WoW Project
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The WoW Resource Package
The WoW Resource Package is now available for you to view and use. If you click on the package above you will be able to access the package and associated tools which will assist you in your efforts to implement a collaborative nursing model (CNM) on your ward or unit.
The WoW Resource will:
- introduce the evidence for considering a CNM in your ward/unit
- provide guidelines for implementing a CNM in your ward/unit
- provide an audiovisual representation of nurses working collaboratively
- provide tools that can be used to support and evaluate a CNM.
What is the WoW project?
The Nursing and Midwifery Office commenced the Ways of Working (WoW) Project in mid 2010. The project will explore the ways in which nurses organise their clinical work.
What do we hope to achieve?
It is anticipated that outcomes from this project in NSW will include:
- more efficient use of nursing resources
- improved communication between staff
- improved patient outcomes
- improved support for staff new to an area of practice
- improved capacity to effectively utilise all skills within the nursing team.
What is happening now?
The WoW Project Manager conducted site visits and discussions with a number of nurses and other key stakeholders across NSW to gain an understanding of the variety of ways that work is organised at the ward/unit level.
A number of ways of working across NSW have been identified. These include patient allocation, task allocation, case management and team models.
The more collaborative approaches will help to build future nurses skills and capabilities.
The WoW Resource is being developed and will be released in early June 2011. The WoW Resource contains educational material, guidelines and tools to assist Nursing Unit Managers in their efforts to introduce a collaborative nursing model into their wards/units. It also includes a short film called Making it Real which showcases a nursing team working collaboratively over the course of a morning shift. The WoW Resource will be distributed to NUMs across the state and will also be available to view via the NaMO website.
When nurses work collaboratively in teams, team members need to have an understanding of the individual team member’s roles. To this end, a project to examine the EN and AIN role across the NSW public health sector has commenced.
There are a variety of skills and knowledge that underpin a collaborative nursing model and the next step of the project will be to identify opportunities to assist staff in improving their work environment and organisation, collaboration and communication.
Tools
WOW PowerPoint presentation
Building nursing teams for the future contains information supporting a collaborative nursing model.
Short Summary of the different ways that nurses use to organise their clinical work.
Sample schemata for team assignment
When allocating teams for a collaborative nursing model it is important to be flexible in the way the team is composed to allow for patient acuity, changes to skill mix and to cover untoward situations such as sick leave replacement. Some sample schemas for the shift staffing are available here.
Benner’s stages of clinical competence
When preparing the rosters for a collaborative nursing model it is important to divide the roster into levels of expertise. One good way to determine the level of expertise is to use the framework proposed by Patricia Benner (1984) – “Novice to Expert”. This framework is used widely and is acknowledged as an effective way to classify nurse skill acquisition. Patricia Benner’s framework is based on The Dreyfus Brother's 1980 work, "A Five-Stage Model of the Mental Activities Involved in Directed Skill Acquisition", also known as the "Dreyfus model of skill acquisition”
Conflict resolution flowchart
It is not unusual to have conflict in the workplace. In the event that conflict occurs in teams there should be a standard mechanism for dealing with it. Here is a sample conflict resolution flow chart which you might consider using.
How to:
- Conduct a values clarification exercise
All nurses should be given the opportunity to contribute to a shared vision for the wards/unit. Follow these instructions for conducting a values clarification exercise. - Conduct a claims, concerns and issues exercise
As part of the discussions about the WoW on the ward/unit it might be useful to conduct a Claims Concerns and Issues exercise to address any issues the staff might have about modifying or changing their current WoW.
Questionnaire
Nurse satisfaction with the model of care is pivotal to the success of the collaborative nursing model. The Nursing Workplace Satisfaction Questionnaire (NWSQ) was developed specifically to evaluate job satisfaction with a new model of team nursing (Fairbrother, Jones & Rivas, 2009). The tool is available to use for the project with the support from the authors. The NWSQ will be useful in evaluating the level of nurse satisfaction before and after introducing a new WoW.
- NWSQ
- Instructions for using the NWSQ
- Excel spreadsheet for entering and analysing questionnaire data
Surveys
The Nursing Teamwork Survey (NTS) measures the level of nursing teamwork in acute care settings. The NTS was developed and validated for use in the United States (Kalisch, Lee & Salas, 2010). Minor demographic changes were required for the Australian context. The NTS will be useful in evaluating the level of teamwork before and after introducing a new WoW.
- NTS short
- NTS long survey
- Instructions for using NTS
- Excel spreadsheet for entering and analysing questionnaire data
Useful links
Nursing and Midwifery Board of Australia – National competency standards for the registered nurse
Australian Nursing Federation – Competency standards for the advanced enrolled nurse
NSW Health – Working with AINs
NHS Institute for Innovation and Improvement – Sustainability
Clinical Excellence Commission – Enhancing Project Spread and Sustainability