Launch of Public Health Nursing Clinical Guideline Development February 8th 2011
Public Health Nursing Clinical Guideline Development
Introduction
Patient Safety and quality of health service provision are the key driving forces for the HSE in the development of health care practice.
To support a culture of patient safety within the public health nursing profession and the values underpinning the vision for an Irish health service (DOHC 2008) the National Director of Public Health Nursing Group commissioned a project team to collect, collate and to advise on dissemination, training and governance in relation to clinical policies, procedures protocols and guidelines (PPPGs) for public health nursing teams .The overall aim was to compile all of the Public Health nursing PPGs which have been developed and approved nationally and produce a PPG resource which may be used or adapted by PHNs/Community RGNs nationally.The PPG resource will be printed in CD ROM format and housed on the HSE website.
Background
Knowledgeable patients receiving safe and effective care from skilled professionals in appropriate environments with assessed outcomes is the vision or framework on which the Irish health system should be based (DOHC 2008). Good governance is key to the implementation and operation of such a framework and the principles underpinning good governance are clear lines of accountability at individual, team and system level within an organisation with accountability to employers, professional bodies, patients and the public (DOHC2008). Clinical guidelines increase practitioner’s accountability by identifying best practice and reasonable action and serve to
• Promote best practice
• Standardise practice and service delivery
• Ensure that legislative and regulatory requirements are met
• Ensure employees and line managers are clear on their roles and responsibilities
• Facilitate effective staff induction
• Act as educational tools
• Act as a basis for audit and evaluation
(Health Services Executive 2009)
They represent a statement reflecting an expected standard of care which can be introduced in law as evidence of the standard of care expected (An Bord Altranais 2000b) and are also one of the principles for determining practice expansion enshrined in the scope of practice framework (An Bord Altranais 2000a).
The recent Nurses and Midwives Bill (DOHC 2010) will ‘provide for a modern, efficient, transparent and accountable system for the regulation of the nursing and midwifery professions, which will satisfy the public and these professions that all nurses and midwives are appropriately qualified and competent to practice in a safe manner on an ongoing basis’ (An Bord Altranais 2010). Requirements and standards for public health nursing registration education requires that PHNs practice in accordance with legislation affecting nursing practice which includes implementing and contributing to the development and / or critical review of philosophies, policies, protocols and standards of practice to improve health and social well being (Domain 1.1, An Bord Altranais 2005). In response to the above PHNs nationally have developed, audited and revised suites of PPPGs to assist local clinicians in getting evidence into practice. However, lack of a web enabled or other system for communicating and sharing national PPPG’s has resulted in the duplication of many of the topics which are core to public health nursing and in the use of a variety of templates to guide PPPG development.
The National Council for the Professional Development of Nursing and Midwifery supports guideline adaptation to prevent further duplication of developed guidelines and has published a guideline to facilitate this approach (NCNM 2009). The Health Services Executive has developed a standard national procedural template for use by all clinicians and it is now HSE policy that all PPPGs are developed using this procedure (HSE 2009). Both of these documents are available in Section 7 of the CD.
The rationale for this project is to compile a current compilation of national PPPGs which may be used or adapted for use by PHNs nationally but an acknowledged limitation is the fact that this is a once off exercise and therefore does not provide a pathway for future PPPG upgrade. It was beyond the scope of the group to quality proof the PPGs that have been presented for publication.All PPGs within three years of development and approved locally were accepted.
Glossary of Terms
A comprehensive glossary of terms and definitions is to be found in the HSE Procedure for developing PPPGs (HSE 2009) which will help you discern the difference between policy, protocol, procedure and guideline, it is located in Section 7 of the CD with other identified documents which will be needed for guideline use / adaptation.
Explanatory Memo
This comprehensive but not exhaustive list has divided PPPG topics into the following 5 major categories and each category will hold some duplicated topics: Family and Child Health, Adult Health, Health and Safety, Infection Control and Practice Management.
All listed PPPGs are and each PPPG has its own individual date of review which will need to be checked. Any adapted document will need permission from the authors and acknowledgement of adaptation / use. A governance framework for implementation at Local Health Office level is below.
This CD compilation is separated into the following ten sections:
1 Introduction, Explanatory Memo and Governance
2 Family and Child Health
3 Adult Health
4 Health and Safety
5 Infection Control
6 Practice Management
7 Cork/Kerry PPGs –in PDF Format only
8 Cavan/Monaghan-in PDF Format only
9 Wexford Management PPGs in PDF Format only
10 Publications : PPG Template etc.
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Disclaimer
The PPGs used in the CD ROM were developed and approved within a number of different public health nursing services in the HSE.The aim of this CD ROM is to assist Public Health Nursing services develop their own suite of PPGs to support clinical practice .As with all clinical policies, procedures ,protocols and guidelines the evidence provided in the attached PPGs may not be appropriate for use in all circumstances.Decisions to adopt any of the evidence submitted in the PPGs in the development of local ones must be made by the PHN service in light of an assessment of the most up to date evidence.
Acknowledgements
The National Directors of Public Health Nursing extend their gratitude to the National Council for the Professional Development of Nursing and Midwifery who funded this project.Appreciation is also extended to the nurses who submitted their PPGs for inclusion and sharing and to all the members of the project team..Thanks also to Marie Kehoe,Regional General Manager Quality ,HSE South and to the Institute of Community Health Nursing for their advice and support with this development.Finally thanks is extended toms Marian Wyer (Nursing and Midwifery Planning and Development Unit,Tullamore) who acted as project officer and collated the PPGs on behalf of the project group.
References
An Bord Altranais (2000a) Scope of Nursing and Midwifery Practice Framework, An Bord Altranais Dublin
An Bord Altranais (2000b) Guidance to Nurses and Midwives on the Development of Policies, Guidelines and Protocols, An Bord Altranais, Dublin
An Bord Altranais (2005) Requirements and Standards for Public Health Nurse Registration Education Programmes, An Bord Altranais, Dublin
An Bord Altranais (2010) Nurses and Midwives Bill 2010, An Bord Altranais News, Vol 22, No 2 Summer 2010, An Bord Altranais, Dublin
Department of Health and Children (2008) Building a culture of patient safety, Report of the Commission on Patient Safety and Quality Assurance, Government Publications, Dublin
Health Services Executive (2009) HSE Procedure for developing Policies, Procedure, Protocols and Guidelines
National Council for the Professional Development of Nursing and Midwifery (2009) Guidance on the Adaptation of Clinical Practice Guidelines: Getting Evidence into Practice, 6-7 Manor Street Business Park, Manor Street, Dublin 7
