new. With the rights and privileges of professionalism come the obligations to develop and demonstrate the highest level of expertise required to provide a particular service (Styles 1987). Self-regulation to assure quality in performance and service is at the heart of a profession's relationship with the public and is the hallmark of a mature profession (Donabedian 1976). Significant change in the credentialling of nurses is occurring with increasing frequency as a r e d t of the growth of professional nursing, the health-care reform movement and societal expectations.
nd bereaved families in the ediatric intensive care unit GA Paterson, P Sanderson d JH Jeffrey Women's and Children's Hospital Adelaide, South Australia Bereavement follow-up and care has anecdotally been forfeited in our paediatric intensive care unit (PICU), due to its busy, highly demanding environment. A survey in 1997 revealed that staff required more knowledge and support when caring for a dying child and that previous bereavement follow-up had been conducted in a haphazard manner. Our literature search revealed protocols on how other PICUs managed death but there was minimal information on supporting staff. From this, our objectives were directed at isolating the needs of families and PICU staff, to assist them through the grieving process.
A poster was placed within the unit, inviting interested staff members to participate in a bereavement workshop. One third of respondents requested further bereavement education and participated in lectures by a multidisciplinary team. Knowledge drawn from these lectures, combined with experience, led to the 'PICU Bereavement Program', which includes a bereavement package, grief counselling for staff and family and telephone follow-up at 3, 6 and 12 months. Specific dates were highlighted, including the deceased child's birthday and the anniversary of hisher death.
VOLUME 12 NUMBER 2
JUNE 1999