Continuing education: Key to addressing changing patient needs

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By Michael Oreskovich

Ongoing nursing education is the key to ensuring that clinical staff continues to keep up with increasing patient demands at Runnymede Healthcare Centre. According to Ontario’s Action Plan for Seniors, in 2017 people over the age of 65 will outnumber children under age 15 in the province for the first time. As one would expect, older patients require more support from the healthcare system and are likely to have more complex needs compared to other age groups (Canadian Medical Association, 2016). This represents an unprecedented challenge to healthcare organizations across the country.

Specializing in rehabilitation and medically complex care, Runnymede is profoundly affected by the shift in patient demographics and complexity. The majority of its patients are over the age of 75 and in 2015/16, its patient complexity was ranked second highest in the Toronto Central Local Health Integration Network (TC LHIN). “Continuing education is essential for us to meet the increasingly complex needs of our patients,” said Runnymede’s VP of Patient Care, Chief Nursing Executive and Chief Privacy Executive, Raj Sewda. “We saw our RPNs (registered practical nurses) as a vital resource with great potential to enhance the quality of our patient care, so we invested in them with education to help them work to their full scope of practice.”

Both RPNs and registered nurses (RNs) learn from the same body of healthcare knowledge, but RNs study for a longer period of time (College of Nurses Ontario, 2014). Because of this, RNs provide independent care for the more complex, high-risk patients and guide colleagues in building their capacity and expertise. When RPNs are trained to work to their full scope of practice, they are more independent when providing care to less-complex patients. In turn, this increases the time that both RPNs and RNs can spend providing independent patient care, therefore enhancing the patient experience and increasing the effectiveness of service delivery.

To further invest in patient care, Runnymede introduced a new position to coordinate the activities of all clinical educators, and she hit the ground running. “Surveys were conducted with RPNs to establish a baseline for their learning needs, and then we worked together to tailor our educational tools to meet those needs,” said Kim Deroo, manager, professional practice and education. Training consisted of online modules, hands-on workshops, speaker sessions and also included one-on-one mentorship from the hospital’s team of clinical educators.

Skill sets of RPNs were noticeably expanded as demonstrated by enhanced technical expertise including: initiation of intravenous (i.v.) therapy, performing tracheostomy care and peripherally inserted central catheter (PICC) line care. They also enhanced their skills pertaining to clinical assessments and interpretation of diagnostic results. “Another outcome we witnessed is enhanced critical thinking abilities for these nurses, which really benefits everyone and adds to the overall quality of collaboration with other members of the clinical team,” said Deroo. “Today, I’m really proud to say our RPNs work to their full scope of practice, rely much less on guidance from their RN colleagues, and spend more time providing care for our patients.”

In addition, the education has also improved the staff experience for the hospital’s RPNs. “Many of them told me that before receiving our nursing education, they didn’t fully realize the potential they had as healthcare professionals,” said Deroo. “Now our RPNs take more pride and ownership in what they do, and really appreciate the special investment that the hospital has made in their careers.”

Runnymede supports its “you first” strategic direction by empowering staff to perform at the peak of their abilities. Continuing nursing education addresses this priority and contributes to an outstanding patient experience. “Healthcare needs of our patients and the local community are increasing in volume and complexity, and we’re working as efficiently as possible to continue to meet this challenge,” says Sewda. “Supporting RPNs with ongoing nursing education so they can work to their full scope of practice is an example of how we support our staff in the delivery of high-quality care and become more responsive to patients’ needs.”

Michael Oreskovich is a Communications Specialist at Runnymede Healthcare Centre.