VOL: 97, ISSUE: 12, PAGE NO: 45
Angela Artley, BSc, DipN, RGN, is a nursing development sister, South Tees Acute Hospitals NHS Trust
Janice Menhennet, SEN, RGN, CertEd, is a practice development nurse, South Tees Acute Hospitals NHS TrustAccording to Thornley (1997), health care assistants (HCAs) now carry out a number of nursing duties, such as taking observations and obtaining specimens, with 'little or no supervision' more than half the time. This article records how a practice development team standardised a system of training and education for HCAs as an alternative to formal NVQ training.
According to Thornley (1997), health care assistants (HCAs) now carry out a number of nursing duties, such as taking observations and obtaining specimens, with 'little or no supervision' more than half the time. This article records how a practice development team standardised a system of training and education for HCAs as an alternative to formal NVQ training.
The aims of the programme were to:
- Develop a systematic framework of education and training which would support and complement the nurses' work;
- Create uniformity of practice;
- Make the best use of the HCAs' skills for the benefit of patient care;
- Introduce a flexible approach to meet the changing needs of the organisation.
The practice development team and senior management and first-line managers throughout the division contributed to the design of the programme and agreed the activities HCAs should perform. The programme includes open learning - with written material - and a series of seminars to support the teaching package. It is used as an induction programme for new recruits and a resource pack for existing staff.
The teaching pack
The teaching pack covers 84 care activities in which HCAs would assist nurses. It outlines the clinical procedures they could be expected to perform after a period of training and supervision, from monitoring blood pressure to removing urinary catheters.
A rolling teaching programme was introduced to ensure a sound knowledge base, concentrating on topics specifically related to these care activities. For example, mobility was addressed during seminars on tissue viability and total patient care. The programme now links up with NVQ in care levels II and III.
The seminars use a variety of techniques, such as role play, group discussions and reflective exercises. Once competency has been achieved, participants are reassessed after a year to ensure that their skills are up to date and of a required standard.
Evaluation of the programme
An audit tool was designed to evaluate the programme's effectiveness. To date, the results have shown an acceptable standard of performance in every care activity.
In 1999, discussions with key members of the NVQ care team explored the issue of accreditation of prior achievement for those who had completed the HCA programme. This required a programme redesign: for example, evidence log sheets were introduced and each care activity was analysed to establish which NVQ unit it linked to. Finally, an assessment tool was designed.
It was then agreed that each HCA applying for NVQ Level II after completing the induction programme would be individually assessed, resulting in a reduction in the time taken to complete the NVQ.
Nursing shortages and a greater emphasis on quality in recent Department of Health documents (1999) highlight the need for organisations to be flexible and creative in their use of HCAs and approaches to education and training. This will allow nurses to increase their professional status and give them more time to concentrate on the key caring elements of their roles.