Central Finland Health Care District

Nursing Strategy
2015–2018

Patient
comes first
– Patient-orientated,
evidence-based nursing
Strategic framework
for nursing
Our values Our vision
-- Happy patients Patient comes first
-- Responsibility over – patient-orientated,
patients and working evidence-based nursing
environment
-- Constant development
-- Respect for collaboration

Strategic goals
1. Developing patient-orientated operating models
2. Evidence-based, standardised core functions
3. Thriving, competent and committed staff
4. Engaging management
Nursing strategy
The nursing strategy for 2015—2018 draws from the Health Care
District’s strategy for 2015—2020 as well as the nursing strategy for
2011—2013.

The nursing strategy promotes and complements the strategy for

Health Care District, outlines areas of focus and leads the way towards
the new hospital in 2020.

It brings clinical nursing, research and development, practical training

supervision and nursing management together.

Nursing draws from our values

-- Happy patients
-- Responsibility over patients and working environment
-- Constant development
-- Respect for collaboration
The nursing strategy consists of aims (vision), four strategic goals and
concrete milestones to help us reach those goals, as well as actions,
performance indicators and assessment.

Our vision is patient-oriented, safe and evidence-based nursing

which provides health benefits for our patients. “Patient comes first”
stands for the patients’ needs being the basis for all examinations,
nursing and rehabilitation. We encourage our patients to take an active
role in health promotion and treatment.

Reaching our goals is made possible by constant assessment,

development and follow-up actions based on data collected from our
operations. The executive group and quarter-yearly nursing manage-
ment meetings will assess the realisation of our goals with the help of
data collected from the performance indicators as well as evidence-
based information.
Patient first
Goals
-- Safe and trustworthy health care is based on each patient’s individual
needs and ability to function, not forgetting their family.
-- Patients take an active role in health promotion and treatment.
-- Treatment and service plans are revised in each treatment unit, paying
close attention to the overall situation.
-- Patients’ experience of health care is positive.

Actions
-- Health care is based on each patient’s individual treatment or service plan,
revised in each treatment unit and in collaboration with patients and their
families.
-- Patients are provided with the chance to take part in their day-to-day care.

Performance indicators and aims

-- Central Finland Health Care District patient feedback form (section: the
patient’s experience of health care), average score of 4/5.
-- Decrease in objections and complaints by patients and/or their families on
health care.
Developing
patient-oriented
operating models
The development of operating models is based on patient-
oriented nursing organised by the bedside of each patient.
Resources are distributed according to the patients’ needs
and nursing intensity. When handling matters concerning
the patients’ treatment, information flow is guaranteed by
measures taken by the organization.

Goals
-- Standardised practices contribute to developing patient-oriented operating
models.
-- Patient-associated workload is assessed according to the patients’ needs
and nursing intensity.
-- The work time allocation of the nursing staff is reviewed on
a regular basis.
-- The rate of direct care is 60 % in wards and 75 % in outpatient
units.
-- All units utilise the Isbar protocol during handovers.
 
Actions
-- Nursing and support services are separated.
-- The work time allocation is reviewed.
-- Information systems are effectively utilised.
 
Performance indicators and aims
-- Time tracking is carried out each year.
-- Hospital bed-day / appointment = produced service / labour input
-- Sample of patient records: aim for Isbar utilisation rate is 100 %.
Evidence-based,
standardised core functions
of nursing Need for care,
diagnosis
Core functions and practices are
built on research-based evidence.
Standardised practices and
turning strategy into action help
Care needs
us reach our goals for nursing

OF NURSING
assessment (the
efficacy. This will be made health, condition,
diagnosis and
possible by strengthening our overall situation of
research expertise and reviewing a patient)

the organizational structure of = CONTENT OF

NURSING CARE
specialists as well as nursing
management.
 This chart illustrates the core functions of nursing in Central Finland Health Care District.
Our core functions include treatment, examinations and follow-ups for patients, medication,
promoting the ability to function, guidance, discharge and follow-up treatment. Documenta-
tion and registration go hand in hand with everything we do. Patient safety, patient-oriented
nursing, health promotion and active participation form the basis for all core functions.

Patient-oriented core functions of nursing

Kaija Heikura, Sari Viinikainen, Tuula Antinaho, Tuula Kivinen

Treatment
Execution Evaluation
plan

NURSING OUTCOMES
= EFFECTIVE CARE
Documentation, registration

Treatment, examinations, follow-ups

CORE FUNCTIONS

Medication (supply process and administration process)

Promoting the ability to function

Guidance

Discharge and follow-up treatment

Patient safety, patient-oriented nursing, health promotion and

active participation as the basis for core functions
Evidence-based,
standardised core
functions of nursing
Goals
-- All nursing practices and conventions are standardised and based
on evidence.
-- Our organizational structure of specialists is well-functioning.
-- Nursing guidelines are utilised.

Actions
-- Templates for documents and records are utilised.
-- The organizational structure of specialists is developed, making sure
duties and responsibilities are outlined.
-- The number of clinical experts is increased.
-- Training in evidence-based nursing is offered six times a year.
-- A nursing development day is arranged four times a year, and a
research day once a year.
 
Performance indicators and aims
-- Assessment of nursing documentation (Kaila & Kuivalainen©):
average score of 9.
-- HaiPro Adverse Event Reporting System: falls, pressure ulcers,
medicine. Aim: number of adverse events decreases.
-- Utilisation of guidelines: three new sets of guidelines each year.
-- Number of theses per year: doctoral dissertations (1), master’s
theses (4) as well as other theses.
 Needs Project
assessment plan

2010 2011 2012 2013 2014 2015

 New
hospital
Implementation plan and construction

2016 2017 2018 2019 2020

Thriving,
competent and
committed staff
Great human resource management and efforts to improve
the quality of working life make the nursing profession more
appealing. Investing in the well-being of employees, recruiting,
knowledge management and student supervision will bear
fruit. Enhancing the meaning and content of work as well as
flexibility in all life stages will contribute towards improved
well-being at work. Thriving, competent and committed staff
value and develop their professional competences.
Goals
-- Central Finland Health Care District is an inviting workplace.
-- The tasks of the nursing staff match their training.
-- Operational needs lead the way for professional development.
-- Student supervision is high-quality.
-- Workplace orientation is systematic.
 
Actions
-- Performance appraisals take place on a regular basis and highlight
competence.
-- Job rotation, work shadowing, internal mobility, mentoring programmes,
work supervision, training and workplace health promotion are carried out.
-- All units utilise standardised quality criteria for student supervision.
-- Orientation programmes are carried out in accordance with the protocol.

Performance indicators and aims

-- Applicants per open position, no less than 5 applicants per open position.
-- Performance appraisals take place no less than once a year.
-- Feedback from substitutes, grade: “good”.
-- Ensuring competence, grade: “good”.
-- CLES, average score of 8,8/10 + answers open-ended questions.
-- OPE (indicator for orientation), average score of 4/5.
Engaging
management
Nursing management plays a key role in managing multi-
professional operations dealing with patient care. It is based on
evidence, openness and engaging the hands-on professionals.
The director of nursing ensures we can reach our nursing goals in
cooperation with our committed, motivated and competent staff.
The director makes sure the training and competence of the staff
meet the requirements of patient care.

Goals
-- The director of nursing promotes high-quality, efficient and safe health
care services and their results.
-- Nursing operations are cost-efficient.
-- The director of nursing embraces the strengths of the staff in varying
health care operations, and promotes their well-being at work.
-- The director of nursing bases the nursing management on evidence.
-- The director of nursing has both competence and motivation to
management and development.

Actions
-- Feedback on nursing is reviewed on a regular basis, and it is utilised
in resource planning.
-- Follow-up data is utilised in decision making.
-- The director of nursing utilises job rotation, work shadowing, internal
mobility, mentoring programmes, work supervision and training to
develop leadership skills.

Performance indicators and aims

-- More development proposals for HaiPro Adverse Event Reporting
System, reviewing them with the staff.
-- Key ratios: operations and staff (Portti).
-- Produced service / labour input (Portti/Exreport)
-- Nursing intensity / nurse, optimal nursing intensity.
-- Feedback form for staff, average score of 4.
-- Feedback from substitutes, grade: “good”.
-- CLES, average score of 8,8/10 + answers open-ended questions.
-- Indicator for leadership competence, grade: “good”.
Illustration: JKMM Arkkitehti Oy | Layout: Zeniitti
www.ksshp.fi