Providing Postgraduate Critical Care Nurse Education

Growing your own: Providing Postgraduate Critical Care Nurse Education in a Regional Environment.

North Coast Area Health Service

Abstract

The recruitment and retention of critical care registered nursing staff has become an important issue throughout Australia. It has been noted that this is a particular problem in rural areas^1,2. The implementation of a postgraduate critical care education program (PCCEP) has been identified as a key mechanism to address this issue³.  Despite this fact, the majority of PCCEP’s are conducted in metropolitan centres, limiting the ability of nurses working in regional centres to access these programs. In 2007 the decision was made to develop a PCCEP for registered nursing staff in The Tweed Byron Network.

A curriculum for a PCCEP was obtained from a metropolitan hospital in Sydney. The Curriculum was then modified to suit the needs of a rural environment and submitted to local universities for evaluation. The revised PCCEP curriculum was reviewed by local universities and allocated the equivalent of 2 subjects of advanced standing towards the completion of postgraduate critical care studies. 

In 2008 the inaugural PCCEP for the NCAHS was implemented in The Tweed Byron Network. A total of 23 registered nurses were enrolled in to this program. The evaluations for the first 6 months of the program have indicated favourable responses in regards to the methods of teaching and learning (91%) and relevancy of course work to their work place (87%). The implementation of a PCCEP is a viable mechanism to develop a skilled workforce in a regional critical care environment.

Aim

The aim of the program was to implement a PCCEP that attracted advanced standing towards the completion of a postgraduate critical care nursing program in a regional critical care environment.

Nature of the Problem

Regional areas of Australia are experiencing an increasing shortage of critical care nurses. It has been noticed that there are a decreased number of trained critical care staff being employed in critical care environments in the NCAHS. To date places in PCCEP’s have been somewhat limited to metropolitan centres, making it difficult for registered nurses working a regional environment to attend these courses. The implementation of a local PCCEP would be a beneficial in addressing this issue.

Extent of the Problem

Difficulties in the recruitment and retention of critical care registered nurses (RNs) have been identified as significant issues across Australia. This is a particular problem in rural areas^1,2.The National Review of Nursing and Nursing Education 2002 identified educational support as a key strategy in attracting nurses to specialty areas, such as critical care. The establishment of educational support programs for critical care nurses has also been supported by all Australian Health Ministers³.

Strategic Importance

The National Review of Nursing and Nursing Education 2002 identified educational support as a key strategy in attracting nurses to specialty areas, such as critical care.

The establishment of educational support programs for critical care nurses has also been supported by all Australian Health Ministers³.  Addressing the current shortfall in the supply of critical care nurses by building a sustainable health workforce is one of the key priorities for NSW Health (Strategic Direction 6).

Planning and Implementation

Curricular from major metropolitan teaching hospitals who conducted PCCEP’s were reviewed by critical care clinical nurse consultants and clinical nurse educators from the Tweed Byron Network. These curricular were analysed and modified to produce a curriculum for a PCCEP which reflected the needs of a rural environment. The revised curriculum was presented to local hospitals and universities for evaluation. An External Curriculum Advisory committee was established to review the content of the course and assessments.

Outcomes and Evaluation

The revised curriculum was evaluated by local universities as successfully meeting the criteria as for advanced standing for 2 university subjects. In 2008 the number of applications (n=28) for the course exceeded the number of available spaces (n=20). The retention rate of students has been greater than 80% for the first year. The evaluations for the first 6 months of the program have indicated favourable responses in regards to the methods of teaching and learning (91%) and relevancy of course work to their work place (87%). The PCCEP has been successful in increasing the number of locally educated critical care nursing staff and requests have been received to provide education to registered nurses outside of the Tweed Byron Network. If the current group of students successfully complete the requirements of the course the number of trained critical care nurses will increase by 16% in one intensive care unit alone.

Sustaining Change

In 2007 two critical care clinical nurse educator positions were made available to the Tweed Byron Network. These positions increased the number of staff able to provide education for the Professional Certificate of Critical Care which allowed this course to be developed. These are funded positions which will allow the course to continue.

The course has been accredited by the University sector and the New South Wales Nurses Association. Successful completion of the Professional Certificate in Critical Care counts as 2 subjects towards a postgraduate nursing degree. Successful completion of the course also entitles the applicant to claim for a continuing education allowance, which increases their take home pay. Both of these factors provide incentives for staff to enrol and complete the course.

Future Scope

The development of a rural PCCEP in The Tweed Byron Network has provided an example of how specialty based, postgraduate education programs can be successfully delivered in the regional setting. Consideration should be given to the development of postgraduate education programs for other specialty areas of nursing.

The implementation of formalised, post graduate, specialty based education programs can be undertaken in the regional environment.

References

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