INMO welcomes launch of framework to provide safe nurse staffing levels & calls for immediate funded national roll out of programme
The Irish Nurses and Midwives Organisation welcomes the launch today by the Minister for Health, Simon Harris of the “Framework for Safe Nurse Staffing and Skill Mix”. The INMO, in welcoming this initiative, calls for a fully-funded roll out. Furthermore, the INMO welcomes the commitment given by the Government at a cabinet meeting last week where they agreed, in principle, that the plan would be extended to hospitals nationwide. However, this will not happen without immediate investment in the recruitment and retention of nurses and midwives, including improvements in pay, without which the necessary nurses will not be available for implementation.
The evidence from the testing of the Framework shows overwhelmingly that a funded national roll out of the Framework, associated with pay adjustments to improve recruitment and retention of nurses, will save lives, make services safer and reduce costs for our health services.
The INMO has lobbied government to introduce an evidence-based approach to determining nurse staffing levels since the introduction of the moratorium on staffing and the subsequent introduction of the detrimental 20% lower salaries for new entrant nurses in 2012 which caused a mass exodus of nurses from the country leaving workplaces dangerously short. Following this pressure, the then Minister for Health, Dr James Reilly, established the Taskforce on Staffing and Skill Mix for Nursing in September 2014, which led to the development of the Framework. The INMO acknowledges the work of the Nursing Policy Division of the Department of Health in relation to the development and piloting of the Framework over the past 3 years, the UCC research team and the nurses involved in the pilot sites.
The core objective of the Taskforce was the development of a framework to support the determination of staffing and skill mix requirements for the nursing workforce, on specialist medical and surgical wards in acute adult hospitals. The optimum skill mix was determined as 80% Registered Nurse to 20% Health Care Assistant. This method was piloted on 16 wards across three acute hospitals.
The evidence from the pilot sites is overwhelmingly positive in respect of the measurable benefits from ensuring that correct nurse staffing levels are constantly protected and supported.
The research found that correct nurse staffing levels led to reduced length of hospital stay; reduced mortality; reduced reports of care left undone; reduced episodes of nurse sensitive outcomes such as hospital acquired pneumonia, urinary tract infections, patient falls, pressure ulcers, etc.
The supervisory role of the Clinical Nurse Manager 2 (CNM2) and their constant presence on the pilot sites was crucial to the success of this initiative. It was also vital that the roster allowed and provided for replacement nursing staff to cover all leave, including maternity leave, as it was determined that staffing gaps were to be filled with the appropriate skill mix.
Speaking following the launch INMO General Secretary, Phil Ni Sheaghdha said:
“These findings provide a positive and promising approach to determining the nursing workforce requirements. Using this evidence-based approach to determine nursing staff requirements will be a first for Ireland and will challenge those who believe that there are adequate nurse staffing levels currently.
The implementation of the Framework would lead to dramatic improvements in patient outcomes and it would revitalise and re-energise nursing staff. From the outset, the success of the Framework requires an investment in pay to attract and retain nurses and midwives in the Irish health service. It is very clear to patients, visitors and staff that nursing and midwifery numbers are grossly inadequate in the context of the safe delivery of current demands on the overcrowded public health service.”
Ms Ni Sheaghdha concluded:
“The provision of optimal care and hope to patients and the nurses who care for them is now a real possibility. This requires real investment in attracting nurses to work in Ireland and retaining those that are leaving, pay remains the single area not addressed, and the framework requires full roll out without delay.