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Community Health Nurse PROMOTING NURSING IN THE COMMUNITY

CORONA CONTROL | ICHN AWARDS | CERVICAL CHECK PLAN CHILDREN FIRST GUIDELINES | NATIONAL CHILDCARE SCHEME NATIONAL MATERNITY EXPERIENCE SURVEY | HEALTH & WELLBEING

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HEALTH NEWS

Contents ICHN Yearbook 2020 is published by Ashville Media Group on behalf of the Institute of Community Health Nursing. Ashville Media Group Unit 55, Park West Road, Park West Industrial Estate, Dublin 12, D12 X9F9 Tel: (01) 432 2200 Email: info@ashvillemediagroup.com

Material printed in this journal is not necessarily endorsed by the Irish Community Health Nurses or by Ashville Media Group. All rights reserved. Reproductioná by any means in whole or in part without permission of the publisher is prohibited. ©2019

Design: Áine Duffy Production Executive: Claire Kiernan Creative Director: Jane Matthews Sales Director: Diarmaid Lennon Managing Director: Gerry Tynan Photography & Illustrations: iStockphoto.com

ICHN TRAINING & EDUCATION

CERVICAL CHECK

DEATH GUIDANCE

EFFECTIVE COMMUNICATION

ICHN AWARDS

CHILDREN’S FIRST GUIDELINES

NATIONAL CHILDCARE SCHEME

NEWS AND UPDATES

OPEN DISCLOSURE

34 36

NATIONAL MATERNITY EXPERIENCE SURVEY

WELLBEING

COMMUNITY HEALTH NURSE 2020

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FOREWARD

Final address

am very pleased to have been asked to provide the foreword to the 2020 yearbook of the Institute of Community Health Nursing (ICHN). As the ICHN ceased operating as a professional body in December 2019, it is worthwhile to look back at its original foundation, its successes and look forward to a future without the ICHN. The Institute of Community Health Nursing was established in 1985 to promote community nursing services through continuing education, development and research. From 1980 to 1984, the Public Health Nursing course run by An Bord Altranais was held in Gort Muire Conference Centre in Ballinteer, County Dublin. It was during this time that Rev Fr TP Burke, who was resident in the Centre, became acquainted with the Public Health Nursing course. A lecturer in physics in UCD at the time, he was asked by the course leader Ms Ann Flynn to assist with the development and upgrading of the course. A submission with proposals for the course to be placed in a third level setting was prepared and submitted to the CEO of An Bord Altranais Mr Noel Daly, together with a draft syllabus and recommendations. The course was admitted to UCD in September 1987. Rev Burke was then introduced to Ms Eithne Mattimoe, Superintendent Public Health Nurse Eastern Health Board. Following discussion and agreement with the Eastern Branch of the Superintendent PHN Association, Ms Mattimoe invited Fr Burke to meet in March 1984. During a ‘think tank’ weekend in All Hallows College, Drumcondra in 1984 the association agreed that an Institute of Community Nursing should be established to cater for all members of the public health nursing service. The officers of the association worked with Fr Burke to bring this idea to fruition. National meetings of superintendents and Public Health Nurses were organised in each Health Board region to inform all PHNs of the proposed structure with its aim and objectives. Rules and constitutions were written and business procedures were put in place to establish the Institute. Funded by the existing Superintendents Association, the ICHN was incorporated in September 1985. The inauguration ceremony took place in UCD and was launched by the then Minister for Health Mr Barry Desmond. The ﬁrst ICHN President was Ms Mona Sharkey (deceased), and Ms Eithne Mattimoe became the ﬁrst Hon. Secretary. Over the past 34 years the ICHN has had the privilege of working with a number of Honorary Presidents; Ms Eithne Mattimoe, Ms Mary McDermott, Ms Catherine Curry, Ms Nora Cummins, Ms Regina Buckley, Ms Breda Cleary (deceased), Ms Kathleen Cusack, Ms Catriona Duignan, Ms Anne Corridan and Ms Johanna Downey. The Executive Council worked very hard behind the scenes to provide

education through conferences, the ICHN website, strategic plans and forming committees and interest groups. Since its establishment, the ICHN’s vibrancy clearly showed its influence by preparing PHNs and community nurses for the policy changes that have been occurring in social care and primary care. Acting as a unifying and stimulating professional body, the ICHN set out to promote active participation from its members in community and nursing affairs, while fostering their professionalism in the quality of service they provide. As well as supporting its members, the ICHN acted as a consultative body to the Department of Health, the HSE and the Department of Children and Youth Affairs when requested. The ICHN had nomination rights for the Seanad and has always been politically aware, lobbying for healthcare development. Over the last 35 years, the core function of the ICHN was its role in supporting nurses to maintain their professional knowledge working in modern and dynamic healthcare organisations which empower community health nurses by providing a voice through leadership and advocacy for many more years to come. The timely publication of First 5: A Whole-of-Government Strategy for Babies, Young Children and their Families (November 2018) is a signiﬁcant development for Irish children and families and for Irish society as a whole. It contains a substantial body of recommendations in relation to child health and wellbeing. This is an important opportunity to ensure that the current body of policies are implemented in an integrated and joined up way. In particular, the opportunity for synergy and shared wins between Sláintecare and First 5 is signiﬁcant. Strengthening preventative and early intervention supports in pregnancy and early childhood will deliver positive and lifelong outcomes for children and families. It will also result in a reduction of the incidence of a range of health difficulties throughout the life course, reducing longterm dependency on the health service. Developments such as Sláintecare, the Nurture Programme, the Women’s and Infant Health Programme, and Healthy Ireland will support community nurses in delivering a quality, evidence based nursing service. The coming period will see great changes as we embrace the advancing needs of community nurses working in primary care and our communities. I would like to acknowledge the key role that nurses and midwives play in meeting health care needs in the community for individuals, families and communities. I would like to thank community nursing and midwifery for their contribution to health services and I look forward to collaborative working as we progress with the implementation of Sláintecare. Finally, I would like to thank all ICHN members for their support during the last 35 years. You should all be proud of the legacy the ICHN leaves behind.

COMMUNITY HEALTH NURSE 2020

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HEALTH NEWS

COVID-19 Infection Control N E W S A N D U P DAT E S

egular and thorough hand-washing is of vital importance in order to reduce Coronavirus transmissions. This must be done directly before every episode of direct patient care, but also after handling laundry or waste, equipment decontamination, the removal of Personal Protective Equipment (PPE) or any other activity that can potentially contaminate hands. The World Health Organization (WHO) recommends that the minimum alcohol concentration in alcohol-based hand rubs should be 60%. An effective hand rub of this nature should have between 60% and 80% alcohol according to the European Norm 1500 or the American Society for Testing and Materials (ASTM). The correct procedure in putting on and taking off PPE can be difficult to adhere to, especially THE CORRECT PROCEDURE IN PUTTING if you are tired after a long day or when you feel ON AND TAKING OFF PPE CAN rushed or stressed. The correct order for BE DIFFICULT TO ADHERE putting on PPE is as follows: Hand hygiene TO, ESPECIALLY IF YOU ARE with alcohol hand rub - Gown ﬁrst (tied TIRED AFTER A LONG DAY OR behind or to the side to minimise risk of WHEN YOU FEEL RUSHED OR STRESSED. contamination) - Mask – tied to the top of the head for easy removal - Goggles – place over the straps of the mask - Gloves. The correct procedure in removing PPE is: 1 Remove glove 2 Hand hygiene with alcohol rub 3 Remove gown from behind using the straps 4 Lift off goggles from the sides 5 Remove mask using the straps at the back of the head 6 Hand hygiene with alcohol rub. Psychologists use the term automaticity to describe the ability to do something without thinking. The more an action is practised the more automatic it becomes – examples include walking and driving. While this frees up our attentional resource,s there is also a dangerous aspect, as it can make us prone to mistakes. In the current environment, this could lead to very serious consequences. Having a co-worker present to check you are following PPE protocol correctly can be very constructive. If you do make a mistake taking off PPE, it is important to remember that as long as you keep your hands away from your face and perform hand hygiene immediately after you take off the PPE, you can avoid most of the risk involved in any mistake you have made.

THE HSE ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL TEAM HAS DEVELOPED FIVE VIDEOS TO DEMONSTRATE PUTTING ON AND TAKING OFF PPE DEPENDING ON CIRCUMSTANCES, BUT HAND HYGIENE IS FIRST IN ALL CASES. THE INSTRUCTIONAL VIDEOS CAN BE VIEWED ON WWW.HSE.IE AND WWW.HPSC.IE

COMMUNITY HEALTH NURSE 2020

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HEALTH NEWS

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COMMERICAL PROFILE

Post Pregnancy Wipe Out Any new mums can relate to feeling constantly tired, or even wiped out. After all, your body is recuperating from the incredible physical challenge of pregnancy and childbirth. At the same time your caring for a newborn that needs feeding, nappy changes, and hands-on attention around the clock so what sleep you do get is likely to be less restorative because it’s so fragmented.

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MAGGIE EVANS R.M, HV CERT., CERT. ED, MSC HAS 30 YEARS OF EXPERIENCE AS A PRACTICING MIDWIFE IN VARIOUS CARE SETTINGS AND MORE RECENTLY AS A MIDWIFERY LECTURER AT SHEFFIELD UNIVERSITY FOR 10 YEARS.

here could also be other reasons for fatigue post birth, so consult your doctor if you are struggling with feeling constantly tired. Low iron levels are a common cause which can add to fatigue as many women experience lower iron levels during pregnancy and child birth can further reduce iron levels. In this case a natural iron supplement may be beneﬁcial, such as Spatone® Apple. Midwife, Maggie Evans, comments; “Pregnant women are particularly vulnerable to low iron levels due to the increased demand of iron for the optimum growth and development of the baby. In the last six weeks of pregnancy the baby builds up its own storage of iron from its mother to last for the ﬁrst 4-6 months following birth. Therefore iron demands can triple by the end of pregnancy, this is often difficult to achieve from dietary sources alone, so help top up your iron levels with a natural iron supplement such as Spatone Apple.” Top tips to tackle tiredness for new mums Rest: easier said than done, but rest when you can. Try sleeping when your baby sleeps in the day and go to bed as early as possible once you have put your baby to sleep. Drink: plenty of fluids, try to make healthy food choices, and don’t skip meals. Now is not the time to crash diet. Food is your fuel. Walk: try taking your baby out for a walk every day. Exercise can give you a boost of energy, and the fresh air and movement may help you both sleep better at night. Spatone Apple* combines the unique natural liquid iron supplement Spatone with added Vitamin C. One sachet of Spatone Apple provides your recommended daily amount (RDA) of absorbed iron and Vitamin C. Vitamin C is well recognised to increase iron absorption, contributing to a healthy immune and nervous system whilst also supporting our energy metabolism, reducing tiredness and fatigue. Spatone Apple contains Spatone® spa water sourced from the Welsh mountains of Snowdonia National Park - which can help top up your iron levels whilst causing fewer of the unpleasant side effects often experienced with conventional iron supplements. Generally, iron is a very difficult mineral for the body to absorb. However, the iron naturally present in Spatone has been shown to be easily absorbed, with up to 40% bioavailabilityii, compared to 5- 20% from food and other iron supplements. The additional Vitamin C in Spatone Apple helps you to absorb iron, that’s why each sachet of Spatone Apple includes added vitamin C. Notes: It is important to follow a varied and balanced diet and healthy lifestyle. Food supplements should not be used as a substitute. i, ii Worwood, ‘Iron absorption from a natural mineral water (Spatone Iron +)’, Clinical and Laboratory Haematology, 1996

HEALTH NURSE 2020

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OPEN DISCLOSURE

Covid Procedures:

Open Disclosure GUIDELINES FOR STAFF AND SERVICES ON MANAGING OPEN DISCLOSURE AND THE COMMUNICATION CHALLENGES ARISING DURING COVID-19.

he Coronavirus pandemic has presented multiple new challenges to nurses and healthcare workers in recent months. Communicating clearly with Covid-19 patients and their families is among such challenges. Barriers to this include a requirement for staff to wear Personal Protective Equipment (PPE) while also practising physical distancing, resulting in a patient not always knowing who they are conversing with or understanding the full meaning of what is being discussed. Open Disclosure is a core professional requirement which is anchored in professional ethics. The HSE Open Disclosure Policy is ‘To ensure that the rights of all patients to be communicated with in an open, honest, timely, compassionate and empathic manner are met when things go wrong, for whatever reason, during their healthcare journey and that this communication process is managed in a manner that is dignified and respectful’. Maintaining the principles of this policy during Covid-19 has been particularly difficult. There are ten principles to the Open Disclosure Process: Acknowledgement; Truthfulness, timeliness and clarity of communication; Apology/expression of regret; Recognising patient and carer expectations; Staff support; Risk management and systems improvement; Multidisciplinary responsibility; Clinical governance; Confidentiality; and Continuity of care. During a pandemic, face-to-face open disclosure meetings can only be facilitated when it is deemed safe to do so away from Covid-19 wards and with the correct level of PPE equipment. The Infection Prevention and Control

Department can make sure staff and patients are fully protected. A risk assessment must also be undertaken to ensure attendees are not in a vulnerable group. Good hand hygiene and cough practices must be observed and the meeting space has to be of the correct proportions to facilitate physical distancing. PPE should be readily available and potential risks noted. When a face-to-face meeting is not a viable option, another means of communication must be discussed and agreed upon with the patient and their Relevant Person. According to the Civil Liability Amendment Act 2017 a Relevant Person in relation to a patient means a person who is a parent, guardian, son, daughter, spouse or civil partner of the patient. They may also be someone who is cohabiting with the patient or whom the patient has nominated in writing to the health services provider as a person to whom clinical information in relation to the patient may be disclosed.

WE LIVE IN AN AGE OF MULTIPLE TECHNOLOGIES THAT GREATLY ASSIST ALTERNATE MEANS OF COMMUNICATION. FACETIME, SKYPE, MICROSOFT TEAMS, ZOOM AND EVEN A SIMPLE TELEPHONE CALL ARE ALL POSSIBLE OPTIONS DEPENDING ON THE PATIENT’S COMMUNICATION NEEDS AND PREFERENCES.

COMMUNITY HEALTH NURSE 2020

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OPEN DISCLOSURE

There are some important points to take into account when managing open disclosure discussions by telephone or the aforementioned alternatives during Covid-19. The HSE open disclosure checklist can be used to assist in preparing for and managing the meeting. Properly prepare for the call and be clear regarding what you want to achieve. Speak clearly and at the correct pace to make sure you are understood and listen carefully. Because there are no visual cues during a telephone call, it is vital to convey compassion and empathy in your tone of voice and in the words you choose. Give the other person your full attention and if you are unsure of anything they say during the discussion, ask them to clarify what they mean. Encourage questions and summarise the conversation at the end of the call. Arrange and agree a follow-up call, preferably within 24 hours of the open disclosure call or as soon as possible if this is not an option. Record the important points of the conversation in the clinical record and send the minutes of the meeting to the patient or Relevant Person. The ‘Assist Me’ model is available to staff who have been involved in an adverse event in work. This has been adapted from the Medical Protection Society’s A.S.S.I.S.T model of communicating with service users following adverse events in healthcare:

RESOURCES FOR STAFF INCLUDE MENTAL HEALTH AND PSYCHOLOGY SERVICES, EMPLOYEE ASSISTANCE PROGRAMMES, OCCUPATIONAL HEALTH AS WELL AS FROM LINE MANAGERS AND SENIOR MANAGEMENT STAFF.

THE ‘ASSIST ME’ MODEL A: ACKNOWLEDGE – the event and its impact on the member of staff with empathy. Assess the impact on the member of staff’s ability to continue normal duties. Express regret for their experience. S: STORY – allow time and space for them to recount what happened using active listening skills. S: SHARE – personal experiences. I: INQUIRE – encourage questions and provide answers and information. S: SUPPORTS AND SOLUTIONS – provide information on the supports available including formal, informal and practical support. T: TRAVEL – provide continued support and reassurance. M: MAINTAIN – contact and monitor progress moving forward. E: END – reaching a stage of closure from the event. Evaluate feedback and establish any learning which may beneﬁt other staff.

WWW.HSE.IE/ OPENDISCLOSURE HEALTHCARE WORKER HELPLINE: 1850 420 420

COMMUNITY HEALTH NURSE 2020

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COMMERICAL PROFILE

Myhomecare awarded JCI Gold Seal

yhomecare, part of Servisource Limited, has become the ﬁrst nursing care provider within Ireland to achieve the Joint Commission International (JCI) Accreditation, a feat which has only been reached by 24 other homecare companies globally. The accreditation is awarded to companies proving outstanding excellence and dedication to quality and patient safety. JCI is considered the world leader in health accreditation and the author and evaluator of the most vigorous international standards in quality and patient safety. The award is sought solely by companies who set out to improve the quality of care and are committed to prioritising the needs of the patient by developing a diverse set of policies and procedures that place such needs at the forefront of everything they do. Myhomecare, a specialist homecare and home nursing provider are a nationwide, HSE approved service, delivering a multitude of care solutions. This care can range from companionship to advanced nurse lead, around the clock care in the home, from birth to retirement and beyond. The accreditation, also known as the ‘JCI Gold Seal’ within the healthcare profession, was awarded to Myhomecare for demonstrating excellence

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in healthcare standards and a dedication to putting patient safety ﬁrst. By going beyond borders for the quality of care of patients under their services, Myhomecare hopes to inspire better services for the homecare industry for all moving forward. For further information on Myhomecare services contact: Molly McHugh Freephone 1800 400 900 Email: mmchugh@myhomecare.ie Website: www.myhomecare.ie

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DEATH GUIDANCE

HSE introduces the

Interim Clinical Guidance for the pronouncement of death by registered nurses

in identified services in the context of the global COVID-19 pandemic and associated online training.

he Office of Nursing and Midwifery Services Director (ONMSD) has developed this interim clinical guidance to enable pronouncement of death by registered nursing staff in designated centres for older persons registered by HIQA and people being supported by specialist palliative care services during this pandemic. This interim clinical guidance for HSE and Section 38 services may be adapted by other non ✔ National HSE Interim Clinical Guidance for HSE organisations. the Pronouncement of Death by Registered FOR FURTHER The guidance document will Nurses in Identified Services in the Context INFORMATION VISIT: temporarily replace the ‘National of the Global COVID-19 Pandemic (2020) HSE.DRSTEEVENSLIBRARY. Policy for Pronouncement of ✔ Local communication policy in place to IE/LD.PHP?CONTENT_ ID=32887174 Expected Death by Registered support the Interim Clinical Guidance for Nurses’ (HSE, 2017) for the duration the Pronouncement of Death by Registered of the Covid-19 outbreak in Ireland. Nurses in Identified Services in the Context of the Global COVID-19 Pandemic (2020) ✔ Scope of Nursing and Midwifery Practice Framework (2015) THE GUIDANCE IS SUPPORTED BY ✔ The Code of Professional Conduct and Ethics for ONLINE EDUCATION AND TRAINING Registered Nurses and Registered Midwives (2014) RESOURCES WWW.HSELAND.IE TO FACILITATE IMPLEMENTATION AND ✔ Local line management support IS APPROVED BY THE NURSING AND MIDWIFERY BOARD OF IRELAND.

THE REGISTERED NURSE WHO SUCCESSFULLY COMPLETES THIS ON-LINE PROGRAMME WILL BE SUPPORTED WITH THE FOLLOWING:

Following on from completing the online programme, the nurse must: 1

Complete the Self-Assessment of Competency for a Registered Nurse in the Pronouncement of Death in the context of the Global Covid-19 Pandemic. A copy of this completed selfassessment must be discussed with their line manager and a copy logged in their Human Resources ﬁle

In the event that further support is required, complete the Prerequisite to Pronouncement of Death by a Registered Nurse in the context of the COVID-19 Pandemic

COMMUNITY HEALTH NURSE 2020

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ICHN WINNERS

INSTITUTE OF COMMUNITY HEALTH NURSING AWARDS 2019

COMMUNITY HEALTH NURSE 2020

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ICHN WINNERS

Jane Dare ADPHN DSC Lifetime achievement award winner

ane Dare is an Assistant Director of Public Health Nursing in Dublin South West and has had a distinguished nursing career both within the community setting and abroad. Jane was born in Uganda and trained and worked as an RGN, and community midwife in the UK. The beginnings of her community nursing career commenced in Ireland where Jane trained as a PHN and worked in Wicklow as a PHN and A/ADPHN and was a certiﬁed leader of the incredible Years Programme and specialised in sleep issues in children. Jane’s work on sleep was recently acknowledged at a launch by the Minister of Health on a new toolkit to help young people get healthy amounts of sleep.

“SHE IS NOT AFRAID OF CHALLENGE OR CHANGE AND HAS SUCCESSFULLY NAVIGATED HER TEAM THROUGH MANY CHALLENGES AND CHANGES IN THE PAST FEW YEARS.” Throughout her PHN career, Jane has been an excellent advocate for early intervention and improving outcomes for children, which is evidenced through her work in delivering sleep training, the Solihull parenting programme, infant massage and ASQ training to PHNs and student PHNs. Educated to master’s level in Child Health, Jane continuously seeks out and applies evidence based practice to all areas of her work particularly in the area of early intervention to improve outcomes for children. Jane is always at the forefront of change and innovation and has recently completed the train the trainer Newborn Behavioural Observations training, which was showcased by one of its author Professor Kevin Nugent at the launch of the HSE Mychild.ie website in December last. Jane’s expertise and knowledge in the area of child health was quickly recognised and sought out by members of the national Nurture group and was asked to become a Subject Matter Expert (SME) on a number of the nurture eLearning programmes. Jane has also arranged and facilitated the design and production of many of the child health eLearning programmes which were videoed on site in DSW with many of our fantastic PHNs playing starring roles.

“JANE HAS UNQUESTIONABLY BECOME THE GO-TO PERSON FOR EARLY INTERVENTION IN CHILD HEALTH AND KNOWS HER SUBJECT MATTER INTIMATELY.”

Among many of Jane’s talents are her leadership skills. Jane is an excellent team leader and highly respected by her peers and her team. She is not afraid of challenge or change and has successfully navigated her team through many challenges and changes in the past few years. Jane truly deserves recognition for her work in child health and early intervention. She has spent countless hours perfecting the child health eLearning training programmes and PHN training manual and is a true subject matter expert in this area. She has been responsible for the implementation of a large number of quality improvement projects in DSW to include the aforementioned child health training in sleep, Solihull, infant massage, ASQ -3, etc and is currently working on an evidence based integrated care pathway for clients with leg ulcers in primary care. Jane has unquestionably become the go-to person for early intervention in child health and knows her subject matter intimately. Her mastering of child health training has been a huge asset to the team in DSW and improving the child health service we offer. Despite the huge professional (and personal) investment she has made to child health and early intervention, whenever Jane is called out for her work, she makes it clear that it is a group effort, never wanting to take all the credit. Jane is always collaborative and works to make sure that people feel included and have a say. Education and career development is something Jane has proven is important to her, through her actions and her encouragement of staff to progress within their careers through the development of nurse led sleep clinics and baby massage classes and the use of the Solihull parenting support model in their practice. Jane has been the driving force for education and research and she has been a valued advocate for professional, personal and practice development, and as such a deserved winner of this prestigious Lifetime Achievement Award. From each and every Nurse in Dublin South West, we wish her the very best for her future and thank her for all that she has done for our nursing community.

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ICHN WINNERS

COMMUNITY HEALTH NURSE 2020

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ICHN WINNERS

Aileen Carrig PHN Dublin West

hroughout her career, Aileen has embraced the whole concept and principles of partnership both with the individual clients and families she has worked with. Since qualifying in 2012, she has undertaken a postgraduate certiﬁcate in therapeutic play skills and is utilising these skills providing play therapy to children aged between 3-12 years presenting with social, emotional and behavioural problems. When she decided to undertake play therapy training, there was limited evidence from an Irish context in relation to play therapy and the role of the PHN. She initially undertook a certiﬁcate in play therapy and is now undertaking a diploma and is currently delivering play therapy to children, setting standards to ensure high quality of care when play therapy,

therapeutic play skills and creative arts therapies are used with children to improve emotional literacy and alleviate behaviour and mental health problems. She is actively involved in patient education with a specialist focus on child development and supporting patients and familes as well as the PHN service. Through her commitment in developing play therapy in her practice, she has made a difference to children’s lives. Her goal at all times is to provide support to her colleagues and patients. “SHE INITIALLY UNDERTOOK A CERTIFICATE IN PLAY THERAPY AND IS NOW UNDERTAKING A DIPLOMA AND IS CURRENTLY DELIVERING PLAY THERAPY TO CHILDREN SETTING STANDARDS TO ENSURE HIGH QUALITY OF CARE WHEN PLAY THERAPY, THERAPEUTIC PLAY SKILLS AND CREATIVE ARTS THERAPIES ARE USED WITH CHILDREN TO IMPROVE EMOTIONAL LITERACY AND ALLEVIATE BEHAVIOUR AND MENTAL HEALTH PROBLEMS.”

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ICHN WINNERS

Mabel Murtagh, Caitriona Rigney and Sarah Mahon PHN Dublin West

abel qualified as a PHN in 1998, Caitriona qualified as a PHN in 2011 and Sarah qualified as a PHN in 2008. All three have a strong background in providing health and social care to patients on their individual case loads. All three advocate for the patient and service user by listening to their views and opinions and consider them in how to plan and deliver the PHN service. In 2018, these three PHNs undertook training in Managing Children’s Sleep Disorders in Clinical Practice (Sleep Training Programme for Parents) in Southampton UK. This course provided the PHNs with the basic understanding of sleep physiology, the impact of sleep disorders on the child and family and a rapid guide to core sleep disorders. Workshops were due to commence in May 2019 and a suite of information including presentations to

parents with children aged 6- 18 months and 18 months to 3 years have been prepared along with a parent information booklet. Parents who attend will then carry out a sleep training programme with their child. Support will be provided to the parents by the area PHN who has undertaken training in the Millpond sleep programme. Completing the training programme gave them the impetus to drive this initiative in the department. All three have successfully completed the Millpond training course and also have undertaken self-directed learning in this area. Combined, they have 39+ years’ experience in Community Nursing and utilise evidence based research in practice; for e.g. when establishing the sleep training workshop they worked closely with the DPHN developing a guideline, parent information booklet and PPPTs for the workshop. They stand out as the department leads in this area and all three very much enjoy mentoring student PHNs and undergraduates. All three are dedicated to their continuous education and seek out that which is relevant and transferable to their role.

COMMUNITY HEALTH NURSE 2020

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ICHN WINNERS

Margaret Dwyer PHN Dublin South East

roviding health and social care to older persons is challenging given that the older persons often present with multiple diseases and a complex health situation. As such many professions and organisations are involved. Margaret has a deep understanding that lack of interprofessional and interorganisational collaboration can lead to fragmented care and where care planning meetings before hospital discharge have been used to overcome this, they have their limitations in identifying long-term needs at home. Where MDTs are a central space for case discussion, Margaret is integral in co-ordination and provides a specialist support in the management of complex cases in the community. Margaret has recently graduated from UCD with a Graduate Diploma in Person Centred Care Older Persons. She has also completed a Professional Certiﬁcate in the Management of Elder Abuse as well as facilitation skills. Margaret has applied her theory to her practice intelligently.

She represents the Community Nursing Service DSE as member of the working group in St Vincent’s University Hospital, who are developing an effective discharge communication sheet using ISBAR to ensure a safe discharge home. Margaret also represents the Community nursing service DSE on the Values in Action working group within Community Health Care East. Margaret is currently leading out on setting up an older persons working group within DSE incorporating the Cognition and Mental Health in Older Persons.. “MARGARET HAS A DEEP UNDERSTANDING THAT LACK OF INTERPROFESSIONAL AND INTERORGANISATIONAL COLLABORATION CAN LEAD TO FRAGMENTED CARE AND WHERE CARE PLANNING MEETINGS BEFORE HOSPITAL DISCHARGE HAVE BEEN USED TO OVERCOME THIS, THEY HAVE THEIR LIMITATIONS IN IDENTIFYING LONG-TERM NEEDS AT HOME.”

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COMMERICAL PROFILE

The Alzheimer Society of Ireland The Alzheimer Society of Ireland (ASI) is a national charity providing a range of dementia specific information, support and care services throughout Ireland.

ur services include dementia advisers across 12 counties, social clubs, Alzheimer cafes, support groups and family education courses, we also provide over 50 day centres, a range of home care programmes and two national respite centres.We operate a Mobile Information Service at events, local health offices, hospitals and town centres, if you would like to bring this service to your area call our Helpline to arrange a booking. The Alzheimer Society of Ireland’s National Helpline is a confidential information and support service for people with dementia and their families, carers, anyone concerned about their memory and those working or studying in the field. Our dedicated team of Helpline Advisers and trained volunteers provide a free and confidential information and emotional support service. We work to connect people with local services and supports in their area.We also provide a range of publications which have been written for people with dementia and for family

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carers to help build understanding, manage day-to-day life and plan for the future. To ﬁnd out about our services in your area, order publications, book our Mobile Information Service, or call our free and conﬁdential helpline: 1800 341 341, email: helpline@alzhiemer. ie or live chat via www.alzheimer.ie

22/01/2020 18/12/2018 12:55 12/12/2017 10:07 16:36

HEALTH NURSE 2020

12/11/2020 12:14

When a child loses their home, they lose their entire world. There are almost 4,000 children homeless in Ireland. Donate now.

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04/02/2020 12/11/2020 16:09 12:25

ICHN WINNERS

Rachel Long, overall winner PHN Continence Nurse Advisor

ver the past 12 years working within the Community setting, within North Lee Public Health Nursing Service, Rachel has embraced the whole concept and principles of partnership both with the individual Clients and Families she has cared for. Rachel was one of the ﬁrst nurses to have worked within the Community Intervention Team in Cork, where she worked closely and collaboratively with clients, families, hospital and community healthcare teams in the provision of essential community nursing assessment, planning and implementation of care to clients avoiding hospital admission through the coordination of care packages in a highly professional, competent and caring manner. Rachel then continued to provide such excellent service in her role as CNM1 Caseload Manager in the Cobh area, prior to commencing in her current Continence Nurse Advisor role over the past three years. Through her wonderful interpersonal skills, Rachel recognises the importance of establishing a trusting rapport with all her individual clients, families, the interdisciplinary healthcare team, facilitating the integration of a person-centred model of care, in recognising and valuing the individual experiences and circumstances involved, developing individualised care plans in collaboration

with the client and family. Indeed, Rachel is a highly regarded nurse by all who know her and is always so open, helpful and available to support clients, families and colleagues and inspires conﬁdence with her calm, reassuring, caring and knowledgeable practice. This is evident in the manner in which Rachel implements the learning from her ongoing studies and the past years in undertaking ongoing and continuous personal and professional development, most recently with her completion of the Higher Diploma in Gerontology, University College Cork (UCC) and currently completing a masters in Nursing, UCC, with her research focusing on a qualitative study of client feedback on the use of a continence passport. In addition to her wonderful experience and knowledge base, Rachel has a real positive and encouraging approach which is inspiring to all around her. This is evident in her involvement in continence promotion programmes delivered by Rachel and her leadership in developing PPGs on the national stage, where she worked on the practical and realistic implementation of best practice, where the health and wellbeing of the client is central. Such positivity and enthusiasm influences others, and inspires conﬁdence within a challenging healthcare environment.

COMMUNITY HEALTH NURSE 2020

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EDUCATION

Third level

Colleges THERE ARE ONLY THREE COLLEGES IN IRELAND THAT DELIVER THE POSTGRADUATE DIPLOMA IN PUBLIC HEALTH NURSING: UCD, UCC, AND NUI GALWAY. YOU CAN ALSO AVAIL OF AN MSC IN NURSING OR HEALTHCARE PRACTICE FROM DCU.

POSTGRADUATE DIPLOMA IN PUBLIC HEALTH NURSING, UCC

The Graduate Diploma in Nursing (Public Health) in University College Dublin (UCD) helps you to develop valuable knowledge and skills in the areas of primary healthcare and community nursing leading to registration on the Public Health Nursing division of the Nursing and Midwifery Board of Ireland (NMBI). This is a full-time graduate diploma level programme, which takes place over two academic semesters (September-June). Classes take place on Mondays in semester one and the remaining time represents clinical placement in the public health nursing area or the maternity site. In semester two, classes are scheduled according to the availability of clinical placements and schedules vary from year to year. Successful completion of the programme depends on passing all clinical and academic requirements. Applicants must be registered as a general nurse with the Nursing and Midwifery Board of Ireland (NMBI) and meet the clinical experience requirements set out by the Health Service Executive. All applicants are required to hold a level eight qualification (NQAI) or apply through APEL and be successful in gaining sponsorship as a student public health nurse from the Health Service Executive. Applications must come through the Postgraduate Application Centre (PAC).

The School of Nursing and Midwifery at UCC was ranked in the top 100 nursing schools in the world in the QS World University Rankings by Subject in 2017. The Postgraduate Diploma in Public Health Nursing is a level nine programme which aims to develop informed and skilled public health nurses. The programme helps students to develop selfdirected learning skills and provides an opportunity for personal growth and development. On successful completion of the programme, participants can apply to the Nursing and Midwifery Board of Ireland (NMBI) for registration as a public health nurse (RPHN). This is a one year, full-time programme, usually running from September to June inclusive each year. Students undertake eight modules to the value of 60 credits. There are four blocks of placement with a registered public health nurse in the sponsoring Health Service Executive (HSE) area. If your name is not registered in the midwives division of the NMBI register, you will complete an NMBI approved module or unit of study on maternal and child health as part of the programme. You will also undertake a maternity placement of ﬁve weeks as part of this module. Total clinical placement accounts for over 22 weeks during the year. The recruitment and sponsorship of student public health nurses is a national joint application process between the Higher Education Institutions (HEI) and the HSE. Applicants must be registered general nurses and meet the clinical experience requirements set out by the HSE. It is necessary to have an academic level eight (honours degree or higher diploma) course completed or provide evidence that you can perform at this level as directed on the application form. If English is not your ﬁrst language, fluency must be demonstrated (IELTS 7 or higher). Admission to the course will be subject to a joint HSE/HEI application process.

Further information is available from Dr Gillian Paul, Programme Director. Tel: +353 1 7166406, email: gillian.paul@ucd.ie

Further information is available from Lloyd Philpott, Programme Co-ordinator. Tel: +353 21 490 1509, email: lloyd.philpott@ucc.ie

GRADUATE DIPLOMA IN NURSING (PUBLIC HEALTH), UCD

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EDUCATION

MASTER/POSTGRADUATE DIPLOMA OF HEALTH SCIENCE (PUBLIC HEALTH NURSING), NUI GALWAY The Master’s/Postgraduate Diploma of Health Science (Public Health Nursing) is run over two academic years. Candidates registering for this programme upon successful completion of year one can register with the NMBI as a public health nurse. To successfully complete year one, the student must complete modules totalling 60 ECTS. Students can choose to opt out of the programme on successful completion of year one and will be awarded a Postgraduate Diploma of Health Science (Public Health Nursing). Year one of this programme is offered by the School of Nursing and Midwifery, NUI Galway, and is sponsored by the Health Service Executive. Eligible students progress on to the Master of Health Sciences (Public Health Nursing) totalling 30 ECTS in year two. Entry to the Master’s programme is subject to the student achieving 60% on the aggregate of the Postgraduate Diploma modules undertaken in year one. Year two of this programme is offered by the School of Nursing and Midwifery, NUI Galway, and is not sponsored by the Health Service Executive.

Royal College of Surgeons www.rcsi.ie

University College, Dublin www.ucd.ie

Trinity College, Dublin www.tcd.ie

Galway-Mayo Institute of Technology www.gmit.ie

Maynooth University www.maynooth university.ie

Athlone Institute of Technology www.ait.ie

University of Limerick www.ul.ie

National University of Ireland, Galway www.nuigalway.ie

Sligo Institute of Technology www.itsligo.ie

Cork Institute of Technology www.cit.ie

Blanchardstown Institute of Technology www.itb.ie

Tralee Institute of Technology www.ittralee.ie

Further information is available from Ms Mary Walsh, Programme Director. Tel: +353 91 494129, email mary.b.walsh@nuigalway.ie; Dr. Marcella Kelly, Programme Director. Tel: +353 91 495 036, email marcella.kelly@nuigalway.ie MSC IN NURSING OR HEALTHCARE PRACTICE, DUBLIN CITY UNIVERSITY Currently, we are offering a two-year, part-time MSc programme in Nursing or Healthcare Practice. You can choose from five specialist areas of study including Intellectual Disability, Mental Health, Child and Adolescent, Dementia Care and General Nursing or Healthcare Practice. We also offer a Graduate Diploma option after 18 months, and a Graduate Certificate in Dementia Care. One particular strength of our MSc is that you have both an academic and practice supervisor who support you during your studies. Assessment is conducted through assignments and portfolios, rather than exams. Your practice supervisor and academic supervisor will encourage you to use the portfolio as an opportunity to advance projects that are needed in the clinical area. Many of our students have been successful in gaining advanced practice positions as they have developed their knowledge and practice during the course. Sinéad, a recent graduate from the MSc who has been successful in achieving an ANP role, said, “I really enjoyed my time in DCU. It is a very student-focused course. I was equipped with the skills and knowledge to progress in my career in an area I’m very passionate about.” Entry requirements include a relevant first degree or equivalent, minimum of one year’s practical experience, with three months experience in the defined area of specialism. Further information is available from Deirdre Corby. Tel: +353 1 7008524, email: deirdre.corby@dcu.ie

COMMUNITY HEALTH NURSE 2020

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COMMERICAL PROFILE

UCD School of Nursing, Midwifery and Health Systems The UCD School of Nursing, Midwifery and Health Systems is Ireland’s largest nursing and midwifery school. It is interdisciplinary in character, comprising nursing, midwifery and health systems.

he school is research intensive and globally engaged Our mission is to educate nurses, midwives and other health professionals to provide expert professional health care through skilled and ethical practice based on best evidence and prudent judgement, and to develop and disseminate disciplinary knowledge through research and scholarship. The School is the only School of Nursing in Ireland to have a distinct interdisciplinary division, Health Systems, which is focused on developing interdisciplinary programmes of teaching and research in subjects related to health systems and the health services and resources. We engage with health service provider partners in the design and delivery of undergraduate and graduate taught programmes. We offer a broad portfolio of education and training programmes, ranging from professional certiﬁcates, graduate diplomas, taught

masters, through to masters by research and PhD. Our research is developed in collaboration with key stakeholders, including patients and members of the public, and health and social care professionals. Our faculty and research staff have a track record of securing national and international research funding for both programmatic and single-project research in healthcare practice, health policy and health systems. We conduct research in several focused areas, including health systems and services, the impact of social policy on health, maternal and infant health, social gerontology, family care, palliative care, cancer care, disability assistance, and nursing and midwifery policy. For more information on our school, our programmes, and our research, please visit www.nmhs.ucd.ie

MSC NURSING (PUBLIC HEALTH)

This innovative programme is for qualified Public Health Nurses seeking to attain a Masters qualification in Public Health Nursing.

WHAT WILL I LEARN?

The programme will enhance the Public Health Nurse’s knowledge base by developing key skills in advanced research methods and completion of a fieldwork dissertation. Delivery of the programme will be over one academic year, commencing September.

ENTRY CRITERIA

Applicants must: • be a Public Health Nurse on the live register as maintained by NMBI • have completed a Graduate Diploma in Public Health Nursing within the last 4 years with a minimum GPA of 2.48 (or equivalent) • be working in clinical practice as a Public Health Nurse.

FURTHER DETAILS ON OUR PROGRAMMES ARE AVAILABLE AT

www.nmhs.ucd.ie or by emailing graduate.nmhs@ucd.ie 247486_2L_UCD_JM_ICHN.indd 1

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CERVICAL CHECK

What is cervical screening?

cervical screening test checks the health of your cervix. The cervix is the opening to your womb from your vagina. It is not a test for cancer, it’s a test to help prevent cancer from developing. Screening ﬁrst looks to see if you have any of the high-risk types of human papillomavirus (HPV) that cause cervical cancer. If HPV is found, your same test sample will be checked to see if you have any abnormal (pre-cancerous) cells in your cervix. HPV CERVICAL SCREENING: ✔ is a better way of cervical screening ✔ prevents more cancers ✔ means fewer tests

IF YOU HAVE HAD A SMEAR TEST IN THE PAST, HAVING A CERVICAL SCREENING TEST WILL FEEL THE SAME.

KEY THINGS TO KNOW ABOUT CERVICAL SCREENING ✔ It’s not a test for cancer, it’s a test to help prevent cancer from developing. ✔ All people with a cervix aged 25 to 65 should be invited for regular free screening by letter. ✔ During the screening test, a small sample of cells is taken from your cervix. ✔ The sample is tested for human papillomavirus (HPV). ✔ HPV can cause abnormal cell changes in the cervix. ✔ HPV is the main cause of cervical cancer. ✔ If your sample tests positive for HPV, we will check for abnormal cells.

Do not delay having a cervical screening test when it’s due. It’s one of the best ways to protect yourself from cervical cancer.

✔ Abnormal cell changes are sometimes called precancerous cells. ✔ In most cases, it takes 10 to 15 years for cells in the cervix to go from normal to pre-cancer to cancer. ✔ Finding HPV or abnormal cells early means you can be monitored or treated so they do not turn into cervical cancer. ✔ You’ll get your results by letter, usually about 4 weeks after your screening test.

CHANGES TO HOW YOU ARE SCREENED ✔ most people with a cervix will be invited for screening less often ✔ people aged 30 to 44 will now have a screening test every 5 years instead of every 3 years ✔ all eligible people with a cervix are screened up to age 65

WHY SOME PEOPLE WILL HAVE CERVICAL SCREENING LESS OFTEN ✔ People aged 25 to 29, are screened more often because they are more likely to have HPV at that age. ✔ If you are aged 25 to 29 you will usually have a cervical screening test every 3 years.

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CERVICAL CHECK

✔ If you are aged 30 to 65, you will usually have a cervical screening test every 5 years. ✔ It is safe to wait for 5 years between tests if you do not have a HPV infection. This is because: • your risk of developing cell changes is very low • a test showing that you do not have HPV is more reliable than a test ﬁnding normal cells ✔ In most cases, it takes 10 to 15 years for an HPV infection to develop into cervical cancer. ✔ Cervical cancer is a rare outcome of an HPV infection. ENDING CERVICAL CANCER Australia and Rwanda are set to become two of the ﬁrst countries in the world to end cervical cancer.

NOT A TEST FOR CANCER ✔ A cervical screening test is not a test for cancer. It’s a test to help prevent cancer from developing. ✔ A screening test looks to see if you might be at risk of developing cancer in the future. This is why it can be effective in reducing the risk of cancer. ✔ Like all screening tests, it’s carried out on people who seem to be healthy. They do not have any symptoms. ✔ But cervical screening, like all screening tests worldwide, is not perfect. ✔ Some people will still develop cervical cancer despite regular screening. While the risk of cervical cancer can be reduced, it cannot be eliminated by screening. ✔ Cervical screening is still one of the best ways to prevent cervical cancer from developing. ✔ This is why it is important to attend for a screening test when it is due.

This is because of: • the success of the HPV vaccine for school children • HPV cervical screening ✔ Australia was one of the ﬁrst countries to bring in HPV cervical screening. It was also the ﬁrst to recommend that most people with a cervix are screened every 5 years. ✔ The evidence worldwide is that HPV cervical screening is the best way to carry out cervical screening. ✔ Italy, Netherlands, New Zealand, Sweden and the UK have all recommended the introduction of HPV cervical screening. ✔ A smear test is still a very effective way to prevent cervical cancer developing. It is the way we screened for cervical cancer before HPV cervical screening was introduced.

HOW NEW HPV CERVICAL SCREENING COMPARES WITH THE OLD SMEAR TEST ✔ HPV cervical screening is a new way of cervical screening. The test looks to see if you have HPV ﬁrst.

✔ If HPV is found, your test sample is checked for abnormal cells. ”IF A HPV INFECTION IS FOUND EARLY, THE ✔ The old TEAM CAN MONITOR smear test IT AND OFFER YOU looked for TREATMENT…” abnormal cells first. But finding HPV first is a better way to screen for cervical cancer. ✔ If a HPV infection is found early, the team can monitor it and offer you treatment if there are any changes to cells in your cervix. ✔ If 1,000 people are screened, about 20 people will have abnormal (precancerous) cervical cells: • 15 of these 20 people will have these cells found through the old smear test; 5 people will not and may develop cervical cancer • 18 of these 20 people will have these cells found through new HPV cervical screening; 2 people will not and may develop cervical cancer

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COMMERICAL PROFILE

Irish Cancer Society The impact of our services in local community services

e are committed to meeting the needs of people across all stages of cancer and provide 17 programmes and services from prevention, to support, through to survivorship and at end of life. The impact of these programmes is measured each year. Fig 1. Shows the programmes and services available to cancer patients and their families in the communityCancer Prevention: With more than half of all cancers being preventable our programmes provide a supportive environment for people to engage in lifestyle changes. Cancer Support: Our Cancer Nurseline and Daffodil Centre Cancer Nurses offer free cancer information, support, advice. Booklets are available free of charge and reliable information is on our website. A free locally provided counselling service provides a safe environment for those affected by cancer. Financial grants help to reduce families and patients’ ﬁnancial burden and our Volunteer Driver Service provides free transport to chemotherapy appointments.

PREVENTION

SUPPORT

SURVIVORSHIP

PALLIATIVE

We Can Quit Fit for Work and Life X-HALE Publications Website information Cancer Nurseline Daﬀodil Centres

Cancer Nurseline Daﬀodil Centres Volunteer Driver Service Travel2Care Financial Support Programme Publications Website information

National Conference for Cancer Survivors Counselling Prostate Cancer Psycho-Educative Programme Living Life Strides for Life Survivor Support Cancer Nurseline Daﬀodil Centres

Night Nursing Cancer Nurseline Daﬀodil Centres

Cancer Survivorship: Our Survivorship Support Volunteers meet cancer patients offering practical support. Two Living Well with and Beyond Cancer conferences for anyone who has had a cancer diagnosis are held each September. Palliative Care: Our Night Nursing service ensures that the patient can die at home with dignity and respect surrounded by their family and friends. For further information on any of the above services, call the Cancer Nurseline on Freefone 1800 200 700, visit www.cancer.ie or drop into one of our 13 Daffodil Centres nationwide.

Want to talk Call the Cancer Nurseline on

Freefone 1800 200 700

Visit our Daffodil Centres nationwide

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NURSE HEALTH

Effective Clinical Communication ISBAR

(Identify-Situation-Background-Assessment-Recommendation)

Good communication is essential for safe patient care. Bad communication can have serious consequences. Without a framework, the communication of important clinical information may be forgotten or missed. The ISBAR (Identify-Situation-BackgroundAssessment-Recommendation) technique is a simple way to plan and structure communication. It allows staff an easy and focused way to set expectations for what will be communicated and to ensure they get a timely and appropriate response. It helps to prevent vital information being missed, provides a recognised framework within which to organise what you want to say and give the opportunity for you to state what outcome you desire from the conversation.

I S

IDENTIFY It identifies those to whom the call relates. Verify that you are speaking to the person you are seeking to communicate with, state your name, grade and the location you are calling from and identify the name of the patient you are communicating about.

SITUATION It identifies why you are calling and allows you to state the problem.

BACKGROUND

ASSESSMENT

RECOMMENDATION

It gives a summary of information relevant to the current problem. This may include medications, laboratory results, diagnostic tests or surgical procedures.

Summarise relevant information gathered; what has changed? What is your interpretation of this? It describes what you found on examination of the patient, charts and results. It may include an ABC assessment or an Early Warning Score.

ACKNOWLEDGEMENT The SBAR tool originated from the US Navy and was adapted for use in healthcare by Dr M Leonard and colleagues from Kaiser Permanente, Colorado, USA.

28 COMMUNITY HEALTH NURSE 2020

It allows you to ask for what you would like to happen without hinting or hoping for the right action. It may be that your recommendation is simply to ask for advice. An action plan should be agreed between you.

CHILD HEALTH

Children First National Guidance for the Protection and Welfare of Children 2017

hildren First National Guidance for the Protection and Welfare of Children 2017 was launched on October 2nd 2017. This Guidance is a primary reference The Children First Act 2015 was enacted on November 19th 2015 and commenced in full on December 11th 2017. for all citizens to report concerns and includes the new legislative obligations. It provides The Act places a number of statutory obligations on speciﬁc groups clarity between the legislation and the of professionals and on particular organisations providing services existing non-statutory obligations to children. which will continue to operate for all sectors of society. Through the provisions of the Act, it is intended to: IT PROVIDES CLARITY BETWEEN Children First Guidance ✔Raise awareness of child abuse and neglect THE LEGISLATION ✔Provide for mandatory reporting by key professionals describes the four main AND THE EXISTING types of abuse and sets ✔Improve child safeguarding arrangements in NON-STATUTORY out the steps which organisations providing services to children OBLIGATIONS. should be taken to ensure ✔Provide for co-operation and information-sharing that the child or young between agencies when Tusla – Child and Family Agency is undertaking child protection person is protected from harm. It has been updated to include new information about the The legislation also contains a provision that removes the defence of Children First Act 2015 and it includes reasonable chastisement in relation to corporal punishment as part of speciﬁc information for the professionals court proceedings. The policy intent is that the legislation will operate side-by-side with and organisations that now have legal obligations to keep children safe. The the existing non-statutory obligations provided for in Children First Guidance also outlines the roles of the main National Guidance for the Protection and Welfare of Children 2017. statutory bodies involved in child welfare The Criminal Justice (Withholding of Information on Offences against and protection: Tusla - Child and Family Children and Vulnerable Persons) Act 2012 and the National Vetting Agency, and An Garda Síochána. It contains Bureau (Children and Vulnerable Persons) Act 2012 are additional key details of how to report a concern about a pieces of complementary legislation designed to improve child safety child and what happens once the report is and protection. received by Tusla.

CHILDREN FIRST ACT 2015

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CHILD HEALTH

National Childcare Scheme

he NCS will replace all existing targeted childcare support programmes and the current universal childcare subsidy by 2021. It gives ﬁnancial support towards the cost of childcare for the hours spent outside of pre-school or school. The Early Childhood Care and Education (ECCE) programme provides early childhood care and education for pre-school children. It will not be affected by the NCS and will continue to operate alongside the NCS. The National Childcare Scheme provides 2 types of childcare subsidy for children over 6 months of age - a universal subsidy for children under 3 which is not means tested and an income assessed subsidy for children up to 15 which is means-tested. A child must be attending a childcare provider who is registered with Tusla (including childminders and school-age childcare services) and has a National Childcare Scheme contract with the Department of Children and Youth Affairs. Subsidies are paid directly to the childcare provider, however a parent/guardian must apply for the subsidy. The provider then

The National Childcare Scheme (NCS) is a new scheme that provides ﬁnancial support to help parents to meet the costs of childcare.

subtracts the parent’s subsidy from their childcare bill. Parents/ guardian can apply online and by paper application. The ﬁrst subsidy payments have been made to childcare providers from November 25th 2019. The Department of Children and Youth Affairs (DCYA) is responsible for NCS policy, legislation and oversight, but day-today management of the scheme is carried out by Pobal (the scheme administrator). WHAT HAPPENS TO EXISTING CHILDCARE PROGRAMMES? The NCS replaces most of the current childcare programmes but parents/guardian do not have to switch to the NCS immediately. They can choose to stay on their current programme until August 2021. See the table below for details. Alternatively, they can switch to the NCS from November 2019 onwards. When they switch to the NCS, they will stay on their current programme until their childcare provider registers them for the NCS and they conﬁrm the registration.

EXISTING TARGETED PROGRAMMES

• • •

• •

PROGRAMME NAME

CLOSING DATE FOR NEW REGISTRATIONS

CLOSING DATE

TRAINING AND EMPLOYMENT CHILDCARE (TEC), WHICH COVERS:

Registrations to the ASCC, CEC and CETS programmes closed permanently on February 14th 2020

August 2021

Registrations to the CCS and CCSP programmes closed permanently on October 25th 2019

August 2021 CCS will merge with CCSP for its ﬁnal two years - 2019/20 and 2020/21.

After-School Child Care Scheme (ASCC) Community Employment Childcare programme (CEC) Childcare Education & Training Support (CETS)

Community Childcare Subvention (CCS) Community Childcare Subvention Plus (CCSP)

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CHILDCARE

KEY POINTS ABOUT THE UNIVERSAL SUBSIDY ✔ It is only for children aged between 6 months (24 weeks) and 3 years (36 months) ✔ It is available to parents with any income level and it is not means tested ✔ Parents of children over 3 years (36 months) who have not yet qualiﬁed for the free pre-school programme (ECCE) can apply ✔ Your subsidy will be 50 cent an hour. This is €20 a week (or €1,040 a year) if you qualify for the maximum of 40 hours of subsidised childcare a week. See ‘Rates’ on page 35. ✔ Children must be attending a childcare provider who is registered with Tusla

PARENT/GUARDIAN CAN CHOOSE TO HAVE THEIR INCOME ASSESSED AUTOMATICALLY OR MANUALLY FOR THE INCOME ASSESSED SUBSIDY.

KEY POINTS ABOUT THE INCOME ASSESSED SUBSIDY ✔ It is for children aged between 6 months (24 weeks) and 15 years ✔ It is means tested and available to families with an annual reckonable income of up to €60,000. See ‘Rules’ right ✔ Parent/guardian’s hourly subsidy rates are based on their individual circumstances (depending on reckonable family income and the age and educational stage of their child). ✔ Parent/guardian can use subsidised hours for before-school and after-school childcare costs ✔ Children must be attending a childcare provider who is registered with Tusla ✔ Parent/guardian does not have to be employed but the number of childcare hours available will depend on the hours they work, study or train. HOW IS INCOME ASSESSED FOR THE NCS? Parent/guardian can choose to have their income assessed automatically or manually for the income assessed subsidy. The application will take longer if they choose the manual method. ✔ Automatic method (Fast Track): Parent/ guardian’s income can be assessed automatically

RULES ✔ Relationship to the child: Parent/ guardian or their current partner must be a parent of the child or acting in loco parentis (this means acting as a parent to the child). ✔ Residency status: Parent/ guardian must be ordinarily resident in Ireland and have a legal right to live here (that is, parent/ guardian are either a national of an EU/EEA member state or Switzerland, or have immigration status or leave to remain). ✔ PPS numbers: Parent/guardian must provide their own PPS number and the PPS number of the child or children they are applying for. ✔ Age of the child: To qualify for the universal subsidy, the child must be between 6 months (24 weeks) and 3 years (36 months). To qualify for the income assessed subsidy, the child must be between 6 months (24 weeks) to 15 years.

using information available from Revenue and the Department of Employment Affairs and Social Protection (DEASP). If they agree to this, the NCS will get the information directly from Revenue and the DEASP using their PPS number (and partner’s, if they have one). ✔ Manual method: Parent/guardian can ask for their income to be assessed manually. They must provide documents such as payslips or DEASP declarations which show their income. These are reviewed and assessed by Pobal (the scheme administrator). Parent/guardian can get a full list of the documents accepted as proof of income (income proofs) in Appendix 2 of the NCS policy guidelines. WHAT ASSESSMENT PERIOD IS USED? ✔ Income is normally assessed based on reckonable income from all sources for the previous tax year. ✔ For the 2019-2020 programme year, the previous tax year is 2018 (1 January 2018 to 31 December 2018). You can read more about current year assessments in the NCS policy guidelines (pdf). HOW MANY SUBSIDISED CHILDCARE HOURS AM I ENTITLED TO? The number of childcare hours a parent/guardian can get depends on the hours they (and their partner, if they have one) work, study or train. ✔ Enhanced hours subsidy: If the parent/guardian (and partner, if they have one) are working, studying or training – they will be entitled to up to 40 hours of subsidised childcare per week. This will increase to a maximum of 45 hours from September 2020. ✔ Standard hours subsidy: If parent/guardian (and partner, if they have one) are not working, studying or training, they can qualify for up to 15 hours of subsidised childcare per week. This will increase to a maximum of 20 hours from September 2020. The subsidised weekly hours include any time a child spends in pre-school or school. No longer eligible: Parents must also notify Pobal if they are no longer eligible for the subsidy; for example, they are no longer caring for the child for whom they were given a subsidy. If parent/guardian or partner no longer meet the criteria for the enhanced hours subsidy, the subsidy ends 20 working days after the notiﬁcation.

COMMUNITY HEALTH NURSE 2020

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CHILDCARE

WHAT IS WRAP-AROUND CHILDCARE? The NCS offers wrap-around care for families to help with the cost of childcare for the hours that children spend outside school or pre-school. This means their subsidy can be used for childcare costs for hours outside of school or pre-school, including: • Childcare used before school or pre-school starts

• After-school childcare • Childcare used outside term time (school holidays and mid-term breaks) Outside term time (during school holidays), parents are entitled to the maximum number of childcare hours they have been awarded. During term time, this is reduced. See the tables below.

TERM-TIME HOURS

OUTSIDE TERM-TIME HOURS

ENHANCED HOURS SUBSIDY

STANDARD HOURS SUBSIDY

ENHANCED HOURS SUBSIDY

STANDARD HOURS SUBSIDY

ECCE (PRE-SCHOOL)

JUNIOR AND SENIOR INFANTS

1ST - 6TH CLASS

SECONDARY SCHOOL

IF THE CHILD IS IN PRE-SCHOOL OR SCHOOL AND THE PARENT/GUARDIAN ARE ENTITLED TO THE STANDARD HOURS SUBSIDY (15 HOURS OF SUBSIDISED CHILDCARE PER WEEK), THEY CAN ONLY USE THESE 15 HOURS FOR CHILDCARE DURING SCHOOL HOLIDAYS AND MID-TERM BREAKS (NOT DURING TERM TIME).

HOW TO APPLY Parents/guardians can apply online at ncs.gov.ie from November 20th 2019. To apply online, you will need: ✔ A verified MyGovID account ✔ Your children’s information, including their date of birth and PPS numbers ✔ Your employment and income-related details ✔ Your partner’s PPS number (your partner does not need a verified MyGovID account) ✔ Your partner’s employment and income-related details You can get more information about getting a verified MyGovID from the MyGovID website. • The NCS website has a step-by-step guide to the online application process. • A paper-based application became available on March 13th 2020. You can apply by post by contacting the Parent Support Centre. These applications will take longer to process and may affect the start date of the subsidy payment.

Subsidies are awarded on a yearly basis. Parents and childcare providers will be notiﬁed when a subsidy is due for renewal. You will get this notiﬁcation at least 20 working days before your subsidy payment is due to expire. A 6-month renewal date will be set in some situations – set out in the NCS.

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CHILDCARE

THE NATIONAL CHILDCARE SCHEME RATES UNIVERSAL SUBSIDY

Available to all families with childcare costs for children aged between 6 months (24 weeks) to 3 years (36 months)

IF YOU ARE SEPARATED FROM THE PARENT OF YOUR CHILD AND YOU ARE BOTH AWARDED A SUBSIDY FOR THE CHILD, YOU EACH GET A DIFFERENT CHICK (CHILDCARE IDENTIFIER CODE KEY).

RATE PER HOUR AVAILABLE TO ALL FAMILIES WITH CHILDCARE COSTS FOR CHILDREN AGED BETWEEN 6 MONTHS (24 WEEKS) TO 3 YEARS (36 MONTHS)

50 cent

INCOME ASSESSED SUBSIDY RECKONABLE INCOME

RATE PER HOUR (0-1 YEARS)

RATE PER HOUR (1-3 YEARS)

RATE PER HOUR (OVER 3, NOT YET IN SCHOOL)

RATE PER HOUR (SCHOOL AGE AND UP TO 15)

€26,000 or under

€5.10

€4.35

€3.95

€3.75

€27,500

€4.90

€4.18

€3.78

€3.58

€32,500

€4.22

€3.61

€3.19

€3.03

€37,500

€3.54

€3.05

€2.61

€2.48

€42,500

€2.87

€2.48

€2.03

€1.93

€47,500

€2.19

€1.92

€1.45

€1.38

€52,500

€1.51

€1.35

€0.87

€0.83

€57,500 to €60,000

€0.84

€0.78

€0.33

WHAT HAPPENS WHEN MY APPLICATION HAS BEEN APPROVED? • You get a unique code called a CHICK (Childcare Identifier Code Key) when your application is approved • Your provider then uses the CHICK and your child’s name and date of birth to register your child on the National Childcare Scheme • You get an email notification asking you to confirm that the hours of childcare are correct • Your subsidy is paid directly to your childcare provider on your behalf • Your childcare provider subtracts the subsidy from your childcare bill

IF YOU CHOOSE TO USE 2 DIFFERENT CHILDCARE PROVIDERS FOR A SINGLE CHILD (FOR EXAMPLE, ON DIFFERENT DAYS OF THE WEEK) YOU CAN USE A SINGLE CHICK FOR BOTH PROVIDERS.

COMMUNITY HEALTH NURSE 2020

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CHILD NEWS

The National Maternity Experience Survey

The National Maternity Experience Survey was launched on February 4th 2020.

he National Maternity Experience Survey offers eligible new mothers the opportunity to share their experiences of Ireland’s maternity services — from antenatal to postnatal care — in order to improve the safety and quality of care provided to women and their babies. Women who gave birth in October 2019 were invited to participate in the survey. Nineteen maternity hospitals and maternity units from across the country, as well as the National Home Birth Services, participated in the National Maternity Experience Survey. SURVEY MODEL AND METHODOLOGY The National Maternity Experience Survey includes 65 structured, tick-box questions and three open-ended (freeflow) questions. The survey covers the full pathway of maternity care — from antenatal care, through labour and birth, to postnatal care in the community. QUESTIONNAIRE DEVELOPMENT The National Maternity Experience Survey includes questions taken or adapted from a library of questions developed by the National University of Ireland, Galway (NUIG) in collaboration with the National Care Experience Programme. Over 250 people, including women who have recently used maternity services, women’s representatives, midwives, public health nurses, GPs, obstetricians, policymakers, data analysts and academics were involved in selecting the questions most relevant to the Irish context. THE DEVELOPMENT STEPS ARE OUTLINED BELOW: ✔ A systematic review of the literature on questionnaires to measure women’s experiences of their maternity care was

conducted by NUIG. The review identified 19 relevant, international maternity care experience surveys, from which each question was categorised for consideration for inclusion in the final questionnaire. ✔ An international review of maternity care experience surveys identified international experience and best practice with regard to the models and methodologies employed to deliver a national maternity experience survey. ✔ Focus groups, involving users and providers of maternity care in Ireland, identified the most important question areas in maternity care. ✔ A gap analysis further identified questions which are relevant to the Irish context of maternity care. ✔ A list of 396 questions was assembled from the previous steps, of which a Delphi Study identified 95 priority questions. ✔ Picker Institute Europe checked the measurement and analytic quality of the questions. ✔ Further review by experts – for example, the Department of Health, HIQA, Picker Institute Europe and the National Maternity Experience Survey Programme Board – further prioritised questions. ✔ Ten cognitive interviews took place with women who have used maternity services to assess the clarity and appropriateness

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CHILD NEWS

THE FIVE MOST IMPORTANT PHASES IN THE NATIONAL MATERNITY EXPERIENCE SURVEY CYCLE

OCT/ NOV 2019

30 APRIL 2020

Survey live All eligible women were contacted by post in February or March 2020 and received information on the survey and a link to the online survey.

Eligibility period Women aged 16 or older who gave birth in October (or November) 2019 were eligible to participate.

Survey closed 1 FEB 2020

The fieldwork phase for the National Maternity Survey concluded at 5pm on Thursday, April 30th 2020. A 50% response rate was achieved, given all of the challenges in promoting the survey during the COVID-19 Pandemic. At this point, the survey results including both qualitative and quantitative data is available on the real-time dashboard. Over 100 people have access to the dashboard across both hospital and community services . The project lead is currently engaging with staff and managers to ensure that they are reviewing the findings for their local areas and thinking about their Quality Improvement Plans in response to the key findings. The survey findings together with a HSE response and local QIPs will be

The survey closed on April 30th 2020.

published in September 2020. Preliminary ﬁndings suggest that 84% of women had a good or very good positive experience of their maternity care overall. A NUMBER OF STAKEHOLDERS FROM ACUTE OPERATIONS, THE NATIONAL WOMEN AND INFANTS PROGRAMME AND PRIMARY CARE ARE WORKING TOGETHER TO ENSURE FULL ENGAGEMENT IN: ✔ reviewing the ﬁndings of the survey and ✔ the development of the QIPs. Reports are published in autumn 2020.

What’s to come: Quality improvements THE HSE AND INDIVIDUAL MATERNITY SERVICE PROVIDERS RESPOND TO THE SURVEY RESULTS BY DEVELOPING QUALITY IMPROVEMENT INITIATIVES. COMMUNITY HEALTH NURSE 2020

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NURSE HEALTH

Minding Wellbeing

The ability to manage stress is at the core of minding one’s n unprecedented level of stress Welbeing, and there are a number of ways in which this can among nurses and healthcare be achieved during uncertain times: workers as a result of Covid-19 has filled newspaper column Eat healthily – reclaim your lunch-break as time that’s yours inches both nationally and and get away from your work environment. Exercise as internationally since the regularly as you can and avoid stimulants and sedatives. Get beginning of the pandemic. outdoors into nature if possible. Plan a sensible bedtime Longer hours, changing shift routine where you can switch off and sleep better. Exercise self-care by prioritising one thing you could do for patterns and new ways of working have all contributed your Wellbeing. Reflect on your self-care practices. Remember to this. Wellbeing or wellness has never been you are worth it. more important as at this critical time. There Keep in contact with friends and family. With are many definitions of wellness but it can new technologies such as Zoom, it is easier than There are ever to stay in touch. Talk to someone you trust easily be defined as the experience of health, many definitions happiness and and prosperity. Workplace and who shares your sense of humour. Laughing of wellness but it can easily be defined wellness being one of the major types. The helps us to feel good and put things into as the experience of others include Emotional, Physical, Social perspective. health, happiness and Societal Wellness. Find your own way to relax. This could be and prosperity. The majority of European healthcare something as simple as taking a bath, going for a professionals are made up of nurses and walk or reading a book. Keeping a journal of midwives, an estimated 7.3 million. The World thoughts and feelings might be a good way to Health Organizations’ (WHO) policy framework for express yourself on paper. health and wellbeing in Europe, Health 2020, highlights nurses and midwives as having increasingly important roles to play TALK TO A COLLEAGUE, MANAGER in meeting constantly changing healthcare demands. OR SOMEONE IN HR IF YOU FEEL There are those who claim to thrive on stress, but they are STRESSED IN WORK. actually thriving on pressure. Stress is not an illness in itself but can be connected to mental health conditions including www.hse.ie / www.yourmentalhealth.ie The Samaritans are on 116 123. anxiety and depression. The most important thing to remember is that one is not alone in experiencing stress.

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