Learning from Ireland: expanding the role of nurses and midwives to improve health outcomes

A survey that included 32 countries in Europe in 2015 found that more than two thirds had extended the official scopes of practice of nurses in primary care. Ireland is one of those countries. 

As of April 2016, a total of 894 nurses and midwives in the country were registered to prescribe medicinal products. This includes 193 advanced nurse practitioners in 53 specialties and 8 advanced midwife practitioners in 6 specialties, all registered with the Nursing and Midwifery Board of Ireland. It is not necessary to be an advanced practitioner to prescribe. 

While the overall number of prescribing nurses and midwives has remained small in numerical terms since the introduction of the regulations in 2008, the impact has been significant. An independent evaluation reported that expanding nurse roles in Ireland has led to, among other things: 

  • improved continuity of patient care;
  • reduced admission rates;
  • reduced workload of doctors;
  • reduced waiting times for services;
  • improved family and carer satisfaction; and
  • increased professional development and satisfaction of nurses and midwives

To read more about expanding the role of nurses and midwives on the WHO Europe website go to: WHO/Europe | Health workforce – Learning from Ireland: expanding the role of nurses and midwives to improve health outcomes

Nurses and midwives strengthen health systems

In the WHO European Region, nurses and midwives – an estimated total of 7.3 million – make up the majority of health care professionals, delivering health services to people of all ages. A recently published compendium of good practices in nursing and midwifery illustrates the fundamental importance of these health care professionals to public health and well-being. Its 55 case studies from 18 countries provide examples of how nurses and midwives enhance health.

While the case studies illustrate good practices and innovations, the compendium reveals that they are not always well documented, rigorously evaluated, scaled up or shared within or among countries in the Region. Consequently, they have limited influence in decision-making at national or local level, and the contribution of nurses and midwives to research and collecting evidence and in the design of services and technology is also limited.

To read more about the role of nurses and midwives in health systems on the euro.who.int website.

The changing role of nursing

The latest issue of the Eurohealth Observer, which is produced by the European Observatory on Health Systems and Policies, includes a range of articles on nursing. These cover the changing role of nursing, the state of nursing in the European Union, nurse migration, EU accession and nursing, and whether there should be an EU framework for nurse education.

To download the Eurohealth Observer from the euro.who.int website

eHealth guidelines for nurses

The EU-funded Ens4Care project has developed five guidelines for European nurses and social workers on how to use eHealth for:

  • promoting a healthy lifestyle and prevention
  • clinical practice
  • skills development for advanced roles
  • integrated care
  • nurse ePrescribing.

The ENS4Care network brought together 24 partners from all over Europe, with a mix of professional associations in nursing and social care, nursing regulators and unions, informal carers, patients, researchers and research communities, civil society representatives and industry. They collected a total of 122 existing good practices of using eHealth tools by nurses and social workers at both national and regional levels.

To find out more about the eHealth Guidelines and the project itself, go to the ens4care.eu website

Finding enough health professionals for the future

According to the latest WHO/Europe core health indicators for 2015, the number of physicians and nurses in the Region may not be sufficient to cover the future health needs of an ageing population, despite an increase of around 10% in the past 10 years. The report “Core health indicators in the WHO European Region 2015, special focus: human resources for health” also points out that physicians in Europe are getting older: almost every third physician is over 55 years old. In addition, the skills-mix of health professionals needs to change: for example, the proportion of general practitioners (GPs) among all physicians should be increased.

For more information about the report, on the euro.who.int website

Training for health professionals

The EU has developed some training programmes for health professionals with the specific aim of improving health services for migrants and ethnic minorities. These programmes have been developed in collaboration by institutions in Spain, Denmark, Italy and the Netherlands and have been tested in these countries as well as in Poland, Romania and Slovakia. They include specific modules for the Roma people, as the most important ethnic minority in the EU.

The final package of training should be available by January 2016 and for more information, click here on the ec.Europa.eu website

Movement of health professionals around the EU

This article ‘Health professional mobility in the European Union: Exploring the equity and efficiency of free movement’ looks at the effects of health professional mobility in terms of efficiency and equity implications at three levels: for the EU, for destination countries and for source countries. The analysis suggests that there is a risk the free health workforce mobility disproportionally benefits wealthier member states at the expense of less advantaged ones. It can also lead to a redistribution of resources from poorer to wealthier EU countries.

To download this article by Irene Glinos, click here on www.healthpolicyjrnl.com