Improving the quality of nursing appraisal to meet revalidation

Revalidation pilot site

Dr. Lyn (Carolyn) Middleton, Senior Nurse

Overview of session y ABUHB – overview of pilot engagement.

y How do you quality assure the nursing appraisal process?

y How can you monitor nursing development through appraisal?

y How can you ensure all nurses are engaged in effective appraisal?

y Top tips for nurse managers in delivering appraisal.

y Looking forward to revalidation: developing pilot site experiences.

Aneurin Bevan University HB

Pilot engagement

• ABUHB was the only Welsh pilot site & had the largest UK pilot participation.

• ABUHB employs over 4000 registrants. • 1000 eligible for the pilot. • 888 enrolled into the pilot. • 813 completed the whole process:

Includes: General Adult / Paediatrics (hospital & community) / Midwives / LD / Mental Health / Practice Nurses

y ABUHB = >38% of the entire UK pilot cohort

How do you quality assure the nursing appraisal process?

What is quality?

The dictionary definition of quality relates to a degree of ‘goodness’ or ‘worth’.

It is a subjective description which underlines that quality is difficult to define and thus measure.

How do you quality assure the nursing appraisal process cont.

Defining Quality

Improving Quality

Quality Assurance

Measuring Quality

Defining Quality means developing expectations or standards of quality. A good standard is reliable, realistic, valid, clear, and measurable. Improving Quality uses quality improvement methods (problem solving, process re-design) to close the gap between the current and the expected level of quality defined by the set standards. Measuring Quality consists of quantifying the current level of performance or compliance with expected standards. When standards define quality, measuring quality requires assessing the level of compliance with standards.

How do you quality assure the nursing appraisal process cont.

Appraisal PDD Confirmation

Organisational structure Roles and responsibilities

Organisational processes

Standards, rules and guidelines

Methods, techniques and tools.

How can you monitor nursing development thorough appraisal? Monitoring nursing development can be achieved through aligning revalidation and annual review:

y 450 practice hours y 40 hours of CPD (20 participatory) y 5 examples of feedback on practice y 5 reflective accounts y PDD y Confirmation

450 Practice Hours

40 Hours CPD (20 participatory)

5 Examples of feedback on practice

5 Reflective accounts What was the nature of the CPD / feedback activity? Feedback on practice – compliment from a patient.

What did you learn? The patient reported that she had ‘not been believed’ in previous attendances in clinics in relation to her health problem. She had felt ‘brushed aside’, but when attending the nurse led clinic, she reported that she felt that during the consultation I had given her time, was empathetic and most of all she reported feeling that she had been believed. I learned that by listening to the patient, she felt valued and respected and it was possible to build a relationship with the patient and it helped me really understand the patient’s experience and start to generate a treatment plan.

How did it change your practice? I remember a quote that I learnt years ago; ‘Pain is what the patient says it is….’ (McCaffery 1968), The experience reinforced the importance of adopting a truly holistic approach to patient assessment, beginning with listening and believing the patient in order to develop an appropriate treatment plan to both the clinician and the patient. Co-production is the delivery of care based on effective information exchanges between the patient and the healthcare professional, also valuing patients and treating them with dignity is essential, dignity is about treating people with worth, respect and value. I will always endeavor to adhere to this in order to provide the best possible care for patients.

How is this relevant to the code? Prioritizing people – treat people with kindness, respect and compassion. Avoid making assumptions and work in partnership with people to make sure you deliver care effectively.

Professional Development Discussion

PDD is a means of: y Assessing knowledge and understanding of the learning

undertaken. y The impact the learning has had on the registrants practice

and specifically on their delivery of patient care. y How the learning undertaken relates to the code. y The PDD helps to bridge the theory / practice gap.

Confirmation

Aligning Revalidation & PADR Annual progress towards the triennial review

Ensuring all nurses are engaged in effective appraisal?

Top tips for nurse managers in delivering appraisal?

Key Message

Key Message

Key Message

Looking forward Looking forward to Revalidation ‘going live’, ABUHB will build upon the experiences of the pilot project.

‘It was lovely to let my manager see how I had learnt something that REALLY had an impact on my practice and the way I deliver care to my patients. I felt that in the past the PADR (personal appraisal development review) was a tick box exercise, this time it was great, I felt a real sense of achievement coming away’.

Thank you, Any questions…..