Nursing Practice Development Unit: University Hospital Limerick

The Nursing Practice Development Unit is staffed by nurses committed to supporting training and practice development for nurses in UL Hospitals.

About the NPDU

NPDU staff are responsible for providing a broad range of basic and advanced training and study days related to Resuscitation, Early Warning Scores, Medication Management, Venepuncture and Cannulation training. The unit oversees the Clinical Allocation and placements for Undergraduate Student Nurses in partnership with the University of Limerick.  Nursing Documentation, Quality audits and other initiatives including Registered Nurse Prescribing are supported by staff from within the Unit.

The Unit Manager is Gerardine Kennedy, Nursing Practice Development Coordinator.

A compact team of Clinical Placement Coordinators (CPCs) and the Clinical Liaison Officer support student nurses who are undertaking clinical placements as part of their B.Sc., in General Nursing University of Limerick and their preceptors. CPCs also support undergraduate nurses and midwives on specialist placements from other disciplines. They provide sessions for staff and students on reflective practice as well as information sessions and induction for students. CPCs work together with their colleagues in Ennis Hospital, Nenagh Hospital and St John’s Hospital to support and facilitate clinical education and reflection sessions for all undergraduate students.  CPCs provide support to Ward Managers regarding preceptorship for students, and they support staff and students with advice about competencies and competency assessments. CPCs may provide and support clinical skills learning sessions for students in the clinical placement site. CPCs are happy for students to contact them whenever they need to regarding any concerns or queries they have while in clinical placements.

Staff Training, Workshops and Education Sessions

Resuscitation training: Resuscitation Clinical Nurse Specialists provide training for multidisciplinary staff in ranges of basic and advanced Resuscitation study days and also engage in ward and department based education and audits of practice.

Nursing Quality Assurance Programme

This quality assurance audit process has been in place since July 2012 and now includes all general medical and surgical inpatient wards in Ennis Hospital, Nenagh Hospital, Croom Hospital and University Hospital Limerick. Lead Clinical Nurse Managers on each ward are involved in the audit process, supported by Clinical Nurse Manager 111’s and Assistant Director’s of Nursing (ADONs). Audit results are input into a ward computer based tool across 5 fundamental nursing care metrics focused on safety and consistent documentation for: Clinical Observations, Medications, Falls prevention and care, Nutrition and related care,  and Pressure Ulcer prevention and care.

Practice Development is privileged to work with experienced and dedicated nurse managers and staff from UL Hospitals and across the Medical and Surgical Directorates to support and sustain this initiative. This requires leadership, hard work and commitment of all Nursing Managers and nursing staff across UL Hospitals to monitor and improve standards of nursing care and documentation for inpatients.

The audit process is based on two monthly audits currently. To date managers audited their own wards with a senior nurse manager from another area. We are now progressing to unannounced audits at UHL which entails managers and senior nurse managers auditing other wards without notice which we hope will help to reinforce the validity and reliability of results. This will extend to all wards in the near future.

Following the audits, Ward Managers reinforce and commend good practices seen in the audits and develop action plans and Quality Improvement Plans to sustain improvements and to address shortfalls in the individual wards results. Ward results are reviewed by the Ward Managers with their relevant Operational Assistant Directors of Nursing, CNM 111’s and Directorate Nurse Managers.

Results for UL Hospitals are presented every two months at the Senior Nurse Management Meeting Chaired by the Hospital Chief Director of Nursing, Midwifery and Clinical Operations, Ms. Noreen Spillane. Trends and priorities are discussed.

Overall improvements have been noted across a number of areas of care and in particular care planning and the early warning score has had a positive impact on the standard of clinical observations monitoring and management. We also wish to acknowledge the support of the Clinical Audit Advisor, the IT department and the Software Development Provider. Contact gerardine.kennedy@hse.ie

Policies and Guidelines

We are currently focused on developing and or revising a number of Guidelines and Policies for UL Hospitals related to Intravenous Cannula Care, Central Venous Catheter Care and Urinary Catheter Care. We work in collaboration with other stakeholders and expert groups such as the Infection Prevention and Control Team and relevant Clinical Nurse Specialists. The Q Pulse system allows access to guidelines and policies to users across UL Hospitals at all levels of service.

Undergraduate B.Sc., Nursing programmes UL Hospitals

A compact team of Clinical Placement Coordinators (CPCs) and the Clinical Liaison Officer support student nurses in clinical placements and their preceptors who are undertaking the B.Sc., in General Nursing University of Limerick and also undergraduate nurses and midwives on specialist placements from other disciplines. They provide support sessions for staff and students on reflective practice as well as information session and induction for students. CPCs work together with their colleagues in Ennis Hospital, Nenagh Hospital and St John’s Hospital to support and  facilitate clinical education and reflection sessions for undergraduate students in addition to Induction Days  for First year and Internship Students.

Resuscitation training: Resuscitation Clinical Nurse Specialists provide training for multidisciplinary staff in ranges of basic and advanced Resuscitation study days as also engage in ward and department based education and audits of practice.

The CNM2 provides/coordinates full-day and refresher training for Intravenous Medication Management and Manual Handling and People Handling. Also Venepuncture, Peripheral Intravenous Cannulation, Induction and orientation of new staff. Colleagues in Haemovigilance, Infection prevention and Control, Pharmacy and the NPDU also present on the IV Medication management Study Day. We are grateful to them for their consistent support and this is an excellent example of working across disciplines and departments for patients. Facilities such as e-learning and hseland.ie are available. Staff are encouraged to use these where possible.

Some other current activities: NPDU Staff are involved in supporting facilitation of other programmes for staff with colleagues from the CNME and within service and the Office for Nursing and Midwifery Services Development (ONMSD). The most recent involvements include End of Life Care, Leadership Programmes and working with our colleagues in the CNME and University of Limerick to support Teaching and Assessing Study Days for nursing staff. The development of Registered Nurse Prescribers (RNPs) is supported by the Practice Development Coordinator and the support of the Drugs and Therapeutics Committee is also invaluable. The Number of RNPs has increased significantly and the dedication of  Nurses to expanding their practice for the needs of patients and their mentors is very encouraging.

NPDU Staff endeavour to continue to work with Nurses and colleagues and staff  from other disciplines to support high standards of quality and safe clinical practice and care for the people who utilise the services of UL Hospitals.

Contact details for all staff are on the local email contact list under Nursing Practice Development Unit.