National Paediatric Cardiothoracic Education An Interprofessional Pathway Kerry Cook Senior Lecturer Coventry University Chair of the Paediatric Cardiac Nurses Association UK 29/01/2014 1
Aim To share with you the findings of collaborative work undertaken to assess the need for a national approach to paediatric cardiothoracic education To outline the vision and solutions for rectifying the problem 29/01/2014 2
Introduction My Role/Clinical Background RGN, RN (child), BA (Hons), ENB 160, ITEC Dip., PG Dip Currently completing MSc Advanced Nursing Practice Senior Nurse Paediatric Cardiac ITU Senior Lecturer, Coventry University Chair of the Paediatric Cardiac Nurses Association UK PCNA UK 29/01/2014 3
Set up over 10 years ago Network for nurses from Paediatric Cardiac Units (PCU) all over UK Over 250 members Committee members represent most PCUs Over last 3 years education top of agenda 29/01/2014 4
Background Nationally recognised paediatric cardiothoracic courses (ENB 160), for nurses, were previously available via South Bank University and Great Ormond Street Hosp. Thames Valley University and the Royal Brompton Hosp. These provided the opportunity to develop the necessary knowledge and specialist skills required to care for children with complex needs Both disbanded over five years ago Little formal education programme since 29/01/2014 5
Department of Health Views Regarding Education The DoH emphasise that continuous quality improvement and introduction of clinical governance rests on the clear commitment to continuing professional development and lifelong learning (Making a Difference, DoH, 1999, p. 29) 29/01/2014 6
National Service Framework for Children children and young people should receive high quality evidence based care, that is appropriate to meet their specific needs and delivered by staff that have the right knowledge base, expertise and skills (NSF for Children, 2003) 29/01/2014 7
Royal College of Nursing 70% of the nursing establishment should demonstrate knowledge skill and competency attained by specialist post registration education (RCN, 2003) 29/01/2014 8
Bristol Inquiry (2001) The days when courses were designed exclusively for doctors, or exclusively for nurses, should be behind us. What matters is that those caring for patients with a particular condition or illness learn and develop their skills together to provide the best possible care for patients (p330) 29/01/2014 9
Kennedy Report Identified the need for continuing professional development for this specialism Inter-professional and multi-professional in nature Foster a culture of transparency where members of the team would be able to understand and respect each other s roles and responsibilities The Kennedy Report (DoH, 2001) 29/01/2014 10
Problem identified in 2001 by PCNA Children with cardiothoracic problems are being cared for by staff that have not received specialist training How did we know this? 29/01/2014 11
Feasibility Study Initial Feasibility study considered: National training needs analysis National service needs analyses Difference between general and specialist paediatric nurse What is expected of nurses at each level/grade Career pathways Match skills, knowledge and competency to service developments 29/01/2014 12
Training Needs Analysis Results (2002) Total number of questionnaires returned = 234 Units that participated: Bristol Guys Newcastle Belfast Brompton Leicester Southampton Birmingham 29/01/2014 13
Grades D Junior nurse 19% 65% E 46% F Junior Sister 19% G Sister 14% H Senior Sister 2% I Nurse Managers 0% 29/01/2014 14
Years qualified < 1 year 7% 1-2 years 16% 3-5 years 14% 5-10 years 25% 63% 10+ years 38% 29/01/2014 15
Years in speciality (cardiac) <1 year 13% 1-2 years 23% 3-5 years 17% 5-10 years 23% 47% 10+ years 24% 29/01/2014 16
Benefit from specific course? Strongly agree 54% 87% Agree 33% Not sure 10% Disagree 2% Strongly disagree 1% 29/01/2014 17
Should a course be made available? Strongly agree 69% 98% Agree 29% Not sure 2% Disagree 0% Strongly disagree 0% 29/01/2014 18
Results The results showed that despite the best efforts of individual units, there remained an overwhelming perceived need for a national standardised approach to education Cook et al (2005) 29/01/2014 19
Service Needs Analysis (2002) Service Needs Analysis Sent to all PCU s Replies were received from 6 PCUs: Bristol PICU and Cardiac catheter suite Guys - ward and PICU Leicester - ward Oxford ward Birmingham wards 11 & 12 One Location Not known 29/01/2014 20
Service Needs Analysis Questions Have you been able to offer your staff formal paediatric cardiac education If not what education do you currently offer Does this meet your paediatric cardiac education needs,support development and career progression 29/01/2014 21
Have you been able to offer your staff formal paediatric cardiac education 25% No yes 75% 29/01/2014 22
If not what education do you currently offer? 15% 57% 28% None In-House Education External Study day 29/01/2014 23
Does this meet your paediatric cardiac education needs, support development and career progression 25% 13% 62% No Short Term Yes 29/01/2014 24
Action PCNA Symposium 4 th Dec 2002 - focus on education Included: Lectures: Flexible learning and assessment Helen Langton (Associate Dean Coventry University) Inter-professional Education Dr. Vin Diwaker (Consultant Paediatrician / Post Grad Clinical Tutor) Focus Groups: Preferred methods/ style of learning Curriculum content Competency development Career pathway development 29/01/2014 25
Action (cont.) Development of a Business Proposal in an attempt to gain funding Utilising data gathered from: Supporting Evidence - National Documents TNA SNA Focus Groups 29/01/2014 26
Distribution of Proposal (Jan 2003) Department of Health Modernisation Agency British Heart Foundation Children s Heart Federation Local Workforce Confederations Chief Executives & Directors of Nursing Primary Care Trusts Strategic Health Authorities Specialist Commissioning for Children s Services National Patient Safety Agency Royal College of Paediatrics and Child Health Constructive Dialogue and Clinical Accountability Nursing and Midwifery Council Royal College of Nursing Open University UK Healthcare Partnership 29/01/2014 27
Factors influencing modernisation of the workforce Skills Escalator (DoH) Skills for Health, Sector Skills Council Competence Frameworks Knowledge Skills Framework Competence Frameworks Agenda For Change Working Together/learning Together (DoH) National interprofessional education programme (PCNA/BCCA) 29/01/2014 28
Skills Escalator allows employee to move up career ladder at own speed as far as they would like to go Consultant Roles Advanced Skills and Roles PhD MSc Senior Registered Practitioner PGDip Professional/Specialist Skills Registered Practitioners Degree Foundation Course Health Care Support Worker Diploma NVQ Pre-registration curricula Assistant Practitioners NVQ Level 1 Interprofessional learning and development is based on requirement of the role and career stage
Progress - 2005 Coventry University Agree input for accreditation Centre of Excellence in Teaching and Learning (CETL) Centre for Interprofessional e-learning (CIPeL) Formal collaboration agreed British Congenital Cardiac Association (BCCA) Allied Health Professionals Children s Heart Federation (CHF) 29/01/2014 30
Overall Aim of National Paediatric Cardiothoracic Education Programme To develop an inter-professional paediatric cardiothoracic education strategy that promotes and supports mutual learning within the clinical team 29/01/2014 31
What is aim of the pathway? National/? International Interprofessional Accessible Flexible Innovative Blended Learning E-based 29/01/2014 32
Why approach CPD in this way? Difficulty accessing traditional programmes Geographical Work pressures Shifts Family/other commitments Current/previous programmes uniprofessional Very few programmes available Teamwork 29/01/2014 33
Design Flexible, accessible Modular, career pathway Degree to Post Graduate Diploma level Distance learning, e-based,?summer camps Clinical competences Practical placements in own area / trust Sharing resources with other professional groups 29/01/2014 34
How? Interprofessional all professionals involved in the care of these children Blended learning styles E-based Patient Journeys Virtual learning sets Talking Heads Didactic teaching Via Telemedicine / videoconferencing Modular Follows Career pathway/ Skills escalator 29/01/2014 35
Skills Escalator Pathway Design PG Diploma 12 weeks 12 weeks 12 weeks Pre-requisite Single Module Degree Level Basic anatomy and physiology e based package Core skills Clinical examination ECG/Echo/CPB/radiology Double Module 24 credits Part 1 Scheduled/unscheduled care Simple CHD Part 2 Scheduled/unscheduled care Complex CHD Single Module 18 credit points Work Based Learning Single Module 18 credit Options Module 29/01/2014 36
Modules Prerequisite Module Basic anatomy and physiology Core competencies Clinical Examination ECG/Echo/Radiology Cardiopulmonary bypass http://www.cancernursing.org/ 29/01/2014 37
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Content of 1 st PGDip Module Basic embryology Morphology Pathophysiology Presentation and physical signs Investigations Non-invasive Invasive Indications for Treatment Simple then complex CHD Treatment options Medical Surgical Interventional Current Outcomes Standard outcome measures Quality of Life Social and family issues 29/01/2014 40
Delivery of PG Dip Modules Patient Journeys For example Callum s Journey Core Curriculum Friday Afternoon Teaching Face to face Via Live Videoconferencing Or via web retrospectively http://www.cardiacmorphology.com/ 29/01/2014 41
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Progress 6 patient journeys at final draft stage More working group members being identified Resources available Material produced by the experts for the prereq. module (from core curriculum) Scoping Internationally 29/01/2014 43
Next Stage Module/programme approval with Stakeholder Event Helen Langton CIPeL secondment Develop e-based material Higher Education Authority (HEA) bid Web designer British Heart Foundation (BHF) bid Collaborative with BCCA 29/01/2014 44
Summary Exciting, Innovative Approach to Paediatric Cardiothoracic Education Standardise care Improve quality of care Enhance teamwork Improve understanding of others roles? Reduce morbidity/mortality 29/01/2014 45
Any Questions 29/01/2014 46