RCNA National Conference 2012 program and book of abstracts

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RCNA

National 23–26 May Conference Cairns

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Cairns Convention Centre

CORPORATE AND CLINICAL GOVERNANCE

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PROGRAM AND BOOK OF ABSTRACTS

RCNA

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

Quality ISO 9001


Personally Controlled Electronic Health Records

Connecting Australian healthcare A 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.

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PROGRAM AND BOOK OF ABSTRACTS

CONTENTS Welcome from the President, Royal College of Nursing, Australia

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Overview/Aims and objectives

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General information

4

Patricia Chomley Memorial Oration

6

Prizes and awards

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Opening address

8

Keynote speakers

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Plenary speakers and workshop presenter

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Facilitators

10

Conference Steering Committee

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National Conference Abstract Review Committee

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Events team

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Sponsors

12

Conference program

18

OfďŹ cial conference social program

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Concurrent sessions

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Poster listing

23

Faculty forums

25

Exhibitors

31

Exhibitor proďŹ les

31

Abstracts

36

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PROGRAM AND BOOK OF ABSTRACTS

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

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RCNA National Conference 23–26 May 2012

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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PROGRAM AND BOOK OF ABSTRACTS

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 points

5&1$ҋV /LIH /RQJ /HDUQLQJ 3URJUDP

Call 1800 061 660 to enquire about RCNA membership and 3LP

EFFECTIVE ADVOCACY CAN INFLUENCE THE HEALTH REFORM AGENDA 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.

WE WANT YOUR INVOLVEMENT!

visit www.rcna.org.au

RCNA Australian member of ICN

Quality ISO 9001

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RCNA National Conference 23–26 May 2012

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.

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.

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RCNA National Conference 23–26 May 2012

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.

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 hospitalbased 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.

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PROGRAM AND BOOK OF ABSTRACTS

PLENARY SPEAKERS 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.

WORKSHOP PRESENTER 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.

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RCNA National Conference 23–26 May 2012

CONFERENCE FACILITATOR

Adjunct Associate Professor Debra Cerasa FRCNA FCN GAICD Chief Executive Officer, RCNA

FACILITATORS

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Adjunct Associate Professor Stephanie Fox-Young FRCNA FCN

Julie Shepherd FRCNA RCNA Board Member

Christine Smith FRCNA RCNA Board Member

Gayle Heckenberg FRCNA RCNA Board Member

Gay Lavery FRCNA RCNA Board Member

Paula Elliott FRCNA RCNA Board Member

Maryanne Craker MRCNA RCNA Board Member

Maryann Curry MRCNA The College of Nursing Board Member


PROGRAM AND BOOK OF ABSTRACTS

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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RCNA National Conference 23–26 May 2012

SPONSORS PRINCIPAL SPONSOR

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BRONZE SPONSOR The Nursing & Allied Health Rural Locum Scheme (NAHRLS) is an Australian Government funded programme and has been established to address some of the challenges and barriers that rural and remote health professionals face when trying to take leave. The NAHRLS supports rural and remote nurses, midwives and eligible allied health professionals to take leave by providing their employers with access to locums to back-fill positions. Key NAHRLS facts:

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RCNA National Conference 23–26 May 2012

SATCHEL SPONSOR JCU’s School of Nursing, Midwifery & Nutrition is committed to providing educational programs that are responsive to the current and projected workforce needs of North Queensland and beyond – we offer excellence in teaching and research in a unique tropical setting. Our aim is to produce graduates who can make a lasting contribution to the intellectual, cultural, social, health, environmental and economic fabric of the region. The School is a designated World Health Organization Collaborating Centre for Nursing and Midwifery Education and Research Capacity Building in the Western Pacific Region – an accolade that reflects the established and world-renowned research profile of the School.

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RCNA National Conference 23–26 May 2012

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FACULTY FORUM SPONSOR Movement Disorders and Parkinson’s Nurses Faculty (MDPNF) Abbott is a global, broad-based health care company devoted to the discovery, development, manufacture and marketing of pharmaceuticals and medical products, including nutritionals, devices and diagnostics. The company employs approximately 91,000 people and markets its products in more than 130 countries.

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Foundations of Directorship As a new director, senior executive or manager in a NFP, government, private or public company, you will benefit from a practical, director oriented introduction to your duties and responsibilities. This includes board meetings

Building strong corporate governance

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June dates New South Wales 6 June

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Victoria 5 June

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6 June

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7 June

Strategy and Risk for Directors

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RCNA National Conference 23–26 May 2012

PROGRAM 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 reception

Hosted by

RECOGNITION AT A GLANCE RCNA Nurse ID cards $4.00ea

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RCNA MEMBER

RM

REGISTERED MIDWIFE

ENDORSED ENROLLED NURSE

EEN

REGISTERED MIDWIFE

ENDORSED ENROLLED NURSE

EEN RM

RCNA MEMBER

RN NP EN

ENROLLED NURSE

RCNA MEMBER

NURSE PRACTITIONER

RCNA MEMBER

REGISTERED NURSE

RN NP EN

RCNA MEMBER

ENROLLED NURSE

REGISTERED NURSE

NURSE PRACTITIONER

Discounts available for bulk orders Available at www.rcna.org.au freecall 1800 061 660


PROGRAM AND BOOK OF ABSTRACTS

Thursday 24 May

Cairns Convention Centre

8.00am

Registration opens

Pick me up sponsor

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

Hosted by

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 – 3.15pm

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

Optional educational workshop (max 30 participants)

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

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RCNA National Conference 23–26 May 2012

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

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

Optional educational workshop (max 30 participants)

10.55am – 12.30pm

Concurrent session 3

12.30pm – 1.30pm

Hosted lunch: Proudly sponsored by MyCareer Using 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

2.00pm – 2.45pm

Plenary presentation: Dr Heather Gluyas FRCNA Health care failures: What can we learn to improve clinical and corporate governance?

2.45pm – 3.30pm

Plenary presentation: 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

2012 RCNA NURSING & HEALTH EXPOS HELD ON SUNDAYS 10AM–3PM Gold coin donation welcomed, proceeds go to charity

+ SA – 3 June 2012 n Centre Adelaide Conventio VIC – 8 July 2012 ilding Royal Exhibition Bu TAS – 15 July 2012 cellor Hotel Grand Chan

www.rcna.org.au RCNA Australian member of ICN

20

Quality ISO 9001


PROGRAM AND BOOK OF ABSTRACTS

OFFICIAL CONFERENCE SOCIAL PROGRAM Hosted by

Wednesday 23 May 2012 Welcome reception Venue: The Sebel Hotel, Cairns Time: 6:30pm – 8:00pm Dress: Smart casual

Thursday 24 May 2012 Conference dinner Venue: Cairns Convention Centre Time: 6:30pm Dress: Frock up!

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21


RCNA National Conference 23–26 May 2012

CONCURRENT SESSION 1 Thursday 24 May

11:00am – 12:15pm

STREAM 1

STREAM 2

STREAM 3

Establishing corporate and clinical governance

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

Challenges/possibilities of being on a clinical governance committee

Nurses sew up governance with elective surgical waiting list

Finding and recognising clinical leaders at all levels

Patricia Humphreys MRCNA

Dr David Stanley MRCNA

Autonomous professional or token member? Nurses on clinical governance committees

Proudly sponsored by KPMG

Dr Bernadette Eather Developing the structure to support clinical governance

The up-and-coming Catherine Ryan

Sandra Moss

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

Clinical governance in the immigration detention environment – the challenges and achievements

Associate Professor Marg McLeod FRCNA

Sandy Eager Leanne Lancaster Lyn Baczocha

CONCURRENT SESSION 2 Thursday 24 May

2:05pm – 3:15pm

STREAM 1

STREAM 2

STREAM 3

Establishing corporate and clinical governance

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

Managing the challenges

Engagement in clinical governance in a large metropolitan health service

Management of primary health care networks

From chaos to calm through a model of clinical governance

Adjunct Professor Cheyne Chalmers FRCNA

Professor Jeffrey Fuller FRCNA

Dr Bev Turnbull FRCNA

Promotion of clinical research engagement using a clinical governance framework

Nurse practitioner collaborative practice models – contributing to health reform

Registered nurse perceptions of the law and governance in relation to clinical practice

Professor Fiona Newall MRCNA Bernadette Twomey MRCNA Dr Sharon Kinney

Anne Davies MRCNA

Dr Pam Savage MRCNA

Framing the work: Implementing an understandable framework for quality systems in a diverse clinical program

Key learnings from the implementation of a clinical governance framework

Patient safety, everyone’s responsibility. But it helps to have a clinical champion

Dr Bernadette Eather

Adjunct Associate Professor Christine Hanna MRCNA

Proudly sponsored by KPMG

Karen Tuqiri

22


PROGRAM AND BOOK OF ABSTRACTS

CONCURRENT SESSION 3 Friday 25 May

10:55am – 12:30pm Workshop

STREAM 1

Establishing corporate and clinical governance Proudly sponsored by KPMG

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

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

the Human back “Bringing to Human Resources “ 1300 1 STAFF | www.staffaus.com.au | sfoley@staffaus.com.au

23


RCNA National Conference 23–26 May 2012

JOIN ONE OF RCNA’S FACULTIES… Disaster Health Faculty

Movement Disorders and Parkinson’s Nurses Faculty

New Generation of Nurses Faculty

Health and Wellbeing in Ageing Faculty

Rural Nursing and Midwifery Faculty

Community and Primary Health Care Faculty

RCNA

freecall 1800 061 660 canberra@rcna.org.au www.rcna.org.au

Australia’s peak professional nursing organisation

24

RCNA Australian member of ICN

Quality ISO 9001


PROGRAM AND BOOK OF ABSTRACTS

FACULTY FORUMS Saturday 26 May

Faculty Forums – Cairns Convention Centre

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 reform 2. 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 midwives 5. 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 University Glenis Beaumont MRCNA, Chief Executive Officer, Maryborough District Health Service

12.30pm – 1.00pm

Lunch

25


RCNA National Conference 23–26 May 2012

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

Saturday 26 May

Faculty Forums – Cairns Convention Centre

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.

Forum sponsored by

8.30am – 9.00am

Registration and coffee

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:

What is Parkinson’s – the pathophysiology Oral medications for Parkinson’s and their management

10.30am – 11.00am

Morning tea

11.00am – 12.30am

Appropriate treatments

Atypical Parkinson’s Impact upon daily life

Mary Jones MRCNA and Victor McConvey MRCNA Outline:

Using strategies and daily management of Parkinson’s Emerging treatments for Parkinson’s The use of deep brain stimulation surgery

12.30pm – 1.00pm

Lunch

1.00am – 2.00pm

Movement disorders and health care settings Mary Jones MRCNA and Victor McConvey MRCNA Outline:

26

Other movement disorders; Tourettes, Essential Tremor, Dystonia, Patho physiology

2.00pm – 2.30pm

Open discussion

2.30pm – 3.00pm

Afternoon tea and networking

Nursing roles – hospitals, aged care facilities and community care


PROGRAM AND BOOK OF ABSTRACTS

AUSTRALIAN COLLEGE OF NURSING RCNA & TCoN

Leading nursing expertise and care through access, learning and advocacy

The future of nursing looks bright Important 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.

ACN membership – get all your RCNA benefits…

And more…

` Engagement in RCNA policy and representation activities

` Discounts off all courses offered through The College of Nursing

` Networks and faculties connecting you regionally and professionally ` Publications covering all areas of nursing life ` Annual nursing events across the country

` Membership to the largest dedicated nursing library in the Southern Hemisphere ` Professional events and education

` Discounts on services ` Status and recognition

For a lower fee! RCNA MEMBERSHIP CATEGORY Honorary Fellow Distinguished Life Fellow Fellow Retired Fellow Member Retired Member Corporate Partner Graduate Member Degree or Diploma Student Nurse Associate Companion

ACN MEMBERSHIP CATEGORY Honorary Fellow Distinguished Life Fellow Fellow Fellow Member Member Member Member Student Member Associate Member

ACN ANNUAL FEE No fee No fee $320 standard rate $120 retiree rate $295 standard rate $120 retiree rate $200 affiliate rate $150 graduate rate $120* $200

* One off fee valid for a maximum of three years * ACN joining fee for all current RCNA complimentary student members irrespective of graduation date

RCNA

freecall 1800 061 660 canberra@rcna.org.au www.rcna.org.au RCNA Australian member of ICN

Quality ISO 9001

27


RCNA National Conference 23–26 May 2012

Saturday 26 May

Faculty Forums – Cairns Convention Centre

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. 8.30am – 9.00am

Registration and coffee

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.

10.30am – 11.00am

Morning tea

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?

28


PROGRAM AND BOOK OF ABSTRACTS

12.30pm – 1.00pm

Lunch

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

2.30pm – 3.00pm

Afternoon tea and networking

Saturday 26 May

Faculty Forums – Cairns Convention Centre

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 nurses 2. education regarding appropriate engagement methods of the new generation of nurses 3. information related to intergenerational differences and the importance of ensuring the profession provides a stimulating work environment for young nurses 4. thoughts regarding the retention of young nurses in the workplace. 8.30am – 9.00am

Registration and coffee

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

10.30am – 11.00am

Morning tea

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.

29


RCNA National Conference 23–26 May 2012

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 ďŹ elds and operate within diverse environments. This presentation will focus on the role of the nurse in the many diverse ďŹ elds 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 ďŹ elds in which nurses are represented. This diversity is part of the attraction of this profession.

12.30pm – 1.00pm

Lunch

1.00pm – 1.30pm

Reections 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

2.30pm – 3.00pm

Afternoon tea and networking

'.$1740' EGhEI 70' FNEF

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14 /14' +0(14/#6+10 #0& 61 4')+56'4 (14 6*' %10('4'0%' 2.'#5' 8+5+6U 999T&#0#%10('4'0%'T%1/T#7

30


PROGRAM AND BOOK OF ABSTRACTS

EXHIBITORS Australian Medicines Handbook (AMH)

Melbourne Convention + Visitors Bureau (MCVB)

Australian Nursing and Midwifery Accreditation Council (ANMAC)

MyCareer

Crisis Support Services (CSS)

Nursing and Allied Health Rural Locum Scheme (NAHRLS) Nursing and Midwifery Board of Australia

CRANAplus Elsevier Australia

Personally Controlled Electronic Health Record System (eHealth Record)

GradSchool, The University of Newcastle

Remote Area Health Corps (RAHC)

Guild Insurance

Royal College of Nursing, Australia (RCNA)

Healthcare Australia

The College of Nursing

Independence Australia

TrendCare

James Cook University

EXHIBITOR PROFILES 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.

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 qualiďŹ cations 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

31


RCNA National Conference 23–26 May 2012

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.

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.

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.

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.

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PROGRAM AND BOOK OF ABSTRACTS

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.

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RCNA National Conference 23–26 May 2012

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.

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.

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.

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.

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Be part of the effort to 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.

Get involved.

rahc.com.au


RCNA National Conference 23–26 May 2012

ABSTRACTS (Abstracts of conference presentations are printed here as submitted to RCNA) CONCURRENT SESSION 1 Thursday 24 May 11.00am – 12.15pm STREAM 1

Developing the structure to support clinical governance

Establishing corporate and clinical governance

Sandra Moss, Princess Alexandra Hospital

Nurses Sew Up Governance with Elective Surgical Waiting List

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.

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.

36

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 statewide 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 statewide 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.


PROGRAM AND BOOK OF ABSTRACTS

RCNA

Community and Primary 17–19 October Health Care Nursing Conference Perth

12

SHAPING AND INFLUENCING PRIMARY HEALTH CARE

`

SAVE THE DATE 17–19 OCTOBER 2012 THE VINES, SWAN VALLEY, PERTH

For more information contact RCNA Events:

RCNA

freecall 1800 061 660 events@rcna.org.au www.rcna.org.au

An event of RCNA, Australia’s peak professional nursing organisation

RCNA Australian member of ICN

Quality ISO 9001

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RCNA National Conference 23–26 May 2012

` 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

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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.


PROGRAM AND BOOK OF ABSTRACTS

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.

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RCNA National Conference 23–26 May 2012

` CONCURRENT SESSION 1 continued

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.

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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.


PROGRAM AND BOOK OF ABSTRACTS

RCNA GRANTS AND TRUSTS RCNA GRANTS AND TRUSTS ARE AVAILABLE ANNUALLY TO MEMBERS AND FELLOWS OF RCNA 9BE+

4CC?<64G<BAF 4E8 BK BC8A ` Annie M Sage Memorial Scholarship – $10 000

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

Postgraduate research studies in nursing at an Australian university.

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

` Florence Nightingale Memorial Scholarship –

$10 000 Doctoral or postdoctoral studies in an Australian higher education institution.

` Centaur Nurses Memorial Education Trust

` Joyce Wickham Memorial Grant – $5000

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

Doctoral studies in nursing at an Australian university.

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

` NSW Nurses Research Grant – $10 000

Postgraduate community nursing studies at Queensland University of Technology only.

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

` Rural Nursing and Midwifery Faculty Grant –

Postgraduate or honours studies at an Australian higher education institution.

$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.

` RCNA Research Grant – $10 000

` Edie Smith Memorial Scholarship

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

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.

` RCNA Scholarship Grant – 2 x $5000

For more information, visit www.rcna.org.au or email grants-awards@rcna.org.au Applications close COB Friday 13 July 2012

RCNA

freecall 1800 061 660 canberra@rcna.org.au www.rcna.org.au

RCNA Australian member of ICN

Quality ISO 9001

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RCNA National Conference 23–26 May 2012

` CONCURRENT SESSION 1 continued ` STREAM 3 continued

CONCURRENT SESSION 2 Thursday 24 May 2.05pm – 3.15pm

Clinical Governance in the Immigration Detention environment – the challenges and achievements

STREAM 1

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.

Establishing corporate and clinical governance 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 sixpoint 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.

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PROGRAM AND BOOK OF ABSTRACTS

Promotion of Clinical Research Engagement Using a Clinical Governance Framework

Framing the work: Implementing an understandable framework for quality systems in a diverse clinical program

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

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

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.

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RCNA National Conference 23–26 May 2012

` CONCURRENT SESSION 2 continued

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.

44

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.


PROGRAM AND BOOK OF ABSTRACTS

5&1$Ň‹V /LIH /RQJ /HDUQLQJ 3URJUDP

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

)RU PRUH LQIRUPDWLRQ 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 3LP@rcna.org.au to set up a FREE TRIAL.

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.

RCNA

freecall 1800 061 660 canberra@rcna.org.au www.rcna.org.au

Australia’s peak professional nursing organisation

RCNA Australian member of ICN

Quality ISO 9001

45


RCNA National Conference 23–26 May 2012

` CONCURRENT SESSION 2 continued ` STREAM 2 continued

STREAM 3

Key learnings from the implementation of a Clinical Governance Framework

From chaos to calm through a model of clinical governance

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.

46

Managing the challenges 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.


PROGRAM AND BOOK OF ABSTRACTS

Registered Nurse Perceptions of the law and governance in relation to clinical practice

Patient Safety, Everyone’s Responsibility. But it Helps to Have a Clinical Champion

Dr Pam Savage MRCNA, CQUniversity

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

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 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.

47


RCNA National Conference 23–26 May 2012

CONCURRENT SESSION 3 Friday 2 May 10.55am – 12.30pm

Telehealth Nursing and Clinical Governance

STREAM 1

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.

Establishing corporate and clinical governance 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.

48

Cheryl Wallace MRCNA, National Health Call Centre Network

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.


PROGRAM AND BOOK OF ABSTRACTS

RAIT ISLANDE ABORIGINAL AND TORRES ST

R HEALTH SCHOLARSHIPS

SCHOLARS PUGGY HUNTER MEMORIAL

HIP SCHEME

ARE YOU AN ABORIGINAL OR TORRES STRAIT ISLANDER PERSON? ` 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

2SHQV -XO\ &ORVHV 6HSWH PEHU 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.

S R A L O H C S G IN S R U N E R A C D AGE

HIPS

AGED CARE NURSING SCHOLARSHIPS ARE AVAILABLE FOR: ` UNDERGRADUATE ` POSTGRADUATE ` NURSE PRACTITIONER

` CONTINUING PROFESSIONAL DEVELOPMENT

` NURSE REENTRY

2SHQV -XO\ &ORVHV $XJXVW Aged Care Nursing Scholarships (ACNS) are funded by the Australian Government.

Apply online at www.rcna.org.au | freecall 1800 116 696

RCNA, Australia’s peak professional nursing organisation, is proud to partner the Department of Health and Ageing as the fund administrator for this program.

OLARSHIP NURSING & MIDWIFERY SCH

S

IS IT TIME TO BEGIN OR GROW YOUR NURSING CAREER? Nursing and midwifery scholarships are available in the following areas: ` PREREGISTRATION NURSING ` POSTGRADUATE ` NURSE REENTRY ` CLINICAL PLACEMENT

` CONTINUING PROFESSIONAL DEVELOPMENT

` PREREGISTRATION MIDWIFERY ` MIDWIFERY CREDENTIALING

Apply online at www.rcna.org.au | freecall 1800 117 262

RCNA

2SHQV -XO\ &ORVHV 6HSWH PEHU 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.

scholarships@rcna.org.au www.rcna.org.au RCNA Australian member of ICN

Quality ISO 9001

49


RCNA National Conference 23–26 May 2012

` CONCURRENT SESSION 3 continued ` STREAM 1 continued

Foundations of Care: Setting a framework for Clinical Governance at an organisation level

Creating Our Future: Improving clinical and corporate governance structures

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

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.

50

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.


PROGRAM AND BOOK OF ABSTRACTS

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.

51


RCNA National Conference 23–26 May 2012

NOTES

52


PROGRAM AND BOOK OF ABSTRACTS

NOTES

53


CALL FOR ABSTRACTS NOW OPEN

18–23

Equity and Access to Health Care

18–23 ONLINE ABSTRACT SUBMISSION

NGRESS

CO NOW OPEN FOR THE 2013 ICN

– the largest rses 25th Quadrennial Congress The International Council of Nu ing to Australia in May 2013. international nurses event is com

ICN 25th Quadrennial Congress: tion deadline for ` 11 JANUARY 2013 – Registra submission of

` 16 APRIL 2012 – Online abstracts opens

abstract ` 14 SEPTEMBER 2012 – Online t CET) submission closes (midnigh tration opens ` 14 SEPTEMBER 2012 – Regis ation of abstract ` 1 DECEMBER 2012 – Notific acceptance

abstract presenters

d registration

bir ` 14 FEBRUARY 2013 – Early W! NO IRE ses (midnight CET). clo

out the For further information ab stract congress or to submit an ab .ch please visit www.icn2013

RCNA Australian member of ICN


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