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Policy Information

Nursing and Midwifery

Published: 25 July 2019
From: Department of Health

Nursing Policy

The Office of the Chief Nursing Officer (CNO), part of the department, works to shape nursing and midwifery policy around the needs of the health service.

The Strategy for the Office of the Chief Nursing Officer (CNO) provides the necessary direction for the Office in supporting the nursing and midwifery professions and maximising their contribution to health policy. Most importantly, the Strategy's ultimate aim is to help ensure that patients receive the best possible care.

The initiatives below aim to:

  • embed the values of nursing and midwifery
  • stabilise the nursing and midwifery resource
  • maximise nursing and midwifery outcomes
  • measure the impact of nursing and midwifery

These initiatives are fully integrated. Once implemented, they have the potential to revolutionise the delivery of nursing and midwifery services within the community and acute health services.

Values of Nursing and Midwifery

The Values Initiative is led by the Chief Nursing Officer and the Department of Health, in partnership with the Office of the Nursing and Midwifery Services Director, the Health Service Executive (HSE) and the Nursing and Midwifery Board of Ireland.

A national consultation process asked nurses and midwives to identify, agree and commit to a set of core values that underpin their practice in Ireland. Values are ingrained principles that guide the actions of nurses and midwives.

Three core values were identified by this consultation process:

  • compassion
  • care
  • commitment

The consultation process produced a position paper. Developed in collaboration with the HSE and the Nursing and Midwifery Board of Ireland, this paper describes the core values underpinning and guiding the practice of nursing and midwifery in Ireland.

These values and their associated behaviours are the essence of nursing and midwifery practice. They form the basis for professional decision-making and actions. Taken together, these values represent the unique contribution of nursing and midwifery to safe patient care.

The HSE and the Nursing and Midwifery Board of Ireland are committed to supporting nurses and midwives to practise these values. The values are endorsed and supported by the Office of the Chief Nursing Officer.

Learn more about the core values.

Nursing and Midwifery Performance Indicators

Significant investment is being made in nursing and midwifery. It is therefore important to measure the outcomes and impacts of nursing and midwifery initiatives on patients.

To do this, the department has developed a framework for national performance indicators for nursing and midwifery. This ensures that their development, prioritisation, endorsement and monitoring is standardised.

Learn more about the framework.

Taskforce on Staffing and Skill Mix

A framework to determine the staffing and skill mix requirements for the nursing workforce was also developed. This means a significant change of emphasis, designed to put patient needs first, in calculating the number and type of nurses needed to work on each ward.

Instead of matching the number of nurses to the size of the ward, this framework matches nurses to the type and number of patients on the ward, and their needs.

The framework is equally focused on creating a healthier and more attractive work environment for staff by stabilising the nursing resource and providing for fairer workloads, a critical factor in recruiting and retaining this vital resource.

Phase One

Phase One focused on the development of a Framework for Safe Nurse Staffing and Skill Mix in General and Specialist Adult Hospital Medical and Surgical Care Settings in Ireland.

The Phase One Pilot, which took place in six hospital wards, delivered significant benefits.

These benefits include:

  • an increase in the amount of time the Clinical Nurse Manager spent in supervision, with resulting improvements in staff perceptions of the quality of care delivered, and a relative increase in staff perceptions of support received from nursing leadership
  • an overall decrease in patient length of stay to 0.5 days
  • a reduction in missed care events (referred to as Safety CLUEs), from 75% of nurses reporting that at least one necessary item of care was left undone due to lack of time on their last shift, to 32% following the framework's implementation
  • a reduction in the requirement of one-to-one enhanced care, or 'specialling' for patients by more than 70%
  • substantial reductions in the use of agency staff, in some cases up to 95%
Phase Two

The focus of Phase Two of the framework is on the Emergency Department and their specific needs in relation to the nursing team.

Developing graduate, specialist and advanced nursing and midwifery practice

A growing body of evidence shows that advanced nurse and midwife practitioners make a substantial and positive contribution to the management of long-term conditions. They can improve patient access to services and reduce waiting times, while delivering high quality healthcare.

As senior decision makers, advanced nurse and midwife practitioners undertake a comprehensive advanced physical and or mental health assessment of patients with complex healthcare needs, including those in crisis. They can interpret the results of different assessments and investigations to make a diagnosis, and plan and deliver care.

As team leaders they can confidently and competently make ethical, evidence-based decisions and interventions. They can use appropriate therapies when faced with complexity, and assess and manage the risk associated with these decisions.

The policy aims to create 700 advanced nurse practitioners by 2021, to meet service needs and contribute to addressing the current challenges in service provision.

Learn more about the Policy on the Development of Graduate to Advanced Nursing and Midwifery Practice.

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Policy