Annual Report: Nursing & Midwifery

Mr Rory Farrelly

Director of Nursing and Midwifery

Nurses, midwives and healthcare supports workers play an important part in improving patient experience across all sites in the RCSI Hospital Group. We continue to provide an environment that supports professional development to enable nurses, midwives and healthcare support workers achieve their full potential and to use their skills to enhance patient experience. This is achieved by working in partnership with all our nursing and midwifery academic partners.

In January 2018, we appointed Grainne Milne into the post of Director of Midwifery for Our Lady of Lourdes Hospital and Louth County Hospital, and in June 2018, we appointed Fiona Hanrahan as Director of Midwifery & Nursing for the Rotunda Hospital.

The RCSI Hospital Group continues to recognise the contribution and efficiency of advanced nursing and midwifery practice. With the support from the Health Service Executive and the Chief Nursing Officer at the Department of Health, this National Initiative enabled the Group to appoint a further seven Advanced Nurse Practitioners (ANPs) across the RCSI Hospital Group. They have been appointed to areas linked to Unscheduled Care, Chronic Disease, Respiratory, Rheumatology and Older People which this has enabled nurses and midwives to improve patient and family experiences.

The Advanced Nurse Practitioner/Advanced Midwife Practitioner (ANP/AMP) Forum Network met in 2018 in partnership with Professor Thomas Kearns and Professor Marie Carney from the Faculty of Nursing & Midwifery at RCSI. The purpose of this forum continues to support Advanced Nursing Practitioners (ANPs) and Advanced Midwifery Practitioners (AMPs) in their professional development and research requirements, providing a forum for sharing initiatives and practice at Group level and act as a conduit for interactions between ANPs/AMPs.

The Faculty of Nursing & Midwifery RCSI was delighted to launch the RCSI Hospital Group Advanced Practice Network on the 31st May 2018.

The Network is providing opportunities for ANP/AMPs to exchange information, knowledge and expertise and provide a more formalised support mechanism, as many ANP/AMPs revealed that their working environment can leave them isolated, especially in services where they are the only ANP/AMPs. It is also hoped that it will create a forum for communication and interaction between ANP/AMPs and enhance further networking opportunities. Undoubtedly, this will also facilitate the development of candidate ANP/AMPs.

It is also envisaged that the Network will facilitate and support the educational, research and professional needs of ANP/AMPs in the RCSI Group, enhance their access to resources and contribute to the growth, development and further enhancement of the advanced practice role. More importantly, it is anticipated that this will have an impact on the quality of care that is delivered to patients.

The RCSI Hospital Group set itself an ambitious aim to reduce the incidents of stage 3 and 4 pressure injuries during 2018. The Directors of Nursing, Directors of Midwifery and Quality Manager worked in collaboration with other disciplines across all sites to set out a number of measures to achieve this target. With these measures, the incidents within year 1 of the service plan has reduced by 20%. This represents 10 incidents of stage 3 or 4 pressure injuries reported between January and December 2018 (FIGURE 12). This is part of a learning and improvement journey to eliminate these serious reportable events. The achievement to date has required wide stakeholder input and a deep understanding at every clinical area level of the approach to care that is expected.

(FIGURE 12)

 

The National target for healthcare workers vaccinated against the Influenza virus was 45% for season 2018. The RCSI Hospital Group achieved above this target and demonstrated a significantly higher performance than National performance for staff uptake of the Flu vaccine (FIGURE 13).

 

All hospitals sites across the RCSI Hospital Group played a critical role within the health system in ensuring appropriate plans were in place to deal with influenza season. Prolonged outbreaks can lead to progressive spread of infection with rapidly increasing service demands that can potentially overwhelm the capacity of the hospital and other referral hospitals. Peer to peer vaccination in place on all sites to improve staff influenza vaccine uptake, has been a key performance indicator for the RCSI Hospital Group since 2015 with the target of 45% for season 2018. In 2018, the RCSI Hospital Group achieved an overall compliance rate of 46% vaccination uptake.

RCSI Hospital & National Performance – Seasonal Flu Vaccine Uptake (FIGURE 13)

Note: Seasonal flu vaccine data for 2012-2013 unavailable for Rotunda; for 2014-2015 unavailable for Cavan Hospital; for Our Lady of Lourdes Hospital Drogheda is unavailable from 2012-2015

  • RCSI HG achieved national target and demonstrated a significantly higher performance (64%) than national performance (34%)
  • current hospital compliance: Beaumont (60%); Connolly (62%); Rotunda (77%); Cavan & Monaghan (49%); OLOL & LCH (75%).