rcna national conference 2012 program and book of abstracts

RCNA Australian member of ICN

Quality ISO 9001

RCNA Australia’s peak professional nursing organisation

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CORPORATE AND CLINICAL GOVERNANCE

National 23–26 May Conference CairnsRCNA 12

PROGRAM AND BOOK OF ABSTRACTS

Personally

Controlled

Electronic

Health

Records

To receive a reminder when registrations open,

for more information or to sign up to receive regular

updates visit www.yourhealth.gov.au or call the

Helpline on 1800 PCEHR1 or 1800 723 471.

Connecting Australian healthcareA national system of eHealth records

has the potential to deliver better care

for patients and make the health system

more efficient.

Over time, the national eHealth record

system will give you better access to

patient information – patient medications,

test results and allergies or treatments –

meaning better, safer and more efficient

care for patients.

Eligible healthcare professionals,

including nurses can register with the

Healthcare Identifiers Service right now

to get ready for the eHealth record system.

Visit www.medicareaustralia.gov.au

and follow the links.

From July 2012, Australians can

choose to register for a personally

controlled electronic health

record (eHealth record). eHealth brings it all together


1

CONTENTS

Welcome from the President,

Royal College of Nursing, Australia 3

Overview/Aims and objectives 4

General information 4

Patricia Chomley Memorial Oration 6

Prizes and awards 6

Opening address 8

Keynote speakers 8

Plenary speakers and workshop presenter 9

Facilitators 10

Conference Steering Committee 11

National Conference Abstract Review Committee 11

Events team 11

Sponsors 12

Conference program 18

Official conference social program 21

Concurrent sessions 22

Poster listing 23

Faculty forums 25

Exhibitors 31

Exhibitor profiles 31

Abstracts 36

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WELCOME FROM THE PRESIDENT,

Royal College of Nursing, Australia (RCNA)

Dear Colleagues,

At the 2012 RCNA National Conference the concept of ‘integrated governance’ that reflects the joint

corporate governance and clinical governance duties of health care organisations will be examined. Most

importantly, effective governance to provide strong corporate and clinical leadership, together with the value

of accessing and utilising nursing knowledge within governance structures, will be highlighted.

As our health care system undergoes a range of reforms, new governance frameworks are being

established. It is crucial that the role and responsibilities of the nursing profession are understood in this

reform environment. Strong corporate and clinical governance is essential for quality health care systems.

Clinical and corporate governance frameworks provide for continuous improvement in the quality of

services, and safeguarding high standards of care within a system governed by rules, processes, or laws by

which our health care system is operated, regulated and controlled.

Nursing must assume its place in the health system governance structures in order to effectively contribute

to ensuring the optimal outcomes for patients, clients and communities.

This year’s conference is certain to be a momentous event as it will be the last conference proudly delivered

under the banner of RCNA. As many of you would be aware, a positive member vote approved the unification

of RCNA and The College of Nursing; July 2012 will see the launch of our newly combined entity the

Australian College of Nursing. This unification is such a positive and strong step for the nursing profession

because with a united voice we will act as a strong, focussed, national voice representing and leading the

nursing profession within Australia. This conference will provide the perfect opportunity to not only reflect

all that has been achieved over RCNA’s 60 plus year history but offer inspiration and invigoration about the

future and all it has to offer.

The skills and scope of practice available to nurses today is impressive and I can only see this growing and

strengthening over the coming years. It is indeed an exciting time to be a part of our wonderful profession

and I, for one, am excited about the many possibilities that are on the horizon. I would encourage all our

conference delegates to engage, debate, absorb and enjoy all elements of the RCNA National Conference

program. We are thrilled to have you here and look forward to being inspired by the discussions and debate

that will take place throughout the conference.

Adjunct Associate Professor Stephanie Fox-Young FRCNA FCN

President, RCNA

RCNA National Conference 23–26 May 2012

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OVERVIEW

The 2012 RCNA National Conference – Corporate and Clinical Governance will highlight the importance

of effective corporate and clinical governance. It will examine the value of accessing and utilising nursing

knowledge within governance structures.

AIMS AND OBJECTIVES

The 2012 RCNA National Conference will:

promote the appropriate engagement of nurses in governance structures

promote and progress the involvement of clinical nurse leaders in systems-level governance

encourage responsiveness of clinical governance structures

explore the concept of ‘integrated governance’

drive the development of strong corporate and clinical leadership into the future.

GENERAL INFORMATION

The destination

Cairns is a modern vibrant city located in beautiful Far North Queensland. Easily accessible from major Australian cities,

Cairns is a fantastic conference location ensuring delegates are within walking distance of all venues and a great range of

accommodation options. Cairns also offers a diverse range of tourist experiences all within close distance.

Social media

Join the RCNA National Conference conversation on Twitter at #rcnanc2012

The venue

The award winning Cairns Convention Centre is only ten minutes from the Cairns International Airport which is Australia’s

gateway to the Asia Pacific. The centre is renowned for its unique environmental design and is surrounded by the Great Barrier

Reef and ancient tropical rainforests. The convenient location is only a short walk from accommodation, transport, restaurants

and local attractions.

Mobile phones

As a courtesy to other delegates, please ensure your mobile telephone is turned off during conference sessions.

Name badges

Name badges should be worn at all times. It is your official pass to conference sessions, refreshment breaks and social

functions.

Registration desk

Registration for the conference will take place at two different locations and at the times identified below:

Conference:

Wednesday 23 May 2012 The Sebel Cairns 3.00pm – 5.30pm

Thursday 24 May 2012 The Cairns Convention Centre 8.00am – 4.30pm

Friday 25 May 2012 The Cairns Convention Centre 8.00am – 3.40pm

To contact RCNA staff on the registration desk please call: 0428 421 434

Faculty Forums:

Saturday 26 May 2012 The Cairns Convention Centre 8.30am – 3.00pm

To contact RCNA staff on the registration desk please call: 0422 006 949


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RCNA provides a strong voice and policy focus for the nursing profession. RCNA actively participates on many national and state/territory forums of significance to the nursing profession. We take your ideas forward to government and other health stakeholders.

RCNA’s strength comes from the participation of and support from its members.

Our members are able to provide a diverse nursing perspective to our policy development.

AS AN RCNA MEMBER YOU CAN:

contribute to an RCNA submission – provide your ideas, feedback, experiences or comments to inform RCNA submission development

raise professional issues that concern you –

send us your thoughts on issues affecting the nursing profession

apply to become an RCNA representative –

RCNA regularly seeks experienced and enthusiastic members and fellows to represent us on a wide variety of working groups, advisory bodies and at professional functions.

EFFECTIVE ADVOCACY CAN INFLUENCE THE HEALTH REFORM AGENDA

WE WANT YOUR INVOLVEMENT!visit www.rcna.org.au RCNA Australian

member of ICN

Quality ISO 9001

Special requirements

The venue has been notified of special dietary requirements for those delegates who advised RCNA of their needs prior to

the conference. Delegates with pre-ordered special meals should make themselves known to function staff as it will not be

possible for staff to locate them personally.

Timing

As a courtesy to speakers and fellow delegates, please be seated at least five minutes before the scheduled commencement

time of each session. Entry doors will be closed at the listed commencement time.

Trade exhibition

The trade exhibition will be open for viewing at the following times:

Thursday 24 May – morning tea, lunch and afternoon tea

Friday 25 May – morning tea and post-lunch refreshments.

RCNA continuing nurse education (CNE) points

RCNA CNE points are awarded to professional development activities that are organised by RCNA or have been endorsed

or accredited by RCNA. One point equates to 60 minutes of education. RCNA recommends that nurses should aim to achieve

30 CNE points per year (that is, 30 hours of professional development per year) when enrolled in the RCNA Life Long Learning

Program.

Attendees of the RCNA National Conference will receive:

Oration – Wednesday 23 May 1 CNE point

Conference day one – Thursday 24 May 5.5 CNE points

Conference day two – Friday 25 May 5 CNE points

Faculty Forums – Saturday 26 May 4.5 CNE pointsCall 1800 061 660 to enquire about

RCNA membership and 3LP


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PRIZES AND AWARDS

Distinguished Life Fellow Award

Conferred on a Fellow of RCNA in recognition of outstanding achievement both to the field of nursing and to RCNA.

PATRICIA CHOMLEY MEMORIAL ORATION

Established in 1966, the Patricia Chomley Memorial Oration has become part of tradition at

RCNA and has been presented annually to honour Miss Patricia Chomley, the first director of

the then College of Nursing, Australia (now known as RCNA).

Appointed in 1949, Miss Chomley was director until her retirement from the position in 1964.

During the 15 years of Miss Chomley’s leadership, some 600 students undertook courses.

Many of those nurses subsequently held responsible positions throughout Australia and were

instrumental in important developments in the nursing profession and in upgrading the quality

of patient care.

Miss Chomley passed away 24 October 2002 and the Patricia Chomley Memorial Oration is a

fitting tribute to her leadership and contribution to RCNA.

46th Patricia Chomley Memorial Oration

Emeritus Professor Robin Watts AM FRCNA (Ret)

Professor Watts is an Emeritus Professor of Nursing, Curtin University and a Director of the

Western Australian Centre for Evidence Informed Healthcare Practice, a collaborating centre

of the Joanna Briggs Institute. She has been involved in nursing education for 42 years and

served on or chaired numerous national and state nursing education committees, reviews

and projects.

Professor Watts commenced her basic nursing training at Princess Margaret Hospital for

Children (PMH) in 1962. Following her graduation in 1965, Professor Watts undertook her

midwifery training at the Royal North Shore Hospital in Sydney before travelling overseas

where she gained valuable nursing experience in both Canada and the then war torn

Honduras.

Upon her return to Australia in 1971, Professor Watts undertook her Diploma of Nursing

Education at the Royal College of Nursing in Melbourne and in 1973 accepted an appointment

as the Senior Nurse Educator in the School of Nursing at PMH for Children. Following the

transition of nursing education to the tertiary sector, she left the hospital in 1976 to take up

a lecturer’s position in paediatric nursing in the School of Nursing at the Western Australian

Institute of Technology (now Curtin University). Although promoted to various administrative

positions within the university since then, Professor Watts has always maintained a close

interest in the quality of health care provided for children in all health care settings in Western

Australia and beyond.

Professor Watts’ contribution to the nursing profession has been and continues to be

immense. Of particular note is her involvement with the Australian Health Ethics Committee,

the Australian Council of Deans of Nursing, the National Review of Nursing Education,

management of the Shared Health Interactive Practice initiative and her work as the Director

of the WA Centre for Evidence Based Nursing and Midwifery. These are current examples of

her leadership and ongoing desire to progress the nursing profession.

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8

KEYNOTE SPEAKERS

Professor Judith Dwyer

Professor Dwyer will be presenting a plenary address at the conference. Professor Dwyer is Director

of Research in the Department of Health Care Management at the Flinders University School of

Medicine, and is a former CEO of Southern Health Care Network in Melbourne, and of Flinders

Medical Centre in Adelaide. Professor Dwyer was the inaugural President of Women’s Hospitals

Australasia, and was listed as one of ‘Australia’s Smart 100’ by The Bulletin in 2003. She is a

Research Program Leader for the Lowitja Institute, Australia’s national Aboriginal health research

institute, and teaches in the Flinders’ Masters of Health Administration. Her research interests

include the governance of the Australian health system, and Aboriginal health services and policy.

Associate Professor Lee Stewart MRCNA

Associate Professor Stewart is a registered nurse and endorsed midwife. Her clinical nursing and

midwifery experience includes working in public hospitals, private hospitals and community health

settings. Associate Professor Stewart’s background in nursing education commenced in a hospital-

based school of nursing. She holds positions as an educator for the nursing certificate program, as

a regional staff development educator and as a nurse educator attached to clinical units. Associate

Professor Stewart moved into nursing administration and spent several years as a senior nursing

administrator in a large tertiary hospital, leading and managing surgical perioperative and critical

care services. During this period she acted as District Human Resource Manager for the health

service district. In 2003 she joined the faculty of the then School of Nursing Sciences at James

Cook University and has held various positions including Lecturer, Acting Senior Lecturer, Acting

Academic Adviser, Acting Director of Postgraduate Studies, Director of Undergraduate Studies,

Deputy Head of School, and International Director between 2003 and 2009. She was appointed as

Clinical Governance Consultant to the Fiji Ministry of Health from 2004 to 2008.

OPENING ADDRESS

Adjunct Associate Professor Stephanie Fox-Young FRCNA FCN

Associate Professor Fox-Young has had extensive experience in nursing education and regulation in

Queensland and the ACT over the last 30 years. She completed her PhD on women’s decision making

in menopause at QUT in 2000. Associate Professor Fox-Young was Senior Lecturer and Head of the

Bachelor of Nursing Program at Griffith University, Gold Coast in the early 1990s. She then moved

to the Queensland Nursing Council, filling a number of roles there, including Executive Officer and

Director of Research and Policy and most recently was with the University of Queensland School

of Nursing & Midwifery. Associate Professor Fox-Young is a Fellow of Royal College of Nursing,

Australia and a Fellow of the College of Nursing. She is also the President of Royal College of

Nursing, Australia.


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Alison McMillan MRCNA

Ms McMillan has more than 25 years’ experience as both a clinician and an executive in the public

health care sectors of the United Kingdom and Australia. In her new role as the Chief Nurse &

Midwifery Officer for Victoria, Alison provides strategic leadership to the health sector and plays

a pivotal role in collaborating with other state and territory counterparts on national issues and

initiatives relating to nursing and midwifery. She previously held the roles of Director, Quality, Safety &

Patient Experience in the Department of Health and was the Chair of the Australian Commission on

Safety and Quality in Health Care (ACSQHC) Inter-Jurisdictional Committee.

Dr Heather Gluyas FRCNA

Dr Gluyas has had a varied career in nursing with a strong clinical background in critical care

and aged care. She has also been involved in senior management within the public health sector

of Western Australia and is active professionally in areas of nursing policy and planning both

internationally and nationally. She joined academia to pursue her area of interest in patient safety and

clinical governance.

Dr Gluyas completed her doctoral studies in clinical governance and currently lectures in the

postgraduate studies area of Leadership, Quality and Patient Safety in the School of Nursing and

Midwifery at Murdoch University. She also holds an Adjunct Associate professorship with Notre Dame

University. She has presented widely in Australia and internationally in the areas of patient safety and

clinical governance and provides consultancy in the area for several health agencies.

Dr Cathy Balding

Dr Balding, Director of Qualityworks, will be presenting a plenary address at the conference.

Qualityworks is a consultancy dedicated to building the capability of health services for improving

the safety and quality of their care. Dr Balding has been involved in health services management,

quality and clinical governance for 20 years, in national and state policy roles in large and small health

services across the community, acute and aged care sectors. She is the author of The Strategic Quality

Manager and specialises in the development and implementation of workable clinical governance and

improvement systems that combine best practice research and real world experience.

PLENARY SPEAKERS

Melissa Sweet

Ms Sweet is an independent journalist, media columnist, author, blogger and enthusiastic tweeter

(@Croakeyblog).

She specialises in covering public health matters, with a particular focus on under-served areas and

issues, including rural and remote health, Indigenous health, and the social determinants of health.

She coordinates Crikey’s health blog Croakey (which is funded by a consortium of health groups

in an arrangement organised by the PHAA), and writes for a wide range of specialist and general

publications.

She is the author or co-author of several books, including Inside Madness, The Big Fat Conspiracy,

Ten Questions You Must Ask your Doctor and Smart Health Choices.

As secretary of the Public Interest Journalism Foundation (based at Swinburne University in

Melbourne), Ms Sweet is involved in supporting innovation in public interest journalism. She has an

honorary appointment in the Sydney School of Public Health at the University of Sydney, and is involved

in a number of research projects around media and health.

WORKSHOP PRESENTER


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Adjunct Associate Professor

Stephanie Fox-Young

FRCNA FCN

Christine Smith FRCNA

RCNA Board Member

Gay Lavery FRCNA

RCNA Board Member

Maryanne Craker MRCNA

RCNA Board Member

FACILITATORS

Julie Shepherd FRCNA

RCNA Board Member

Gayle Heckenberg FRCNA

RCNA Board Member

Paula Elliott FRCNA

RCNA Board Member

Maryann Curry MRCNA

The College of Nursing Board Member

CONFERENCE FACILITATOR

Adjunct Associate Professor Debra Cerasa FRCNA FCN GAICD

Chief Executive Officer, RCNA


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CONFERENCE STEERING COMMITTEE

Anne Davies MRCNA – Lecturer in Nursing, School of Nursing and Midwifery, Flinders University

Adjunct Professor Cheyne Chalmers FRCNA – Executive Director of Nursing, Midwifery & Support Services, Southern Health

Deborah McKern MRCNA – Director, Aged care consulting and support

Elizabeth Hutchings MRCNA – Project Officer – Concept Development, Australia and New Zealand Breast Cancer Trials Group

Mark Smith FRCNA – General Manager, External Relations, Royal District Nursing Service

Professor Tracey McDonald AM FRCNA – Professor of Ageing (Veterans & Community), Australian Catholic University

NATIONAL CONFERENCE ABSTRACT REVIEW COMMITTEE

Adjunct Professor Debra Thoms FRCNA – Chief Nursing and Midwifery Officer, NSW

Alison McMillan MRCNA – Chief Nurse and Midwifery Officer, VIC

Adjunct Associate Professor Catherine Stoddart MRCNA – Chief Nurse and Midwifery Officer, WA

Belynda Abbott MRCNA – New Generation of Nurses Faculty Advisory Committee Member

Jason Mills MRCNA – New Generation of Nurses Faculty Advisory Committee Vice-chair

Carol Nolan MRCNA – Community and Primary Health Care Faculty Advisory Committee Member

Dr Jeffrey Fuller FRCNA – Community and Primary Health Care Faculty Advisory Committee Member

Dr Elizabath Hanna FRCNA – Disaster Health Faculty Advisory Committee Member

Gay Lavery FRCNA – Disaster Health Faculty Advisory Committee Member

Dr Alison Hutton MRCNA – Disaster Health Faculty Advisory Committee Member

Marianne Cummins MRCNA – Health and Wellbeing in Ageing Faculty Advisory Committee Member

Kristene Rice MRCNA – Health and Wellbeing in Ageing Faculty Advisory Committee Member

Professor Tracey McDonald AM FRCNA – Health and Wellbeing in Ageing Faculty Advisory Committee Chair

Victor McConvey MRCNA – Movement Disorders and Parkinson’s Nurses Faculty Advisory Committee Vice-chair

Mary Jones MRCNA – Movement Disorders and Parkinson’s Nurses Faculty Advisory Committee Chair

Professor Karen Francis FRCNA – Rural Nursing and Midwifery Faculty Advisory Committee Chair

Associate Professor Marg McLeod FRCNA – Rural Nursing and Midwifery Faculty Advisory Committee Member

Jeffrey Faccenda MRCNA – New Generation of Nurses Faculty Advisory Committee Member

EVENTS TEAM

Helen Goodall – Business Services and National Activities Director

Melissa Cantrall – Events Manager

Emily Galbraith – Events Officer

Hannah Veitch – Events Administrator


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Wednesday 23 May The Sebel

3.00pm Registration opens

4.00pm – 5.30pm RCNA Annual General Meeting (RCNA members only)

5.30pm – 6.30pm 46th Patricia Chomley Oration and awards presentation

Emeritus Professor Robin Watts AM FRCNA (Ret)

Nursing’s legacy

As in any year, 2012 has some major anniversaries to celebrate. Some of these are of particular

interest and/or importance. The Queen, for example, has reigned over us for 60 years while

Mawson and his men traversed the Antarctic coastline 100 years ago. Quite different achievements

but both have left or will leave a significant legacy.

Does Australian nursing have a symbolic ‘hut’? If so, are we tending that legacy so it survives? Is

it even a legacy that should survive? Is the legacy rhetoric or reality, or a mix of both? There are

some in the profession who argue any efforts we have made (if we made an effort at all) in this

regard have been a dismal failure.

6.30pm – 8.00pm Welcome receptionHosted by

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IDW

IFE

RECOGNITION AT A GLANCERCNA Nurse ID cards $4.00ea

Discounts available for bulk orders

Available at www.rcna.org.au freecall 1800 061 660


19

Pick me up sponsor

Thursday 24 May Cairns Convention Centre

8.00am Registration opens

9.00am – 9.05am Welcome to country

9.05am – 9.25am Welcome and Opening address:

Adjunct Associate Professor Stephanie Fox-Young FRCNA FCN, President RCNA

9.25am – 10.10am Keynote address:

Professor Judith Dwyer, Health Care Management, Flinders University

The importance of governance in health care – Nurses’ role and the importance of nursing input to governance

10.10am – 10.30am Professional presentation:

Launch of the Personally Controlled eHealth Record System

10.30am – 11.00am Morning tea and exhibition trade opening: Proudly sponsored by

11.00am – 12.15pm Concurrent session 1

12.15pm – 1.15pm Lunch

1.15pm – 2.00pm Plenary presentation:

Alison McMillan MRCNA, Chief Nurse & Midwifery Officer, Victoria

Making the links between clinical governance and quality and safety – How does that link to the health reform agenda?

1.15pm – 3.15pmOptional educational

workshop

(max 30 participants)

Healthcare Australia Master Class (by pre-registration only)The quality and competence of agency nurses in Australia: A master class using the accelerated Delphi method

2.05pm – 3.15pm Concurrent session 2

3.15pm – 3.45pm Afternoon tea

3.45pm – 4.30pm Workshop session:

Melissa Sweet, freelance health journalist, Croakey blog

Social Media

6.30pm Conference dinner

Hosted by


20

Friday 25 May Cairns Convention Centre

8.00am Registration opens

9.00am – 9.45am Keynote address:

Associate Professor Lee Stewart MRCNA, Head of School, School of Nursing, Midwifery &

Nutrition, James Cook University

Clinical governance – An international experience in Fiji

9.45am – 10.05am Morning tea: Proudly sponsored by

10.05am – 10.50am Australian Institute of Company Directors

hosted workshop

10.05am – 12.05am Optional educational

workshop

(max 30 participants)

Healthcare Australia Master Class (by pre-registration only)The quality and competence of agency nurses in Australia: A master class using the accelerated Delphi method

10.55am – 12.30pm Concurrent session 3

12.30pm – 1.30pm Hosted lunch: Proudly sponsored by MyCareerUsing the bi-annual MyCareer Employment Forecast May

2012 report, National Sales Director for Fairfax Employment,

Rodney House will be providing a snapshot into up and coming

employment trends within the health care sector nationally.

1.30pm – 2.00pm Refreshments in exhibition trade area Presentation of conference awards


Dr Heather Gluyas FRCNA

Health care failures: What can we learn to improve clinical and corporate governance?


Dr Cathy Balding, Qualityworks PL

The governance of quality health care: It can’t happen without nurses

3.30pm – 3.40pm Conference close

Closing address:

Adjunct Associate Professor Debra Cerasa FRCNA FCN GAICD, CEO RCNA

www.rcna.org.auRCNA Australian member of ICN

Quality ISO 9001

2012 RCNA NURSING & HEALTH EXPOS Gold coin donation welcomed, proceeds go to charity

HELD ON SUNDAYS 10AM–3PM

SA – 3 June 2012 Adelaide Convention Centre

VIC – 8 July 2012 Royal Exhibition Building

TAS – 15 July 2012

Hotel Grand Chancellor


21

OFFICIAL CONFERENCE SOCIAL PROGRAM

Wednesday 23 May 2012Welcome reception

Venue: The Sebel Hotel, CairnsTime: 6:30pm – 8:00pmDress: Smart casual

Thursday 24 May 2012Conference dinner

Venue: Cairns Convention CentreTime: 6:30pmDress: Frock up!

Hosted by


22

Thursday 24 May 11:00am – 12:15pm

STREAM 1

Establishing corporate and clinical

governance

STREAM 2

Navigating your way into corporate

governance structures at a health

service level

STREAM 3

Challenges/possibilities of being on

a clinical governance committee

Nurses sew up governance with

elective surgical waiting list

Patricia Humphreys MRCNA

Finding and recognising clinical

leaders at all levels

Dr David Stanley MRCNA

Autonomous professional or

token member? Nurses on clinical

governance committees

Dr Bernadette Eather

Developing the structure to support

clinical governance

Sandra Moss

The up-and-coming

Catherine Ryan

Prompting clinical governance

through the improvement of the

surgery community of practice

Sarah Lyons Liesel Straka

Spreading the expertise –

establishing a governance

framework for clinical resources in a

large, complex organisation

Sheryl Davis Catherine Turner MRCNA

India immersion experience:

Reflections on clinical governance at

the Holy Family Hansenorium

Associate Professor Marg McLeod FRCNA

Clinical governance in the

immigration detention environment

– the challenges and achievements

Sandy Eager Leanne Lancaster Lyn Baczocha

CONCURRENT SESSION 1


Thursday 24 May 2:05pm – 3:15pm

STREAM 1

Establishing corporate and clinical

governance

STREAM 2

Governance arrangements proposed

for current health reforms including

lead clinician groups, local hospital

networks, Medicare Locals

STREAM 3

Managing the challenges

Engagement in clinical governance in

a large metropolitan health service

Adjunct Professor Cheyne Chalmers FRCNA

Management of primary health care

networks

Professor Jeffrey Fuller FRCNA

From chaos to calm through a model

of clinical governance

Dr Bev Turnbull FRCNA

Promotion of clinical research

engagement using a clinical

governance framework

Professor Fiona Newall MRCNA Bernadette Twomey MRCNA Dr Sharon Kinney

Nurse practitioner collaborative

practice models – contributing to

health reform

Anne Davies MRCNA

Registered nurse perceptions of the

law and governance in relation to

clinical practice

Dr Pam Savage MRCNA

Framing the work: Implementing

an understandable framework for

quality systems in a diverse clinical

program

Karen Tuqiri

Key learnings from the

implementation of a clinical

governance framework

Dr Bernadette Eather

Patient safety, everyone’s

responsibility. But it helps to have a

clinical champion

Adjunct Associate Professor Christine Hanna MRCNA

Proudly sponsored by KPMG



23


Friday 25 May 10:55am – 12:30pm

STREAM 1

Establishing corporate and clinical governance

Workshop

Governance structure in an aged care environment

Walter De Ruyter Cherie Puckett MRCNA

Integrating clinical and corporate governance for

excellence in staff and patient outcomes

Professor Kim Walker Professor Jose Aguilera

Telehealth nursing and clinical governance

Cheryl Wallace MRCNA

Creating our future: Improving clinical and corporate

governance structures

Debra Cutler MRCNA

Foundations of care: Setting a framework for clinical

governance at an organisation level

Adjunct Professor Cheyne Chalmers FRCNA

1300 1 STAFF | www.staffaus.com.au | [email protected]

Bringing the Human back““to Human Resources

POSTER LISTING

Professional Nursing Governance in a large Australian health service

Adjunct Professor Cheyne Chalmers FRCNA, Southern Health

Paul Bennett, Southern Health and Deakin University

Jo Begbie, Southern Health



24

Health and Wellbeing in Ageing Faculty

Rural Nursing and Midwifery Faculty

Community and Primary Health Care Faculty

New Generation of Nurses Faculty

Movement Disorders and Parkinson’s Nurses Faculty

Disaster Health Faculty

freecall 1800 061 660 [email protected] www.rcna.org.auRCNA

Australia’s peak professional nursing organisation RCNA Australian member of ICN

Quality ISO 9001

JOIN ONE OF RCNA’S FACULTIES…


25

RCNA RURAL NURSING AND MIDWIFERY (RNM) FACULTY FORUM:AMPLIFYING THE VOICES OF RURAL NURSES AND MIDWIVES IN 2012 AND BEYOND

This forum aims to:

1. inform delegates of policy reform2. provide a forum for presentation of rural research 3. disseminate information from the RNM Faculty Advisory Committee (FAC) 4. elicit feedback on issues impacting on rural nurses and midwives5. provide a forum for discussion and debate.

8.30am – 9.00am Registration and coffee

9.00am – 9.10am Welcome:

Professor Karen Francis FRCNA, Chair RNM Faculty Advisory Committee, Head, School of Nursing, Midwifery and Indigenous Health, Charles Sturt University

9.10am – 10.30am Plans for rural nursing/midwifery workforce

Karen Cook FRCNA, Nursing Advisor, Health Workforce 2025, Health Workforce Australia

10.30am – 11.00am Morning tea

11.00am – 11.30am Facilitating entry to the nursing profession in remote areas: A partnership between James Cook University, Tropical North Qld TAFE and the Torres Strait community

Matt Mason MRCNA, Lecturer/Campus Co-ordinator, School of Nursing, Midwifery & Nutrition, James Cook University

Associate Professor Jane Mills FRCNA, School of Nursing, Midwifery & Nutrition, James Cook University

ABSTRACT: Remote health services face multiple barriers to recruiting and retaining culturally competent staff. James

Cook University (JCU) School of Nursing, Midwifery & Nutrition has a small campus on Thursday Island in the remote

Torres Strait which aims to produce a local nursing workforce. In 2012 a partnership arrangement between the local

aged care facility, Tropical North Queensland TAFE, and JCU has led to a new dual enrolment pathway for students into

both the Bachelor of Nursing Science, and TAFE’s Diploma of Endorsed Enrolled Nursing program based on reverse

articulation. Successfully completing a combination of subjects from these existing courses means that students have

the opportunity to graduate as an Endorsed Enrolled Nurse after four semesters of study, establishing a pipeline of

health graduates for the future and ensuring the wise use of scarce resources in this tropical outpost.

11.30am – 12.00pm Too close to home. What are the lived experiences of Queensland rural nurses who have cared for people who have died from cancer?

Ann Aitken FRCNA, Director of Nursing, Atherton Hospital

ABSTRACT: This paper will present the findings of phenomenological research exploring the lived experiences of

Queensland rural nurses who have cared for people who have died from cancer. The PhD thesis will be completed in

2012. The main themes identified from this research are learning different ways to relate to patients and families in

a rural context; bridging the difference between the nurse and the patient’s perceptions of care needs; and learning

from experience to develop coping strategies that reflect the context of rural nursing practice. The paper will

incorporate the research method and methodology, will present the themes and sub-themes, and will summarise the

recommendations from the research to effectively support nurses providing care for the dying in rural areas of practice.

12.00pm – 12.30pm Faculty Advisory Committee news

Panel: Professor Karen Francis FRCNA

Associate Professor Jane Mills FRCNA

Associate Professor Marg McLeod FRCNA, Deputy Head of School/Course Coordinator, Canberra Campus, Australian Catholic UniversityGlenis Beaumont MRCNA, Chief Executive Officer, Maryborough District Health Service


Saturday 26 May Faculty Forums – Cairns Convention Centre

FACULTY FORUMS


26

1.00pm – 2.00pm Facilitated discussion

Professor Desley Hegney FRCNA, Winthrop Professor of Nursing, The University of WA, Chair of Clinical Nursing Research, Centre for Nursing Research, Sir Charles Gairdner Hospital

Planning for the future

Promoting the voice of rural nurses and midwives

Understanding the issues then strategising an action plan

2.00pm – 2.30 pm Open discussion: Professor Karen Francis FRCNA

2.30pm – 3.00pm Afternoon tea and networking

RCNA MOVEMENT DISORDERS AND PARKINSON’S NURSES (MDPN) FACULTY FORUM:UNMASKING THE COMPLEX ILLNESSES THAT ARE MOVEMENT DISORDERS

This forum aims to unmask the complex illnesses that are movement disorders. These conditions that include Parkinson’s, Progressive Supra Nuclear Palsy, Essential Tremor, Tourettes and Dystonia, are often rare and present a challenge for nurses to understand them and provide care for. This interactive seminar will introduce you to the range of movement disorders, their underlying pathophysiology and how they impact upon the individual. Forum participants will also have the opportunity to learn more about current and emergent treatments and care in the community, aged care and hospital/clinic setting.


9.00am – 9.10am Welcome: Mary Jones MRCNA, Chair MDPN Faculty Advisory Committee, Movement Disorders & Parkinson’s Nurse Consultant

9.10am – 10.30am Parkinson’s

Mary Jones MRCNA and Victor McConvey MRCNA, Vice-chair MDPN Faculty Advisory Committee, Parkinson’s Nurse Consultant

Outline:


11.00am – 12.30am Appropriate treatments

Mary Jones MRCNA and Victor McConvey MRCNA

Outline:


1.00am – 2.00pm Movement disorders and health care settings

Mary Jones MRCNA and Victor McConvey MRCNA

Outline:

2.00pm – 2.30pm Open discussion


Forum sponsored by


What is Parkinson’s – the pathophysiology

Oral medications for Parkinson’s and their

management

Atypical Parkinson’s

Impact upon daily life

Other movement disorders;

Tourettes, Essential Tremor, Dystonia,

Patho physiology

Nursing roles – hospitals, aged care

facilities and community care

Using strategies and daily management of Parkinson’s

Emerging treatments for Parkinson’s

The use of deep brain stimulation surgery


27

Leading nursing expertise and care through access, learning and advocacyRCNA TCoN&

AUSTRALIAN COLLEGE OF NURSING

The future of nursing looks brightImportant unification update for all RCNA members TO TRANSFER YOUR MEMBERSHIP TO ACN YOU MUST COMPLETE AND RETURN YOUR

TRANSITION APPROVAL FORM WHICH YOU SHOULD HAVE RECEIVED IN THE MAIL.

FORMS SHOULD BE SENT TO RCNA BY 1 JULY 2012. YOU CAN ALSO DOWNLOAD A COPY

OF THE FORM AT www.rcna.org.au OR CALL US ON FREECALL 1800 061 660.

For a lower fee!RCNA MEMBERSHIP CATEGORY ACN MEMBERSHIP CATEGORY ACN ANNUAL FEE Honorary Fellow Honorary Fellow No feeDistinguished Life Fellow Distinguished Life Fellow No feeFellow Fellow $320 standard rateRetired Fellow Fellow $120 retiree rateMember Member $295 standard rateRetired Member Member $120 retiree rateCorporate Partner Member $200 affiliate rateGraduate Member Member $150 graduate rateDegree or Diploma Student Nurse Student Member $120*Associate Companion Associate Member $200

ACN membership – get all your RCNA benefits… Engagement in RCNA policy and representation activities

Networks and faculties connecting you regionally and professionally

Publications covering all areas of nursing life

Annual nursing events across the country

Discounts on services

Status and recognition

And more… Discounts off all courses offered through The

College of Nursing

Membership to the largest dedicated nursing library in the Southern Hemisphere

Professional events and education

* One off fee valid for a maximum of three years

* ACN joining fee for all current RCNA complimentary student members irrespective of graduation date



Quality ISO 9001


28

RCNA HEALTH AND WELLBEING IN AGEING (HWA) FACULTY FORUM: DELIVERING APPROPRIATE NURSING CARE IN A POLICY MINEFIELD

Nursing in aged care is embedded within several accountability frameworks that determine what and how clinical nursing is funded and monitored by external authorities. In this forum we will examine these frameworks and provide exemplars of what nurses in clinical practice and management can achieve despite policy and regulatory pressures on their time and attention. The forum will be both informative and interactive and provide an ideal opportunity for nurses considering moving to aged care as a career destination to understand this complex and challenging field of nursing, and a chance for those already familiar with aged care nursing to hear of recent advances and to express their own views on the future of this exciting field.


9.00am – 9.10am Welcome:

Professor Tracey McDonald AM FRCNA, Chair HWA Faculty Advisory Committee, RSL Life Care Chair of Ageing, Australian Catholic University

9.10am – 9.45am Policy frameworks and vested interests shaping aged care nursing options

Professor Tracey McDonald AM FRCNA, RSL LifeCare Chair of Ageing, Australian Catholic University

ABSTRACT: Nursing in the aged care environment is pivotal to sustained success of aged care businesses and the

standards of care that nurses design and deploy have implications for the general public, the public health system

and politicians in health and aged care portfolios. It beggars belief therefore that nursing in these arenas is poorly

understood, underestimated and under-resourced by those with the most to gain from promoting nursing excellence.

9.45am – 10.30am Friend at Flinders

Anne Davies MRCNA, Lecturer in Nursing, School of Nursing and Midwifery, Flinders University

ABSTRACT: This presentation will outline an innovative approach by The School of Nursing & Midwifery (SoNM) at

Flinders University to entrench practice development as part of a continuum of education across both the clinical and

academic arenas in health care provision. Practice development is an approach that aims to assist clinicians and health

care teams to look critically at their practice and identify ways in which it might be improved. It facilitates the systematic

review of structures and patterns within the workplace in order to better understand and identify the workplace culture

and its relationship to and impact on service provision. Flinders SoNM has established academic positions to work

jointly with the university and health care sites specialising in acute and aged care. This presentation will share the

journey so far in the aged care setting.


11.00am – 11.30m Private practice: an aged care nurse practitioner flying solo

Lynne Day MRCNA, nurse practitioner

ABSTRACT: ‘Hanging up a shingle’ is a novel concept for a nurse or nurse practitioner in Australia. Several are currently

trying their hand at setting up their own business as solo practitioners or in partnership. Come and learn about my

journey so far; an aged care nurse practitioner, flying solo.

11.30am – 12.00pm Persistent misconceptions about aged care nurses and nursing

Presenter: Kristene Rice MRCNA, General Manager Care Services, Anglican Retirement Villages

Author: Associate Professor Peter Brown FRCNA, Charles Darwin University

ABSTRACT: Aged care nursing is a specialised area of nursing practice that occurs in hospital units especially

established for assessment and care of older people. Aged care assessment teams provide services to older people

both in hospital and community settings. Dementia nursing and psychogeriatric nursing are newer specialties. Aged

care nurses also provide care to older people living in residential care and the community. There are a growing number

of nurses who work as nurse practitioners in aged care and related specialties. This presentation will identify and

discuss popular and persistent misconceptions about aged care nurses and nursing, why these attitudes exist and

describe some possible solutions. Content will apply across a range of clinical settings.

12.00pm – 12.30pm Managing the risks of clinical and corporate governance in aged care

Maryann Curry MRCNA, Vice-chair HWA Faculty Advisory Committee, Executive Manager, Care Services & Strategic Governance, The Salvation Army

ABSTRACT: This session discusses the tenuous balance between service delivery within the constraints of the existing

funding arrangements and the responsibility of clinicians to deliver appropriate care and clinical outcomes. Can we

predict and therefore pre-empt poor performance and know when the wheels are starting to fall off the train?



29


1.00pm – 2.00pm Registered nurse management of clinical issues in aged care

Deborah McKern MRCNA, Director, Aged care consulting and support

ABSTRACT: The clinical management of the ageing journey can be a critical factor in determining the quality of the end

of life experience and even the eventual outcome for some elderly people. Palliative care principles are the framework

for the decisions made but are they enough?

2.00pm – 2.30 pm Facilitated discussion and debate


RCNA NEW GENERATION OF NURSES (NGN) FACULTY FORUM: BUILDING THE FUTURE: VIEWS AND REFLECTIONS FROM THE NEW GENERATION OF NURSES

The NGN Faculty Forum promises to be a significant event for students, clinicians, managers and educators. The forum will provide:

1. reflections on the future of the profession from the perspective of new generation nurses2. education regarding appropriate engagement methods of the new generation of nurses3. information related to intergenerational differences and the importance of ensuring the profession provides a stimulating work

environment for young nurses4. thoughts regarding the retention of young nurses in the workplace.


9.00am – 9.10am Welcome: Jason Mills MRCNA, Vice-chair NGN Faculty Advisory Committee

9.10am – 9.40am From student to academia: A journey of personal and professional growth

Andrew Horne MRCNA, registered nurse, enrolled in MNurs (Research) – University of Wollongong

ABSTRACT: This presentation will discuss the personal and professional journey of a beginning nursing researcher.

A journey of the trials, tribulations and commendable achievements of the nursing research and academia realm.

9.45am – 10.15am The Honour’s year: generating evidence for nursing practice

Jason Mills MRCNA, Vice-chair NGN Faculty Advisory Committee

ABSTRACT: This presentation will focus on the Honour’s year and its relevance to nurses. It will be a case study of my

personal journey to undertake Honours and what this journey ultimately lead to; a positive and enriching educational

and clinical experience that has enhanced my nursing practice.

10.15am – 10.30am Facilitated discussion about the benefits of postgraduate studies

Andrew Horne MRCNA and Jason Mills MRCNA


11.00am – 11.30am A peer support program: A successful framework for training students and junior nurses

Jeffrey Faccenda MRCNA, registered nurse (graduate year)

ABSTRACT: This presentation will discuss the Peer Support Program and highlight how the framework may be used to

develop similar programs. Such a framework has been utilised in various hospitals around Australia to train the new

generation of nurses and ultimately, prepare them for a successful and rewarding career.

11.30am – 12.00pm A day in the life of a nursing student

Rachel Wilkins MRCNA, registered nurse (graduate year)

ABSTRACT: This presentation will guide the audience through the highlights and challenges faced by nursing students,

as they learn their way around this exciting and dynamic profession. Insight will be provided by a current student who

has worked not only within the Australian health care system, but also within the vastly different Tanzanian nursing

community.



30

12.00pm – 12.30pm Nursing: More than just ward work

Presenter: TBC

Author: Liz Hutchings MRCNA, Chair NGN Faculty Advisory Committee

ABSTRACT: Nurses are employed in a number of fields and operate within diverse environments. This presentation

will focus on the role of the nurse in the many diverse fields that this profession offers external to that of traditional

connotations of the ward work. Community, industry, private sector, education, advocacy and clinical trials are some of

the many fields in which nurses are represented. This diversity is part of the attraction of this profession.


1.00pm – 1.30pm Reflections on the future of the profession from the perspective of a Gen Y nurse

Elizabeth Matters MRCNA, registered nurse

ABSTRACT: This presentation will focus on intergenerational differences and the importance of keeping the profession

stimulating for young people. If we work in a positive and interesting environment this will lead to greater retention of

young nurses.

1.30pm – 2.30 pm Facilitated discussion and debate: You can’t call yourself a nurse unless you’re at the bedside

Panel: Jason Mills MRCNA, Jeffrey Faccenda MRCNA, Rachel Wilkins MRCNA, Andrew Horne MRCNA and

Elizabeth Matters MRCNA



31

Australian Medicines Handbook (AMH)

Australian Nursing and Midwifery Accreditation Council (ANMAC)

Crisis Support Services (CSS)

CRANAplus

Elsevier Australia

GradSchool, The University of Newcastle

Guild Insurance

Healthcare Australia

Independence Australia

James Cook University

Melbourne Convention + Visitors Bureau (MCVB)

MyCareer

Nursing and Allied Health Rural Locum Scheme (NAHRLS)

Nursing and Midwifery Board of Australia

Personally Controlled Electronic Health Record System (eHealth Record)

Remote Area Health Corps (RAHC)

Royal College of Nursing, Australia (RCNA)

The College of Nursing

TrendCare

EXHIBITORS

AMH contains independent, evidence-based, peer-reviewed medicines information in a

concise, practical format.

Australian Medicines Handbook is the evidence-based comparative medicines reference

preferred by thousands of clinicians

AMH is completely independent of the pharmaceutical industry. We accept no advertising,

sponsorship or any form of input or support from drug manufacturers.

EXHIBITOR PROFILES

The Australian Nursing and Midwifery Accreditation Council (ANMAC) is the independent

accrediting authority for nursing and midwifery under the National Registration and

Accreditation Scheme.

ANMAC sets the standards for accreditation for nursing and midwifery education programs

and accredits programs leading to registration and endorsement.

ANMAC is also an assessing authority for the Australian Department of Immigration and

Citizenship (DIAC). ANMAC conducts an assessment of the qualifications of registered

nurses and midwives who intend to migrate to Australia under the General Skilled Migration

category.

Crisis Support Services (CSS) is Australia’s leading professional telephone and online

counselling and training provider.

Operating 24 hours a day, seven days a week, CSS is fully accredited in counselling and

suicide prevention, with a 50 year history of helping people in crisis.

CSS manages several specialist services including MensLine Australia, Suicide Call Back

Service and SuicideLine (Victoria).

For more information, visit www.crisissupport.org.au


32

Independence Australia is a leading supplier of continence, wound care, and related health

care products. We offer competitive prices with a great range of over 12,000 product lines.

Our specials are guaranteed to add value and having a local presence in each state ensures

our customers experience prompt and efficient delivery.

Elsevier Australia is a dedicated publisher of textbooks for the Australian and New Zealand

market. Our offerings include not only books, but assessment solutions and an increasing

volume of electronic content.

Working with the most respected researchers, academics and professionals in Australia and

New Zealand, Elsevier Australia has set a high standard for quality.

The psychological support of those delivering health care to the remote and isolated regions

of Australia is one of the three focus areas of CRANAplus.

Funded by the Department of Health and Ageing, the Bush Support Services division provides

a toll free 1800 805 391 confidential support line to multi-disciplinary health workers and

their families working in remote or isolated regions of Australia. BSS also provides training

in the form of self care workshops. Our support line is staffed by psychologists with remote

experience.

GradSchool at the University of Newcastle has over ten years experience in the industry of

online postgraduate study. Therefore, you can be confident that we will match you with a

quality study option relevant to your immediate professional needs and one that will allow the

juggle between career, study and family to remain balanced, allowing you to stay in the place

you are needed most.

Guild Insurance is the largest insurer of Allied Health, Childcare and Not for Profit

professionals in Australia, providing professional indemnity, business, car and home

insurance to more than 90,000 clients.

With customer service staff in every state, Guild Insurance delivers personal service across

all of Australia.

For further information visit www.guildinsurance.com.au

Healthcare Australia is the leading health care recruitment solutions provider of nursing

staff, aged care workers and medical specialist placements in Australia with operations in

every state and territory.


33

The JCU School of Nursing, Midwifery and Nutrition has a growing reputation for attracting

top quality postgraduate and higher degree research students, both nationally and

internationally. If you’re interested in pursuing a postgraduate coursework or research

degree, come along to the JCU booth (19) to discuss your options and collect a free gift!

The Melbourne Convention + Visitors Bureau (MCVB) is a not-for-profit organisation that

markets Melbourne and Victoria nationally and internationally as a premier business events

destination.

MCVB works with associations and event planners to identify and bid for the right for

Melbourne to host meetings, incentive travel reward programs, conventions, exhibitions and

other business events from around the world.

The organisation, which was established four decades ago, is a partnership between the

Victorian State Government and private enterprise.

MyCareer offers a multi-platform employment advertising solution to reach a range of active

job seekers and potential passive candidates. Personalisation is expressed in everything

that we do, from our new brand and refreshed website through to our communication to

candidates and clients. This allows you to highlight your employment opportunities and reach

jobseekers whenever and wherever they are.

Get your locum requests in now for the new financial year! WE CAN HELP.

The Nursing and Allied Health Rural Locum Scheme (NAHRLS) is a government funded

programme to help relieve nursing and midwifery shortages while staff are away for training

and leave up to 14 days per placement. No fees or charges apply.

The Nursing and Midwifery Board of Australia works in partnership with the Australian Health

Practitioner Regulation Agency to deliver the National Registration and Accreditation Scheme

and keeps the public safe by ensuring that the Australian public has access to qualified and

competent nurses and midwives to provide quality nursing and midwifery care.


34

The Remote Area Health Corps (RAHC) recruits Australian registered, urban-based

registered nurses, RN/midwives and other health professionals to undertake short-term paid

placements in remote Indigenous communities in the Northern Territory as part of the effort

to close the gap in Indigenous health outcomes.

TrendCare is the leading workload management and workforce planning system in

Australasia, operating across 35,000 beds, winning national and international awards for

innovation, service delivery and training.

TrendCare provides; rostering, patient acuity, care planning and workload management

solutions.

TrendCare benefits; safe staffing, quality patient outcomes, organisational productivity and

efficiency gains.

The Personally Controlled Electronic Health Record System (eHealth Record) booth will

provide delegates information on the eHealth record and provide an opportunity for delegates

to make enquiries. The Personally controlled eHealth record has the potential to deliver

better care for patients and make the health system more efficient.

Over time, eHealth records will give you better access to patient information – patient

medications, test results and allergies or treatments – meaning better, safer and more

efficient care for patients.

Royal College of Nursing, Australia (RCNA) is the peak professional organisation for nursing,

whose primary interest is promoting excellence in nursing. RCNA members demonstrate a

commitment to nursing, professional development at all levels and a desire to keep in touch

with what is happening in nursing locally, nationally and internationally. Through the expertise

of its members, RCNA influences policy development on issues relating to nursing, health

care in general, welfare and nursing education, free from political allegiance.

The College of Nursing is a national peak professional membership body and the largest

provider of postgraduate nursing education in Australia. It is the country’s only educational

institution run for nurses by nurses. The College offers postgraduate certificates, single

subjects that can be counted towards postgraduate programs or degrees, continuing

professional development, and an assessment of competence program for nurses re-entering

the workforce and internationally qualified nurses. Through these education programs, the

College assists nurses to advance both personally and professionally, and represents them

at every stage of their careers, providing a modern, relevant approach and support for the

profession.

rahc.com.auGet involved.

Be part of the effortto improve Indigenous health

Are you a Registered Nurse or RN/Midwife? Have you thought about being part of the effort to close the gap in Indigenous health outcomes? Now is the time to get involved.

RAHC has opportunities for urban-based Registered Nurses and RN/Midwives to undertake short-term paid placements in remote Indigenous communities in the Northern Territory.

If you are keen to get involved and make a difference, visit our website now and register your interest. Once you have been credentialled our team can find remote paid-placements that work around you, your skills and your current job.


36

STREAM 1


Nurses Sew Up Governance with Elective Surgical Waiting

List

Patricia Humphreys MRCNA, Prince of Wales Hospital Randwick Jennie Barry, Prince of Wales Hospital Randwick Emma Malica, Prince of Wales Hospital Randwick

This presentation will describe how governance has led

to nurses playing a pivotal role in the management of the

elective surgery waiting list in an Australian metropolitan

tertiary referral hospital. Improved waiting list management

has been an evolving process since 2005.

An independent review suggested improvements

were required in the areas of; transparent processes,

accountability, equity of access for discreet patient

populations and robust reporting systems. In essence we

needed improved governance and as such an action plan

was developed. This led to the roles and responsibilities of

everyone involved with the waiting list being clearly delineated

and communicated. The profile of the Clinical Nurse Manager,

Admissions and Perioperative Services was raised and the

incumbent, with strong executive support, was empowered

to govern and oversee adherence to relevant policies.

Improved communication between the executive, nurse

managers and surgeons was established. Risk identification

and minimisation have increasingly become part of the core

business and this has lead to continuous improvement,

changes in the workforce configuration and a more strategic

approach to our waiting list management. Challenges

in compliance with policies and meeting mandated key

performance indicators and targets are addressed in a

positive and proactive manner and solutions and outcomes

are nurse driven.

Our nurse led governance has been facilitated by

organisational structure, culture and leadership and applying

nursing knowledge in a non-clinical area. Their influence will

be discussed as they are considered vital components to our

success.

We envisage our experience will encourage others to review

their work environment from a governance perspective.

Nurses should not be afraid to lead the way and “sew up

governance” in their organisation. Our methods and approach

to governance is transferable to other health care settings.

Developing the structure to support clinical governance

Sandra Moss, Princess Alexandra Hospital

The presentation will share outcomes achieved through

a nurse led project initiative to develop and implement a

governance framework, standardising Nurse Sensitive

Indicator (NSI) reporting to enhance public accountability and

quality improvement throughout the state.

A literature review was undertaken to examine strategic

alignment of NSI; data reporting processes; existing national

and international benchmarking practices.

A scoping survey was conducted in 191 healthcare facilities.

The online survey incorporated 40 questions under 6 areas

including reporting tools; NSI being captured; links to

organisational vision and strategy; governance framework

for reporting NSI; resources which support NSI reporting and

quality processes.

Collaborative brainstorming sessions were conducted with

key stakeholders to utilise information obtain and recommend

the NSI suite and reporting tool format.

A pilot evaluation of the developed NSI suite, NSI reports and

Information Module was conducted within 6 QH hospitals

utilising a paper based survey evaluation tool.

An 89% response rate obtained from the initial scoping

survey, literature review and collaborative workshops enable

recommendations for the development of an NSI suite and

standardised user friendly reports.

Efficiency to examine data sources resulted in the

development of an automated monthly facility level inpatient

reporting tool linking existing information systems and data

sources to create reports which enable benchmarking and

performance comparisons against state and peer groups.

Pilot evaluation results demonstrated significant statistical

improvements and supported state wide implementation.

A governance structure to support sustainability,

transparency and accountability was developed and state-

wide implementation completed.

The importance of developing a standardised NSI reporting

process has wide implications on patient safety, quality, policy

direction, cost efficiency, information equity, transparency,

reporting governance and accountability whilst enabling

Nursing and Midwifery contributions to be measured,

recognised and valued. The NSI reports will provide a state-

wide system of standardised nursing indicators to evaluate

the performance of QH facilities. The NSI reports will provide

evidence based to inform strategic direction for patient safety

and quality initiatives focused on the prevention of adverse

healthcare outcomes.


Thursday 24 May 11.00am – 12.15pm

ABSTRACTS (Abstracts of conference presentations are printed here as submitted to RCNA)


37


For more information contact RCNA Events:

An event of RCNA, Australia’s peak professional nursing organisationRCNA Australian member of ICN

Quality ISO 9001

RCNACommunity and Primary 17–19 October Health Care Nursing Conference Perth 12

SAVE THE DATE17–19 OCTOBER 2012THE VINES, SWAN VALLEY, PERTH

SHAPING AND INFLUENCING PRIMARY HEALTH CARE


38

CONCURRENT SESSION 1 continued

STREAM 1 continued

Spreading the expertise – establishing a governance

framework for clinical resources in a large, complex

organisation

Sheryl Davis, Hunter New England Local Health District Catherine Turner MRCNA (co-speaker), Hunter New England Local Health District

The challenge of developing a range of clinical resources for

a large Local Health District ensuring broad consultation,

application in all clinical settings with a rigorous governance

structure will be explored in this paper.

The Local Health District is based in regional NSW, employs

almost 15000 staff and provides services to approximately

840,000 people in an area which equates to the size of England.

Within specialised services, clinical resources had been

developed and implemented, but not always available to staff

working outside of those facilities. Smaller facilities had relied

on externally produced resources which may not have been

applicable in their context.

In addition to the organisational structure shown above, the

Local Health District has implemented Clinical Networks

that link acute hospital and community services across

metropolitan, regional and rural areas. Clinical procedures and

guidelines which are not the responsibility of specialist services

have been delegated to the Nursing and Midwifery Service.

Nursing and Midwifery have two working/policy groups

established with representatives from across the Local Health

District responsible for:

standardisation of clinical guidelines and procedures

wherever possible

ensuring clinical guidelines and procedures are evidence

based and support best practice

identifying gaps in available resources

establishing a governance structure for ongoing

development, review, approval and authorisation of

documents and resources

maintaining wide consultation with nurses and midwives,

senior nurse managers and other clinical managers,

networks and streams

working collaboratively across areas, networks

and streams, community health networks and the

multidisciplinary teams to improve patient outcomes

ensuring the clinical governance framework is followed for

clinical guidelines and/or procedures

Since the development of a framework and establishment of

a coordinator, significant progress has been made. A culture

of collaboration now exists and the organisation has a viable

system for the development, review and maintenance of clinical

guidelines and procedures, via a central point of contact.

The continued collaborative work by all stakeholders across

such a large geographical area has improved evidence based

standardisation of care and improved patient care outcomes

STREAM 2

Navigating your way into corporate governance structures at a health service level

Finding and recognising clinical leaders at all levels

Dr David Stanley MRCNA, University of Western Australia

Introduction / Background: Clinical leaders are recognised as

central to advancing and supporting a corporate and clinical

governance agenda. However, empirical studies that identify

who clinical leaders are and what their attributes might

be are few and far between. This presentation compares

the results of two studies (undertaken by the presenter),

in two different (western countries) Australia and the UK, 5

years apart, with different health professionals (nurses and

paramedics) and with different gender proportions.

Aims/objectives: Identify who the clinical leaders are and what

characteristics and attributes are associated with effective

clinical leaders.

Methods: A ground theory methodology was used in the initial

study (2001 – 2005) in the UK that used a questionnaire and 50

interviews to generate the data. In the follow up study (2010)

in Australia with paramedics the same methodology was

used, but only the questionnaire was repeated.

Results: Response rate to the questionnaire (2001 – 2005) =

22.6%, and in 2010 it was = 41.6%. In 2001 – 2005 (the nurses

group) the male female ratio of respondents was 5% male /

95% female, but in 2010 (with paramedics) the male female

ratio was 60% (male) and 40% (female). Characteristics

identified were remarkable similar in spite of the differences

in gender, professional groups, country and time. In both

groups clinical leaders were seen to be approachable,

clinically competent supportive, inspiring confidence, visible in

practice and definitely not in positions of control.

Discussion: Clinical leaders were not recognised if they

exercised control, but when they demonstrated the attributes

identified they could be seen at all levels and with remarkably

similar characteristics across both studies.

Summary: Clinical leaders can influence corporate and

clinical governance only once they and their attributes are

recognised and valued.


39

The Up-and-coming

Catherine Ryan, National Rural Health Students’ Network

This presentation aims to promote the engagement of

Nursing and Midwifery students in clinical governance

structures whilst on placement. This type of engagement

will lead to graduates who are better prepared to navigate

governance structures once they enter the workforce.

Nursing and Midwifery students must be considered part

of the healthcare team; hence students must understand

their role under the governance structure at their healthcare

facility. Students are a captive audience whilst on placement

and they can be actively engaged in reviewing roles and

responsibilities within governance models.

There are many definitions of clinical governance, but a

common thread in all definitions the motivation to provide

the highest level of healthcare. Nurses report they do not

feel valued by the system and as a result we are seeing a

fall in the nursing workforce. Our training places emphasis

on academic enquiry to develop autonomous Registered

Nurses and Midwives. As the future health workforce, Nursing

and Midwifery students need to be given an understanding

of clinical governance as a mode to improving healthcare

delivery, in turn making their work meaningful.

Further, leadership amongst students needs to be nurtured

as these students are the future leaders within the clinical

setting. Introducing students to the leadership structure

and roles at a healthcare facility can foster an upcoming

Registered Nurse or Midwife to consider leadership roles in

the workplace.

When discussing placement goals with your next student

of Nursing or Midwifery, encourage them to consider the

broader structure of governance under which they will work

in in the future.

India Immersion Experience: Reflections on Clinical

Governance at the Holy Family Hansenorium

Associate Professor Marg McLeod FRCNA, Australian Catholic University Margaret Boyes, Australian Catholic University

In January 2012, a group of health and education students

and academics from Australian Catholic University, Signadou

Campus, embarked on a three week India immersion

experience.

The main focus of the experience was to visit either

education or health care facilities in Tamil Nadu. The two

nurse academics, two nursing students and one social work

student were assigned a one week observational visit to the

Holy Family Hansenorium, near Tiruchirappalli. The aim of

this paper is to focus on the delivery of health care at the

Hansenorium and to reflect on the governance structure.

The Hansenorium was established in 1955 to care for

people with leprosy, or Hansen’s disease. The organisation

now provides quality care to people affected by leprosy,

tuberculosis and human immunodeficiency virus infection,

or acquired immune deficiency syndrome, irrespective of

their caste, creed or race. Governance of the facility rests

with the Mother of Sorrows Servants of Mary congregation.

The long serving administrator and project director of the

Hansenorium is both a religious sister and a medical doctor.

This remarkable woman is responsible for all aspects of

clinical, operational and financial management. Under her

firm direction the health care team offers a diverse range of

primary, community and hospital based services, a health

worker training school, children’s hostel, and an array of

support services that provide food, shelter and funds.

The Australian students and academics observed that the

governance structure of the Hansenorium was professionally

based: with the doctor at the centre of all decision making.

It was difficult to determine, because of language barriers,

if the nurses were prepared for and aspired to, greater

levels of professional autonomy and accountability. Still,

there was value in observing this extraordinary health care

environment, as it broadened our experiences and confirmed

our expectations of the Australian health care system.


40


STREAM 3

Challenges/possibilities of being on a clinical governance committee

Autonomous Professional or token member? Nurses on

Clinical Governance Committees

Dr Bernadette Eather, KPMG Professor Mary Chiarella FRCNA, University of Sydney

Aim: The image of the nurse as an autonomous professional

is important for their participation on Clinical Governance

Committees. It is apparent that nurses play a vital and

important role in Clinical Governance, but at times this role is

neither recognised nor understood by the healthcare system

and nurses themselves.

Method: This abstract highlights analysis undertaken for a

Doctor of Nursing. Chiarella (2002), in an analysis of legal

cases involving nurses, identified five disparate images:

the domestic worker; doctor’s handmaiden; subordinate

professional; ministering angel; and, autonomous

professional. The experience of nurses in the clinical setting

was analysed and compared to these images.

Results: It was evident that nurses were classified according

to these images by the organisation, doctors and nurses.

Although nurses espouse the autonomous professional

image as ideal, the actions and beliefs of the nurses were

not perceptibly evident in this image. Nurses overwhelmingly

expressed the belief that they were the patients’ advocates,

but on occasion their actions, saw them stand by and watch

patients come to harm. On one hand, nurses set themselves

apart from the doctors by stating they, nurses, are the

patient’s advocate. On the other hand, wish to be viewed as

autonomous professionals, an image which represents that

nurses share in the clinical decision making for patients,

and that their opinions are afforded equal weight to those

of doctors. If nurses are to be truly in equal partnership

with the doctors in clinical decision making for patients

and subsequently as participants on Clinical Governance

Committees, then this should mean a concomitant equal role

in advocating for patients.

Conclusion: If the experience of nurses is genuinely to be

viewed as that of the autonomous professional, one in which

the opinions of nurses are accorded equal weight to those

of doctors, then nurses ought to relinquish their bids for

autonomy in the role of the patients’ advocates and participate

as equal partners on Clinical Governance Committees.

Prompting Clinical Governance through the improvement of

the surgery Community of Practice

Sarah Lyons, Prince of Wales Hospital Liesel Straka (co-speaker), Prince of Wales Hospital

This paper describes changes made to the format and

facilitation of a Community of Practice over a 12 month period

which resulted in the re-engagement of surgical nurses

making it a more effective component of our organisation’s

shared governance framework. In 2007 Prince of Wales

Hospital implemented a framework of emanicipatory culture

in nursing which included Communities of Practice. A

Community of Practice (COP) is a group of people who share a

concern or passion for something they do and learn how to do

it better as they interact regularly (Wegner 1998). The concept

provides means of framing knowing, doing and learning

in practice, integration of doing, reflection on practice

and learning through reflective engagement to improve

performance and develop expertise.

Practice development principles underpinned an approach

that aimed to increase the involvement and attendance

of ward nurses and create a forum where clinical issues

and new procedures and policies could be discussed and

knowledge and ideas could be shared. Activities included a

baseline and follow up survey of the ward nurses awareness

and understanding of the purpose and value of a Community

of Practice. Nurses were also asked “What would make you

attend a COP?” which informed the format and content of the

Community of Practice as well offered the opportunities to

provide incentives.

A comparison of baseline and final surveys revealed an

increase in the awareness and understanding of the surgery

Community of Practice and its relevance and value to surgical

nurses and their everyday work.

The improvements made to the surgery Community of

Practice were assessed over a 12 month period and resulted

in the successful re-engagement and empowerment of

surgical nurses giving them a voice in the organisation. An

increased sense of belonging and an appreciation of the

Community of Practice as a forum to communicate clinical

issues and promote best practice were also observed.


41

RCNA GRANTS AND TRUSTS

RCNA GRANTS AND TRUSTS ARE AVAILABLE ANNUALLY TO MEMBERS AND FELLOWS OF RCNA

Annie M Sage Memorial Scholarship – $10 000

Postgraduate research studies in nursing at an Australian university.

Florence Nightingale Memorial Scholarship –

$10 000

Doctoral or postdoctoral studies in an Australian higher education institution.

Joyce Wickham Memorial Grant – $5000

Doctoral studies in nursing at an Australian university.

NSW Nurses Research Grant – $10 000

Postgraduate studies in (clinical) nursing at an Australian university, and only for nurses practicing in NSW.

RCNA Scholarship Grant – 2 x $5000

Postgraduate or honours studies at an Australian higher education institution.

RCNA Research Grant – $10 000

PhD, postdoctorate or research studies at an Australian university, hospital or health care facility affiliated with a university.

Bequest Fund for Research (VIC only) – $10 000

Postgraduate research studies in nursing at an Australian university and only for nurses practicing in Victoria.

Centaur Nurses Memorial Education Trust

(VIC only) – $5000 Postgraduate research studies in nursing at an Australian university and only for Division 1 and 3 nurses practicing in Victoria.

Margaret Y Winning Grant (QLD only) – $10 000

Postgraduate community nursing studies at Queensland University of Technology only.

Rural Nursing and Midwifery Faculty Grant –

$2000

Supported by RCNA’s Rural Nursing and Midwifery Faculty (RNMF), this grant is offered to members of the RNMF to undertake a continuing professional development or research activity.

Edie Smith Memorial Scholarship

Offered to members of the Rural Nursing and Midwifery Faculty to support an enrolled nurse from the faculty to attend the RCNA Community and Primary Health Care Nursing Conference.

For more information, visit www.rcna.org.au or email [email protected]

Applications close COB Friday 13 July 2012

RCNA Australianmember of ICN

Quality ISO 9001



42


STREAM 3 continued

Clinical Governance in the Immigration Detention

environment – the challenges and achievements

Sandy Eager, Centre for Education and Workforce Development, Sydney Local Health District Leanne Lancaster (co-speaker), IHMS Lyn Baczocha (co-speaker), IHMS

This paper reports on the clinical governance frameworks

that support the health service provisions for people in

immigration detention facilities around Australia. The

challenge of providing quality health care to detainees in

remote facilities, the relentless political scrutiny and the

day to day management of an often volatile environment will

be explored. In particular the role of senior nursing staff in

establishing and maintaining the clinical governance systems

within the detention health system will be discussed.

The Australian Government has a bi-partisan policy

of mandatory detention for people seeking asylum via

unexpected off shore arrival i.e. “boat people”. A network

of detention centres around mainland Australia and on

Christmas Island houses thousands of asylum seekers

awaiting both health and security processing plus detainees

whose claim for protection have been found to be without

merit. Service provision within the detention environment is

shared by the Commonwealth Department of Immigration

and Citizenship, the health services provider, International

Health and Medical Services, and the detention services

provider, Serco.

This sharing of governance arrangements between the three

major players presents unique challenges for the health

service provider. Clinical governance frameworks can be by

challenged by the quick relocation of detainees across the

detention network, increased boat arrivals and the public

health demands of a refugee type population.

Nurses play a crucial and pivotal role in immigration

detention health service delivery. Rigorous policy overhaul,

increased staffing levels and the introduction of senior

management roles onsite within the detention facilities have

all contributed to a service that is required to be open and

accountable to scrutiny by both audit and advisory groups.

This paper offers an insight into a unique clinical environment

with some unique clinical governance opportunities and

challenges.


Thursday 24 May 2.05pm – 3.15pm

STREAM 1


Engagement in Clinical governance in a large metropolitan

health service

Adjunct Professor Cheyne Chalmers FRCNA, Southern Health Kelly Rogerson MRCNA, Southern Health

Introduction: The ability to understand the workforce

perspective is advantageous when developing or

implementing strategies related to workforce governance

or redesign. To identify areas that we could focus within our

workforce, we sought feedback on key areas or drivers from

the perspective of our nurses and midwives.

The instrument and data analysis: The Nurse Engagement

Survey (NES) (Nursing Executive Center, 2008) includes 48

engagement-related workplace attributes, referred to as

engagement drivers. These items form the following eight

factor analysis-derived subscales: Autonomy and input, Nurse

staff teamwork, Non-nurse teamwork, Professional growth,

Recognition, Salary and benefits, Work environment, and

Passion for nursing. Nurses respond to all items using a six-

point scale ranging from Strongly Disagree to Strongly Agree,

with no neutral midpoint.

The survey also contains four key items that explored

satisfaction with and loyalty to the organisation. Nurses

respond to these items using the six point response scale

outlined above and these four items combine to produce

an engagement index. Based on this score, respondents

are classified into the following four categories: Engaged ,

Content, Ambivalent and Disengaged.

Respondents: The Nurse Engagement Survey was completed

by 2179 nurses across Southern Health. Respondents

represented a diverse mix in terms of personal and

organisational demographics, representing all levels of

nursing (i.e., clinical and non-clinical), from all clinical

specialties, across all sites.

This information can now be utilised as a baseline measure

for key initiatives within the organisation. The large number of

respondents to the survey provides a wealth or data to identify

challenges and successes within the nursing and midwifery

units.

Comparison data can also be utilised between units within

the organisation to identify areas of higher engagement and

lower engagement to focus efforts of improvement. This

information assist in supporting governance structures with

our organisation.


43

Promotion of Clinical Research Engagement Using a Clinical

Governance Framework

Professor Fiona Newall MRCNA, Royal Children’s Hospital Bernadette Twomey MRCNA (co-speaker), Royal Children’s Hospital Dr Sharon Kinney (co-speaker), Royal Children’s Hospital

The theoretical benefits of engaging in quality and research

activities are readily apparent; however, engagement of

clinical nurses in these pursuits remains challenging. We

propose that employing a clinical governance framework to

inform nursing research in the clinical setting enhances the

engagement of nurses in the generation and utilization of

evidence to improve the quality of care.

The Victorian Government Clinical Governance Framework

was adapted, employing the domains of Consumer

Participation, Clinical Outcomes, Patient Safety and

Effective Workforce. By establishing initiatives to support the

development of Effective Workforce, as it relates to research

engagement and evidence-based practice, staff participation

in activities aimed at improving the remaining 3 domains was

facilitated. The successful implementation of this strategy

was supported by numerous processes, including the

employment of academically prepared nurses, formation of a

committee of nurses supporting the integration of research

and clinical practice, strategies such as Journal Clubs,

Lunch & Learn sessions and Workshops, plus one-on-one

mentoring to clinical nursing staff. Integration of evidence

into practice was supported through the establishment of

a Clinical Effectiveness Committee, the membership of

which spanned all areas of nursing practice on campus.

This committee supports and facilitates the development of

evidence-based clinical guidelines related to nursing practice.

Since initiating this approach to research development,

involvement of nurses in research focused on organisational

priorities has increased, clinical guideline revision and

publication has improved and nurses’ access to professional

development opportunities has increased.

Embedding nursing research within a clinical governance

framework promotes nursing participation in research and

evidence-based practice by facilitating nurses to identify

and direct the focus of research activities based on clinical

priorities identified by nurses themselves.

Framing the work: Implementing an understandable

framework for quality systems in a diverse clinical program

Karen Tuqiri, Prince of Wales Hospital Jan Woods,Prince of Wales Hospital Danielle Murphy, Prince of Wales Hospital

This paper will discuss the development and implementation

of a clinical governance framework within a diverse clinical

program. The benefits this framework provided for patient

care delivery and engagement of clinical staff will be

highlighted and will incorporate the experiences of the

leaders during this journey.

The development of a framework that incorporated the quality

and patient safety agenda, risk management, accreditation,

research, clinical practice improvement projects, clinical

indicators, benchmarking and education and training of

staff was an integral step in the establishment of clinical

governance within a program that was responsible for

services across the continuum of care from intensive care

unit to the community setting. Engagement of key clinical

leaders with this framework was a critical step to ensuring its

implementation and sustainability.

Quality processes throughout the program were standardised

through the development of a uniform quality agenda

and terms of reference that were used for all program

departments allowing minor adjustments for the specialty.

Communication pathways between the hospital Executive,

Clinical program and Departmental level leaders were

established.

Simplifying multiple quality reporting requirements into a

single quality action summary at departmental and program

level was introduced to reduce duplication and confusion

amongst staff. A series of workshops were held with clinical

leaders on topics such as the management of complaints,

incidents and risk, clinical practice improvement methodology

and the key requirements for the Accreditation process. The

development and use of a program dashboard to monitor

key performance indicators, incident and complaint trending

reports and tracking spreadsheets to monitor the progress

of recommendations arising from complaints, and sentinel

events was an important component of the framework.

Successful implementation of this framework has led to

effective clinical governance that has facilitated engagement

of clinical leaders through providing a defined structure with

clearly defined responsibilities and improvements in clinical

quality.


44


STREAM 2

Governance arrangements proposed for current health reforms including lead clinician groups, local hospital networks, Medicare Locals

Management of primary health care networks

Professor Jeffrey Fuller FRCNA, School of Nursing & Midwifery, Flinders University

Introduction: Service networks, such as Medicare Locals

and Superclinics, are organizational forms proposed as

solutions to the problem of un-integrated health care.

Understanding service networks is a “wicked management

problem”, because of the difficulty in knowing what are the

boundaries of a network and in attributing impact to network

activity. The aim of the study was to advance theoretical and

methodological work that could assist managers to develop

and then maintain quality in health service networks.

Methods:

(1) Literature review on the use of network analysis in health

care management

(2) A traveling fellowship involving site visits with network

research experts in the USA and UK.

(3) Summary findings from two participatory research projects

examining man agement of service networks in primary

health care

Findings: Unlike single organizations with designated

authority and chains of command, networks rely on trust

and reciprocity. Stability is desirable for the development

of this trust, but networks are inherently unstable because

members’ intentions can never be assured. Hence, managers

need to regularly assess pay-off benefits to members by

building network legitimacy, resolving conflict, reaffirming

commitment and articulating accountability. Participatory

network evaluation is a powerful way to do this, but needs

careful facilitation to ensure constructive outcomes and the

wise use of boundary spanners. Some evidence indicates

that change is helped if members first focus on the intended

network products rather than get stuck on their value

differences.

Conclusion: Understanding how to bring change through

networks will benefit attempts to bring GPs together with

state community health services, which have historically

operated with different assumptions about health care and

team values.

Nurse Practitioner Collaborative Practice Models -

Contributing to Health Reform

Anne Davies MRCNA, Flinders University of South Australia Dr Clare Harvey MRCNA, Flinders University of South Australia Dr Penny Lynn, Flinders University of South Australia

This paper draws on data currently being collected for

a longitudinal study examining the role of the Nurse

Practitioner and its impact on health reform, with a focus on

access to care and equity of care.

We focus on one case study in which two separate health

services are contracting the services of one Nurse

Practitioner. As such, they have become initiators of new

models of care. We describe the collaborative arrangements

that have been established and identify the scope of practice

for the Nurse Practitioner. We also outline the hurdles created

by the limited access Nurse Practitioners have to Medicare

rebates that preclude Nurse Practitioners from becoming

viable partners in any business. In spite of the financial

drawbacks of private practice, we illustrate the impact that

the Nurse Practitioner practice is having not only on the

access to care, but also on the quality of that care within an

integrated service delivery model.


45

are you ready for the continuing professional development (CPD) requirements under national registration?

RCNA’s Life Long Learning Program, 3LP, has a new

look and easy navigation to assist you with developing your learning plan, accessing online learning activities, recording your CPD hours and much more.

Visit the 3LP website www.3lp.rcna.org.au or call 1800 233 705.

If you are not an RCNA member, please email us at [email protected] to set up a FREE TRIAL.


Australia’s peak professional nursing organisation RCNA Australian member of ICN

Quality ISO 9001


46


STREAM 2 continued

Key learnings from the implementation of a Clinical

Governance Framework

Dr Bernadette Eather, KPMG

AIM: This presentation seeks to inform nurses about key

components of a Clinical Governance Framework which can

be applied at a ward, unit or organisational level in order to

mitigate patient risk.

The work described is based on the presenters experience

as a nurse in the executive position of Director of Clinical

Governance of a large Area Health Service. The presentation

will address significant areas of risk and introduce outcomes

of actual incident investigation as opportunities for

improvement in the ward, unit or at organisational level.

Specifically, the presentation will focus on the importance of:

1. reporting: it will highlight incidents in which individuals

recognised problems and did not report them. It will

demonstrate how a culture of reporting in an organisation can

result in a mitigation of patient risk.

2. communication: it will describe issues in relation to

interdisciplinary communication, the understanding of

differing terminologies used to describe a patient’s condition,

clinical handover and patient transfer. It will analyse

incidents in which simple miscommunication contributed to

catastrophic patient outcomes. It will highlight the importance

of communication as a component part of any Clinical

Governance Framework.

3. human factors: it will provide an insight into common

human factors contributing to patient risk and specifically,

how clinicians make decisions based on their level of

experience. It will introduce the concept of false hypothesis

error and how a system needs to be designed to ensure

against it

4. leadership: it will describe how nurse leaders demonstrate

that they understand risk, take action to mitigate patient risk,

are proactive, report and make changes to transform the

workplace

It is anticipated that participants will understand the

importance of a Clinical Governance Framework for the

mitigation of patient risk and learn from actual incidents how

to improve their workplace.

STREAM 3

Managing the challenges

From chaos to calm through a model of clinical governance

Dr Bev Turnbull FRCNA, Charles Darwin University Kathleen Blair, Charles Darwin University

Good clinical governance in nursing programs is particularly

challenging when student numbers are predominantly

external. The processes seen retrospectively through a lens of

almost a decade illustrates that separation between politics

and the process oriented elements of governance is rarely

possible since one influences the other.

In 2005 the external numbers in our BNurs program grew

exponentially. Clinical placement was then managed by a

single administrator with nursing input. With few formal

structures in place, placement and monitoring of student

achievement clinically rapidly became chaotic. The clinical

needs of nursing students were poorly understood by senior

university administrators who failed to recognise placement

as a precious commodity with national ramifications.

Strategies over three years included the creation of a clinical

placement team for each state and territory, creation of and

establishment of a data base to record documentation of pre

clinical requirements for each jurisdiction, and establishment

of a suite of clinical protocols to monitor not only the

placement but also student progress according to learning

outcomes.

A particular challenge has been the move to restrict

placement within state boundaries. To compete in the market

place of increasing competition for clinical placement, a

position of clinical director was created. Key objectives of

the position have been to improve linkages interstate, to

explore new placement opportunities, and to improve the

quality of placement through clear documentation of clinical

expectations and scope of practice. Piloting of better protocols

for placement issues and clearer lines of communication

have resulted in documentation to address many of the

governance challenges of placement such as conscientious

objection to vaccination, changing state and territory pre

clinical requirements, impaired progress and appeals against

grades. The myriad requirements and challenges of clinical

governance are ongoing and everchanging. Creation of a

system of clinical governance that is appropriately resourced

is an essential element to reducing chaos to relative calm.


47

Registered Nurse Perceptions of the law and governance in

relation to clinical practice

Dr Pam Savage MRCNA, CQUniversity

A grounded theory research was carried out in Central

Queensland to explore registered nurse perceptions about

legal consequences in clinical practice. A number of themes

were identified in this study. These can give direction to

establishing corporate and clinical governance structures.

A key finding was participants were clear and unambiguous

about their fears and their sense of powerlessness should

they be involved in an adverse event or called on to defend a

clinical outcome. Bryant (1999) points out there is a strong

nexus between regulation of nursing and the individual

responsibility of the nurse but the perimeters of the bailiwick

of the registration boards, the role of employers and the

extent of the responsibility of the nurse are not at all clear.

This disconnection between the regulation processes,

institutional and professional management of adverse events

came to be a core finding in this research.

These participants’ reported many examples of environmental

factors that contributed to violations of practice that would

place the clinician in legal jeopardy and leave them vulnerable

to discipline. The uncertainty a nurse experiences when

involved in an incident as to whether an employer will

elect to deal with the matter locally or initiate a full blown

investigation and a formal report to the regulating authority

was another source of anxiety. There was no doubt that these

nurses believed the “culture of blame” existed and that they

were powerless to defend against it.

Related to this finding were the effects on nurses who had

experienced the consequences of investigation, hearings

and discipline and the way these clinicians responded to

those reports. The negativity and lack of trust in governance

structures clinicians in this study demonstrated not only

affected their practice but their commitment to their

profession.

Patient Safety, Everyone’s Responsibility. But it Helps to

Have a Clinical Champion

Adjunct Associate Professor Christine Hanna MRCNA, St John of God Subiaco Hospital

Patient safety within St John of God Subiaco Hospital

(SJOGSH) is everyone’s responsibility. This philosophy is

aligned with the Hospital’s Mission and Values, included

in the SJOGSH Risk Management Framework and this

message is communicated with all nurses when they join

our team. However, our results in the areas of patient falls

and medication errors, two key Nursing Sensitive Indicators

(NSI’s), indicated that this ‘shared responsibility approach’

needed review.

In June 2010, the role of Clinical Nurse Consultant (CNC),

Patient Safety was introduced. This senior nursing position

was tasked with coordinating, promoting and evaluating

clinical practice in conjunction with the multidisciplinary team

in order to improve patient safety, with a key focus on falls

prevention and medication practice.

The inaugural incumbent proved ideal for this role as they

embraced the objectives of the position, working with teams

to bring about change. This change was evident through

both the promotion of a reporting culture and improved NSI

results.

Some program initiatives include:

Pre Admission Clinic referral to the CNC, Patient Safety of

patients assessed as high risk of falling for follow up when

the patient is admitted.

Revision of policies, resources and learning packages

associated with falls prevention and medication practice

with innovative communication methods to share the

message.

Focused benchmarking within WA and interstate to build

networks, share resources and trial programs.

Promotion of a ‘clinical profile’ to increase nursing

awareness of falls prevention/ medication practice.

Examples of results achieved:

46% increase in the number of patients reviewed between

July 2010 and December 2011.

38% increase in medication incidents reported due to the

promotion of a reporting culture. (July 2010 – June 2011)

Subsequent 72% decrease in medication incidents

reported (July 2011 to Dec 2011) as role/strategies are

embedded.

33% reduction in patient falls reported from July to

December 2011.

The introduction of the Champion has reinforced that patient

safety is everyone’s responsibility.


48


Friday 2 May 10.55am – 12.30pm

STREAM 1


Governance Structure in an Aged Care Environment

Walter De Ruyter, UnitingCare Ageing – South Eastern Region Cherie Puckett MRCNA (co-speaker), UnitingCare Ageing – South Eastern Region

This aged care service in the South East Region NSW is a

composite of residential and community services with a

strong association with local presbyteries and an evolving

corporate management structure. The result is seen in

organizational practice that reflects this history. In recognizing

this history the Care Governance Unit was developed to build

on the strengths of each service whilst aligning practice and

service provision across the South East Region of NSW.

A key role of the Care Governance Unit:

I) To transition the capture of practice vested in key individuals

and systematize this knowledge within a corporate

framework whilst mitigating risk. Specific target areas are,

a) Clinical, i-Care,

b) Aged Care Funding Instrument (ACFI) and

c) Operations.

The objective is to achieve consistency through this

governance approach. The outcome allows for the early

identification of gaps, and a translation of process between

corporate strategic concepts and operational practice. This

limits the ‘dilution’ of the concept into practice.

II) Resident care is a dynamic process supporting the resident

/ client journey. South East Region Care Governance plays

a critical role in;

a) The alignment of management practices,

b) The identification of opportunities to improve practice

and

c) The Management of adverse outcomes and risk.

The objective is to achieve a seamless environment of care for

Aged Care Residents and Clients.

Care Governance supports the capture of operational practice

in systems that ensure care practices reflect aged care

industry benchmarks. This allows for comparative analysis

and the setting of industry KPI’s to drive Uniting Care Aging

SER to best practice.

By systemizing technical aspects of the business frees

up managers to focus on the implementation of Practice

Development, adding further value to the business. The

outcome is to demonstrate a social benefit to clients

whilst reflecting the values of the organisation to the wider

community.

Telehealth Nursing and Clinical Governance

Cheryl Wallace MRCNA, National Health Call Centre Network

Nursing engagement in National telehealth clinical

governance is essential to reflect a nursing perspective and

to provide patient centred nursing care within an evolving

healthcare setting.

Background: Across Australia, Registered Nurses provide

24 hour a day, seven days a week assessment via telephone

triage, including health education resources and provider

referrals. The registered nurses ensure Australians are

advised on the appropriate care they need for their particular

health issue when they need it and where they need it.

Clinical Governance is embedded into the nurse telehealth

service by Registered Nurses who bring their nursing

knowledge and skills to the interdisciplinary governance

process.

Telehealth nursing challenges traditional care delivery

models. For example, telehealth nurses do not have visual

triggers and need to develop telephone empathy to quickly

establish a therapeutic relationship with the patient. The

nurses primarily work from home with a telephony system

and evidence based guidelines that support the nursing care

provided.

The Afterhours GP Helpline (AGPH) and the Medicare Locals,

link closely with nurse teletriage. As such, Governance

structures will need to be responsive to the changing health

environment.

Aim:The aim of this paper is to provide an overview of the

nurse triage service and the nursing contribution to the

telehealth Clinical Governance.

Information and Data to be presented:

Nurse triage Call volumes, demographics and call types

Nurse Triage Call outcomes/dispositions

Caller satisfaction and feedback

The Clinical Governance Domains and Framework

Conclusion: This paper will provide an overview of the

nurse triage telehealth service and the clinical governance

structures within this evolving healthcare arena.

The Australian community has responded positively to

telehealth with an average 75,000 calls per month.

Sound clinical governance and leadership is essential to

ensure best practice is delivered to sustain the quality

domains of access and equity, safety, clinical appropriateness

and effectiveness for all Australians.


49

ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH SCHOLARSHIPS

PUGGY HUNTER MEMORIAL SCHOLARSHIP SCHEME

[email protected] www.rcna.org.auRCNA


Quality ISO 9001

Puggy Hunter Memorial Scholarship Scheme (PHMSS) is funded by the Australian Government.

RCNA, Australia’s peak professional nursing organisation, is proud to partner the Australian Government

as the fund administrator for this program.

who is currently studying or wanting to study an

undergraduate course in a health related field at TAFE or university

who needs financial assistance for study costs.

You may be eligible for an Indigenous health

scholarship worth up to $15 000 per year for full time study.

Apply online at www.rcna.org.au | freecall 1800 688 628

ARE YOU AN ABORIGINAL OR TORRES STRAIT ISLANDER PERSON?

Aged Care Nursing Scholarships (ACNS) arefunded by the Australian Government.

RCNA, Australia’s peak professional nursing organisation, is proud to partner the Department of Health and Ageing

as the fund administrator for this program.

AGED CARE NURSING SCHOLARSHIPS ARE AVAILABLE FOR:

Nursing and Allied Health Scholarship and Support Scheme(NAHSSS) is funded by the Australian Government.

RCNA, Australia’s peak professional nursing organisation, is proud to partner the Australian Government as the

fund administrator for this program.

NURSING & MIDWIFERY SCHOLARSHIPS

IS IT TIME TO BEGIN OR GROW YOUR NURSING CAREER?Nursing and midwifery scholarships are available in the following areas:

PREREGISTRATION NURSING

POSTGRADUATE

NURSE REENTRY

CLINICAL PLACEMENT

CONTINUING PROFESSIONAL

DEVELOPMENT

PREREGISTRATION MIDWIFERY

MIDWIFERY CREDENTIALING



AGED CARE NURSING SCHOLARSHIPS

UNDERGRADUATE

POSTGRADUATE

NURSE PRACTITIONER

CONTINUING PROFESSIONAL

DEVELOPMENT

NURSE REENTRY


50


STREAM 1 continued

Creating Our Future: Improving clinical and corporate

governance structures

Debra Cutler MRCNA, The Prince Charles Hospital

Healthcare organisations have many stakeholders,

challenging priorities and performance targets. Nursing

staff have a pivotal contribution to make to the development

and delivery of health care services. It is essential to work

together to ensure we develop and deliver patient centred

services and adopt an approach which enables continuous

improvements in the quality of services. I believe that effective

clinical governance is inextricably linked to good corporate

governance and in order to ensure that clinical governance

is effective and meaningful to staff, it must be evident at the

point of patient contact e.g. the bedside.

Our organisation did not have a collective vision for nursing

to inform service expansion. The clinical programs worked

separately and hospital-wide nursing services were

fragmented. We assessed the situation and analysed the

causes using: SWOT/PEST/Delphi surveys; reviewed staff

opinion survey/exit interviews and held focus groups.

This identified the need to strengthen governance and

accountability. Our strategy for change included the

development of our shared values, a comprehensive review

of the existing nursing governance, development and annual

evaluation of our Nursing Services Strategy (NSS) and local

Program implementation plans and expansion of the website.

This has resulted in the following improvements:

Articulation and adoption of our shared values (leading,

learning, caring and sharing)

A shared vision with common objectives which are aligned

to local, district and state strategic direction

Strengthened professional self-regulation, accountability

and sharing of good practice

Improved organisational structure with clear lines of

accountability

Devolved and responsive culture, designed to empower

and motivate staff

Increased staff engagement, collaboration and

communication

Improved patient outcomes

Encouraging, supporting and empowering staff to contribute

and influence the strategy ensured their ownership of the

process. We are currently consulting on establishing a

shared governance council structure to further support

the achievement of the NSS objectives and enhance staff

engagement.

Foundations of Care: Setting a framework for Clinical

Governance at an organisation level

Adjunct Professor Cheyne Chalmers FRCNA, Southern Health Kelly Rogerson MRCNA, Southern Health

The Nursing and Midwifery Strategic Directions Plan 2010–

2013 states its ultimate aim as ‘Our community is healthier’.

To achieve these outcomes, it has been identified that the

nursing and midwifery workforce needs to work to an agreed

and aligned set of principles from which an appropriate model

of care can be enacted.

After undertaking a literature review and identifying key

nursing related indicators we utilised the Francis Report.

This inquiring into care provided by the Mid-Staffordshire NHS

Foundation Trust found considerable deficits in the quality of

care provided by health professionals and has been utilised

across Southern Health’s Nursing and Midwifery workforce

to promote discussion, reflection and debate regarding the

quality of care provided within this organization.

Importantly, on review of the available documentation, it

was determined that the appropriate nomenclature for this

work should be ‘Foundations of Care’ as ‘Principles of Care’

had the potential to be confused with the Australian Nursing

and Midwifery Council’s (ANMC) Competency Standards for

Nurses and Midwives. The Foundations of Care are proposed

as complementary to the ANMC documents.

The development of the Nursing and Midwifery Foundations of

Care aligns with the organizational goal of safe and effective

person-centred care. In addition the foundations align with

the Nursing and Midwifery Strategic Directions Plan 2010–

2013, specifically the long-term outcomes of best practice and

best care.

The recommended foundations are designed to provide a

‘back to basics’ platform for the activities undertaken by

nurses and midwives within Southern Health. They have been

developed via extensive consultation with internal staff and

literature review. The resultant themes have been mapped

to the organization’s articulated values (iCARE: integrity,

compassion, accountability, respect, excellence).

The Foundations of Care provide an opportunity for our

Nursing and midwifery leadership team to clearly articulate

the key nursing and midwifery responsibilities across the

organisation. In their current form, they represent ten areas

of nursing and midwifery care that have been central to the

profession over many decades. Together with the ANMC

competency standards, it is anticipated that the foundations

will provide an anchor point for the development and

implementation of appropriate Models of Care. In this way it

is anticipated that the foundations will be the driver for model

of care change across the organisation, setting expectations

of care and accountability for prioritising care to the patient/

client/consumer.


51

Conclusion: The foundations of care provide a back to basics

focus for nurses and midwives within Southern Health.

It is anticipated that their adoption will further place the

patient/client/consumer centrally in the delivery of care.

Additionally, they provide a way forward for the development

and implementation of models of care and a platform to

implement practice change at ward/unit service level. The

foundations of care are anticipated to set minimum standards

and clear expectations for nursing and midwifery practice

at Southern Health, thereby enhancing care delivery and

contributing to our vision of ‘Better Health in Our Community’.

Workshop

Integrating clinical and corporate governance for excellence

in staff and patient outcomes

Professor Kim Walker, St Vincent’s Private Hospital Professor Jose Aguilera (co-speaker), St Vincent’s Private Hospital

Purpose of the workshop:

To present a case study of two internationally recognised

governance frameworks – the Balanced Scorecard and

Magnet Recognition Program® – and enlist workshop

participants in discussion and debate about their merits,

implementation issues and contribution to corporate and

clinical governance.

Brief Description of pertinent research/summary of new data

and other relevant facts and solutions

30 years of international peer-reviewed research evidence

makes an all but irrefutable case for the Balanced Scorecard

and Magnet Recognition Program® as exemplars of good

corporate/clinical governance structures. This workshop will

present a summary of this research as a prelude to the case

study which will illuminate the structures and processes,

systems and outcomes the Balanced Scorecard and Magnet

Recognition Program enable. Indeed it will speak cogently

to the idea of ‘integrated governance’ and the efficacy and

efficiencies arising from such a form of governance.

Conclusion: Our workshop will facilitate robust dialogue

and debate between the presenters and participants as the

core components of the Balanced Scorecard and Magnet

Recognition Program are outlined and elaborated on; we

believe the workshop content is highly topical and timely given

the increasing focus on excellence in nursing care to ensure

quality and safety for patient outcomes. In this respect we

anticipate the workshop will be of high-level interest to many

of the conference attendees.


52

NOTES


53

NOTES

ONLINE ABSTRACT SUBMISSION NOW OPEN FOR THE 2013 ICN CONGRESS

The International Council of Nurses 25th Quadrennial Congress – the largest

international nurses event is coming to Australia in May 2013.

ICN 25th Quadrennial Congress:

18–23

CALL FOR ABSTRACTS NOW OPEN

Equity and Access to Health Care

RCNA Australianmember of ICN

18–23

16 APRIL 2012 – Online submission of

abstracts opens

14 SEPTEMBER 2012 – Online abstract

submission closes (midnight CET)

14 SEPTEMBER 2012 – Registration opens

1 DECEMBER 2012 – Notification of abstract

acceptance

11 JANUARY 2013 – Registration deadline for

abstract presenters

14 FEBRUARY 2013 – Early bird registration

closes (midnight CET).IRE NOW!

For further information about the

congress or to submit an abstract

please visit www.icn2013.ch

rcna national conference 2012 program and book of abstracts

Documents