The health Nursing Care Strategies system in any country is currently strongly influenced by three factors: Civilization development, aging of the society and constant economic restrictions accompanying sociology-economic progress. This currently forces politicians, organizers and hospital management to ergonomically and more rationally use the internal capabilities of the system, as well as to constant care for safe care conditioned by a high level of quality of services, especially in view of the ever-increasing demands of society.
- Knowledge and skills
- Midwives in a healthcare provider
- Intensive care Units
- Conservative and Surgical Departments
- Categories of Nursing
- Final conclusions
- Work of Nurses in Medical Entities
- Nursing Care Strategies subsystem
Knowledge and skills
An indispensable condition that must be met in order to achieve these goals is the appropriate structure and number of medical staff, especially nurses and midwives, to the greatest extent securing the elementary needs of people hospitalized or otherwise requiring constant professional care and care. Therefore, the point is to indicate the number of staff that will guarantee the safety of the sick and employees, and at the same time will not expose the institution to waste of funds due to excessive numbers or unused working time, knowledge and skills of employees
The ordinance of the Ministry of Health on the method of establishing minimum standards for the employment of nurses and midwives in non-business healthcare entities of June 28, 2020 defined the manner in which healthcare entities are to calculate nursing staff in individual hospital departments.
The regulation applies only to public healthcare entities. The ordinance defines the method of calculating the need for nursing care in conservative and surgical wards, wards with a psychiatric, obstetric and gynecological profile as well as delivery wards, pediatric wards and wards with a dialysis profile. The ordinance specifies how or what other provisions are to be apply to other branches.
Midwives in a healthcare provider
There are a number of factors to consider when setting minimum employment standards for nurses and midwives in a healthcare provider. These include: the number of patients cared for in a given year, equipment, in particular medical and technical equipment and apparatus, as well as means of transport and communication, working time schedule, average daily time of nursing services and average available time, the appropriate category of care determined for the patient and the number of patients qualified for a given category of care. The average daily time of direct nursing benefits, the average daily time of nursing benefits, the total and average available time of a nurse or midwife during the year is calculated according to the formulas given in the Regulation.
Intensive care Units
In the case of intensive care units and Neonatology, the ordinance of the Minister of Health on how to set minimum standards for the employment of nurses and midwives in non-entrepreneurial healthcare entities indicates that the minimum standards resulting from the provisions issued pursuant to art. 31d of the Act of 27 August 2004 on healthcare services financed from public funds (Journal of Laws of 2008, No. 164, item 1027 (1) regarding hospital treatment services, relating to the appropriate reference level.
This article refers to the specific conditions for the implementation of guaranteed services in the field of hospital treatment.
It says that for intensive care units, equivalent employment is used when employing nurses, at least 2 full-time staff – specialist nurses in the field of Anaesthesiology and intensive care or nurses after a qualifying course in the field of Anaesthesiology and intensive care. For wards with a second reference level, an equivalent of at least 2.22 full-time posts per intensive care unit, including an equivalent of at least 4 full-time positions – a specialist nurse in Anaesthesiological and intensive care nursing or a nurse after a qualification course in anesthesia nursing and intensive care.
Detailed standards of conduct in intensive care units were set out in the ordinance of the Minister of Health on standards of medical procedure in the field of Anaesthesiology and intensive care for entities performing medical activity of December 20, 2012. According to him, only anaesthesiological nurses can work in intensive care units. According to the ordinance, an anaesthesiological nurse is a nurse who has completed or is undergoing specialization in anaesthesiology and intensive care or has completed a qualification course in anaesthesiology and intensive care.
An intensive care unit ward may be a nurse who has completed a specialization in anaesthesiological nursing and intensive care:
Nurses who do not meet the above requirements and who perform activities may perform the activities provided for the anesthesia nurse no later than December 31, 2016. A ward Nursing Care Strategies who does not meet the above requirements may perform his function no longer than until March 23, 2020.
In intensive care units, the individual nursing care method is most often used. In practice, one nurse on call takes care of one or two patients, helping other Nursing Care Strategies on an ad hoc basis in performing activities that require the presence of more than one nurse. Secondly, the method of teamwork with the presence of a leader is use. Task-base work method and leading nurse are not used in intensive care units.
Conservative and Surgical Departments
The ordinance of the Minister of Health on the method of setting minimum standards for the employment of nurses and midwives in non-business healthcare entities of December 28, 2012 set out in detail the method of calculating the need for nursing staff at conservative and surgical departments. Different methods of nursing work organization are use in these departments.
There is often a full-time nurse for task-based nurses in conservative departments. Her duties may include performing medical orders, administering insulin, and determining blood glucose levels. In the surgical wards, on the other hand, the duties of a task-oriented nurse include daily dressing changes in patients after surgery. Other nurses work as a team method then,
Categories of Nursing
Three categories of nursing care determine in seven different criteria at the conservative and surgical departments. To qualify a patient for the first care category, he must meet the first category criteria or no more than 2 second category criteria or no more than one third category criterion.
To qualify for the second care category, the patient must meet three criteria of the second category or no more than two criteria of the third category.
In order to qualify a patient for the third category of care, he must meet at least three criteria for category three care. Care criteria for conservative and surgical departments include: physical activity, hygiene, nutrition, excretion, vital signs, treatment, health education and mental support. For example, in the criterion of physical activity, the patient will be included in the first category if he is fully independent.
In category two, if the patient moves with a cane, walker, requires little help when getting out of bed, getting out of the chair, he spends most of his time in bed.
The third category will include a patient who does not leave the bed, can change position alone or with the help of a nurse, transport only on a stretcher, a wheelchair. In the case of surgical wards, the third category includes every patient on the first day after surgery. he spends most of his time in bed. The third category will include a patient who does not leave the bed, can change position alone or with the help of a nurse, transport only on a stretcher, a wheelchair. In the case of surgical wards, the third category includes every patient on the first day after surgery. he spends most of his time in bed. The third category will include a patient who does not leave the bed, can change position alone or with the help of a nurse, transport only on a stretcher, a wheelchair. In the case of surgical wards, the third category includes every patient on the first day after surgery.
The current regulation lacks average times of direct services in individual categories of patients:
In this situation, it is the manager of the healthcare provider who independently decides about the time of direct care, often without specialist knowledge on how to calculate needs. This is very subjective and creates the risk of overstating or underestimating the time of care, which is a great danger of reducing the quality of Nursing Care Strategies services. In the draft ordinance approved by the Supreme Chamber of Nurses and Midwives and the National Union of Nurses and Midwives, the above provision existed. The regulation also lacks a provision that the staffing of nurses and midwives in a ward or other organizational units with the same profile may not be less than 2 nurses or midwives per shift. Nowadays,
In times of constant change, development of medicine and transformations in the health and Nursing Care Strategies system, the image and tasks of a nurse are also changing. According to the Act on the Occupations of Nurses and Midwives of On July 15, 2011 (2), the nursing profession is an independent medical profession. Regulation of the Minister of Health, he sets the type and scope of preventive, diagnostic, therapeutic and rehabilitation services provided by a nurse or midwife without medical assistance. The nurse is no longer a “doctor’s assistant” but a collaborator who, in addition to working with the doctor and other therapeutic staff, performs tasks within his or her own competence of Nursing Care Strategies.
Work of Nurses in Medical Entities
Knowledge about the methods of organizing the work of nurses in medical entities and Nursing Care Strategiessuch as hospitals, can significantly affect the functioning of the entire medical entity. The proper organization of work, the correct calculation of the demand for nursing staff can improve the organization of work, its efficiency, reduce costs by taking over certain duties of doctors by Nursing Care Strategies. Nursing has been constantly improving over the past years, thanks to its development, it is heading towards the sphere of increasing professionalism.
In addition, current vocational education standards are prepare by nurses and midwives at the level of higher education (undergraduate and graduate), which allows them to be entrust with a wide range of tasks and powers.
Nursing Care Strategies subsystem
Changes in the Nursing Care Strategies subsystem have already taken place. They do not apply to the last 100-150 years, when nursing belonged to women’s natural activities. Groundbreaking changes occurred in the last decade of the last century with the development of all medicine. The topics discuss at work were intend to show the development that took place in Nursing Care Strategies and possible directions of changes in the organization of work of nurses working in hospital units.