Nursing Strategy for South
Africa
Presentation to the
Portfolio Committee for Health
Cape Town
19 June 2007
1
Purpose
• To brief the Portfolio Committee for
Health on the draft Nursing Strategy for
South Africa
• To highlight priorities set within the
Strategy for Nursing in South Africa
• To give an overview of the Nursing
Strategy in relation to implementation of
the National Human Resources Plan
2
Introduction
• The Nursing Strategy as a critical part
of addressing the serious challenges
faced by nursing
• Proposal for its adoption as the basis
and a blue-print for strengthening
nursing in the country
• To highlight the significance of the
nursing profession in health care
delivery.
3
Introduction
• To highlight production and status quo
of nurses in the country
• Location within the HRH Plan and use
of nursing as tracer profession
• Location of nursing within Policy on
Health Sciences, Education and Training
• Ownership of the process by National
Health Council
4
Overview
• Purpose of a Nursing Strategy:
- address challenges faced by nursing
- articulate how nursing education & training,
practice, resources, social positioning,
regulation and leadership are planned &
linked in support of nation's health system
• Goal of a Nursing Strategy:
- achieve and maintain an adequate supply of
nurses and strengthen the quality of nursing
in the health system
5
Overview
• Intention:
- Develop a coherent approach towards dealing
with nursing challenges thus provide a common
platform
- Each stakeholder to address issues that affect
their core business
• Strategy must therefore be a unifying
platform explicitly addressing all nursing
issues
6
Overview
• Central to the Nursing Strategy:Good quality education and training
- Nursing practice (providing an enabling
environment for nursing service delivery)
- Good nursing leadership in all aspects of
nursing
- Social positioning and better image of nursing
- Resources for nursing (promote accessibility of
nursing to all South Africans)
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Perspectives On Nursing
• Largest category of health professionals
• Responsibility of bringing health services
to all communities
• Issues associated with nursing workforce
particularly complex & dynamic
• Many documented challenges - education
right through to migration
• Serious problem of resources especially
infrastructure related
8
Fundamental Issues
• Nursing in a Changing Health System
• Nursing as a Career of Choice
• Regulating nursing
• Educational qualifications
• Scopes of Practice
• Managing the Nursing Workforce
• International/global influences
9
Strategic Focus Areas
• Nursing Practice
• Nursing Education & Training
• Nursing Leadership
• Values in Nursing (Professionalism)
• Nursing Regulation
• Resources for Nursing
• Social Positioning of Nursing
10
Strategic Thrust
• The strategy to be broad enough to address
challenges, leveraging on all possible
networks i.e.
- How nursing can remain a profession that
offers access to all whilst lifting the bar in
terms of quality education and training
- Finding ways of embracing the benefits of
globalization in a manner that improves
nursing
- How nurses can improve the image of their
profession
11
Implementation Framework
• Similar approach to HRH Plan
• Strategies proposed with understanding that
further development & implementation of
each strategy will require unifying efforts of
all stakeholders
• Primary responsibility & output measures
for each strategic focus identified.
• Cost implications of strategies to be
considered by National Health Council
12
Conceptual Roles
• Sponsoring (government)
• Championing (partners)
13
Concept of Sponsoring
• Provide strategic direction & leadership for the
implementation
• Take the lead in communicating the strategy
• Promote joint ownership of the strategy
amongst stakeholders
• Identify and mobilize resources and support
required
• Monitor and evaluate progress of the
implementation of the strategy
14
Concept of Championing
• Putting in place a mechanisms to popularise
the objectives of the strategy
• Driving the implementation of the education,
training & related aspects of the strategy
• Identifying major policy implementation gaps
& engagement with Department of Health
• Assisting and supporting the DOH throughout
the implementation process
15
Challenge for Nursing Collective
discussed during consultation
• Critical contextual analysis of the quality,
delivery & associated factors to education
• Analysis of strategic role of nursing institutions
• Increasing the pool of educators & nursing
scientists
• Nurturing & entrenching the culture of
research, writing & publishing in nursing
• Ensuring innovation is entrenched in nursing
• Defining practically the social positioning of
nursing & addressing values
16
Key Issues raised during
consultation
• Education & Training
- Qualifications
- Educators
- Research
• Scopes of Practice
- Repositioning of nursing
- Values & human rights approach
• Nursing workforce planning
• Regulating the nursing workforce
17
Key Issues Raised continued
• Implementation of new Scopes of Practice
• Ensuring good standard education & training
- Clinical & theoretical competence
- Integration of theory and practice
- Research
• Recruitment and selection of learners
• Capacity in nursing {capacity understood as ability of
People, organizations and society to manage their
affairs
successfully
• Nurse Educators & Leadership
18
Implementation aspects of the
Nursing Strategy
Strategic Focus Area 1: Nursing Practice
• Establishing and enabling legislative
environment
– Implementable policies in place
– Legislation aligned to nursing practice
– Policy on public nursing agency in place
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Implementation aspects of the
Nursing Strategy
• Improved quality of nursing practice /
promote and assure quality of care
– Finalized scope of practice in place
– Evidence based practice
– Operational plans in line with service
delivery needs and resources
20
Implementation aspects of the
Nursing Strategy
• Improve skills and competency levels of
nurses in accordance with the
competency framework and revised
scope of practice
–
–
–
–
Competency assessment system in place
Skills plan in place
Skills Development Programme in place
CPD activities identified and aligned to
revised scope of practice
21
Implementation aspects of the
Nursing Strategy
• Develop collaborative partnerships with
key stakeholders
– Identify stakeholders and their roles to
participate in the national nurse
production, placement and retention
strategy for nurses
– Adoption of National Nursing Strategy for
South Africa
– Sustained partnership
22
Implementation aspects of the
Nursing Strategy
• Develop Nursing Staff establishments
that are responsive to service delivery
needs
– Nursing staffing norms and standards in
accordance with service needs in place
– Career paths for all categories in place
especially clinical specialties
– Retention strategy implemented
23
Implementation aspects of the
Nursing Strategy
• Strengthen role of Nursing in Health Service
Delivery
– Locate nursing strategically at provincial, local and
international levels
– Ensure and approve quality of supervision
– Build quality nursing teams
– Upgrade current enrolled and professional nurses
in line with new scopes of practice
– Establish provincial and national forums for
sharing best practices on nursing
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Strategic Focus Area 2 –
Education and Training
• Improve quality of nurse educators
– Improved conditions of service
– Ensure all nurse educators appropriately qualified
and updated in current skills
• Ensure harmonization of education and
training
– Finalize recommendations of the Nursing SGB
through the SANC
– Nursing Education aligned with legislative
requirements, training linked to service needs
25
Strategic Focus Area 2 –
Education and Training
• Integrate practice and theoretical
knowledge
– Strengthen collaboration with nursing
education institutions and service providers
– Provide capacity for mentorship and
preceptor programmes
– Ensure qualifications are aligned to needs
– Proper integration of practice and
theoretical knowledge
26
Strategic Focus Area 2 –
Education and Training
• Increased production of nursing
professionals
– Identify and accredit health facilities for
clinical education and training to increase
capacity to accommodate increased
production requirements
– Audit and increase training capacity of
nursing colleges and training courses
– Develop a recruitment and selection
strategy for young nurses
27
Strategic Focus Area 2 –
Education and Training
• Skills improvement
– Identify, develop and strengthen CPD
activities in line with the Nursing Act
– Align CPD to clinical outcomes
28
Strategic Focus Area 2 –
Education and Training
• Recruitment and Retention of Nurse
Educators
– Develop sustainable retention strategies
– Career pathing and succession planning
– Develop quality management systems at Nursing
Education Institutions
– Audit quality of nursing education
– Audit quality and skills of nurse educators
– Improve capacity of Nursing Education
Institutions
29
Strategic Focus Area 2 –
Education and Training
• Improve quality of nursing education
– Nursing Education Institutions to be
integrated into higher education institutions
– Facilitate registration of nursing education
institutions as FET and HET institutions
– Review the role of nursing auxiliaries
within the health care system
30
Strategic Focus Area 2 –
Education and Training
• Ensure implementation strategy for
recognition of prior learning (RPL) for
nurses
– Establish RPL assessment centres in
provinces
– Implement RPL in all provinces
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Strategic Focus Area 2 –
Education and Training
• Promote professional development for
nurses
– Improve selection criteria for trainees
– Conduct pre-selection interviews
– Conduct pre-selection medical assessment
for prospective students
– Develop a plan for training and re-training
in relation to reviewed scopes of practice
32
Strategic Focus Area 2 –
Education and Training
• Improve research capacity of nurses
– Conduct extensive training in research
methodology
– Facilitate nursing research amongst
academic institutions and health facilities
33
Strategic Focus Area 3 –
Nursing Leadership
• Identify and position nursing leadership
in all aspects i.e. registration, practice,
education and labour
– Identify and position nursing leadership
strategically in organizational structures at
all levels i.e. nationally and internationally
34
Strategic Focus Area 3 –
Nursing Leadership
• Enhance nursing leadership capacity to ensure
good governance at all levels
– Audit of skills and competencies, training and
development plan
– Leadership development programmes in place
– Recognize, utilize and reward expertise
– Develop and implement mentorship and coaching
programmes
– Deploy nurses to situations which enhance and
develop their leadership capacity
35
Strategic Focus Area 3 –
Nursing Leadership
• Identify and nurture potential and
emerging nurse leaders
– Increased growth of leadership numbers of
nurses involved in academic issues
pertaining to health and nursing
36
Strategic Focus Area 3 –
Nursing Leadership
• Attract young nurses to nursing
academia
– Encourage academic leaders to positively
influence young nurses into academic
debates on health systems
37
Strategic Focus Area 4 –
Nursing Regulation
• Implement the Nursing Act, 2005 (Act No. 33
of 2005)
– Establish the Nursing Council in terms of the new
Act
– Regulate registration and licensing of nurses
– Regulate scopes of practice, nursing education
– Implement community service for nurses
– Introduce CPD for nurses
– Regulate ethical code and conduct of nurses
38
Strategic Focus Area 4 –
Nursing Regulation
• Ensure high standards of professional
self governance
– Adherence to corporate governance by the
professional regulator (SANC) in
accordance with the new Nursing Act
– Perform periodic governance audits
• Ensure quality service and protection of
the public
– Educational programmes, professional
values responsive to public needs
39
Strategic Focus Area 4 –
Nursing Regulation
• International Benchmarking
– Policies compare with international best
practice
– Nursing legal framework benchmarked and
updated regularly
40
Strategic Focus Area 5 – Social
Positioning of Nursing
• Restore the image of nursing and
maintain professionalism
• Improve understanding of political focus
of the country
• Improve social infrastructural support
i.e. accommodation, EAP and housing
subsidies
41
Strategic Focus Area 5 – Social
Positioning of Nursing
• Promote nursing as a career of choice
– Market nursing as a career of choice
– Create attractive employment opportunities
for nurses
– Recruitment and marketing strategy for
nursing implemented
42
Strategic Focus Area 6 –
Resources for Nursing
• Ensure safe nurse practice with
appropriate nursing resources
– Guidelines on safe nursing practice
• Ensure sustainability of nursing
– Adequate funding of nursing services
– Attractive incentives and remuneration
structures for nursing posts
– Adequate provision for continued education
and development
43
Strategic Focus Area 6 –
Resources for Nursing
• Quality assurance of clinical learning
facilities
– Audit of clinical facilities
– Assess quality of learning facilities and
upgrade
– Enabling accreditation processes to take
place internally and externally
– Provide adequate funding for nursing
research
44
Strategic Focus Area 6 –
Resources for Nursing
• Improve workforce planning
– Work-study to address needs of institutions
with the illnesses of staff and HIV in mind
to review the staff establishment of health
institutions
– Develop Human Resource Plans (Nursing)
institutional, district, provincial and
national level
– Develop capacity for Human Resource
Planning
45
Strategic Focus Area 6 –
Resources for Nursing
• Developing nursing academics / nurse
educators
– Develop a National Health Sciences
Academic Programme
46
CONCLUSION
In conclusion the Department of Health
looks forward to the endorsement of the
Draft Nursing Strategy for South Africa
with a view of developing similar
strategies for other health care
professionals so critical for effective
health
care delivery within the country
THANK YOU
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