Nurse Education in Tertiary Sector (NETS)
Minutes of Meeting held 1011 July 2008 at, Victoria University of Wellington
Present:
AUT / Deb Spence Jo Anne Conaglen
Christchurch Polytechnic IT / Cathy Andrew & Rose Whittle
EIT / Rachael VernonJudy Searle
MIT / Debbie Penlington & Sharon Rydon
MasseyUniversity / Debbie LeucharsAnnette Huntingdon
Nelson-Marlborough IT / Sandra Matheson
NorthTec / Jane Anderson
NZ Royal Plunket Society / Linda Polaschek
Otago Polytechnic / Alison Dixon, Barbara Lowen & Linda Kinniburgh
Southern IT / Lesley Watson
UCOL / Brian Gilchrist
UNITEC / Maurice Drake
University of Auckland / Heather Baker & Judy Kilpatrick
University ofOtago / Lorraine Ritchie
VictoriaUniversity / Jo Walton
Waiariki IT / Patrea Anderson & Maureen Kelly
Whitireia Community Polytechnic / Leanne PoolKerri Arcus
Western ITT / Diana Fergusson & Anne Bride
WINTEC / Glennis BirksHeather Forsythe
Apologies: Thursday: Jo Walton (half day)
Both days: Jill Parsons (SIT), Bert Teekman & Stephen Neville (Massey), Thomas Harding (NorthTec), Wendy Scott (Whitireia), Susan Jacobs (EIT), CarmenTimu-Parata (Wharangi Ruamano), Bev Burrell (University of Otago)
Notetaker: Kerri Arcus

ITEMS

/ DISCUSSION / ACTION / PERSON
THURSDAY 10 JULY 2008 [DAY 1]
1. Welcome
2. Confirmation of the Minutes of the previous meeting / Minutes of the previous meeting held10 & 11 July 2008passed as a true and accurate record with one amendment
  • Glenys Birks & Heather Forsyth notpresent at April meeting (but recorded in apologies).
/ Moved: Alison Dixon
2ndRose Whittle
CARRIED
  1. Matters Arising
INTRODUCTION round. / Action points feedback:
  • Graduate Destination Survey.Survey results circulated by Heather. 61% response rate. Provides some valuable information but raises other questions (including what has happened to up to 400 graduates not accounted for in survey and graduate entry to primary health still low). Aim to have accurate 2008 data by 5/09 and some analysis including flow of workforce themes. Subsequent surveys will now record DHB or non-DHB employment (not public / private). Now collecting data from schools with a mid-year intake. Formal recommendation thatthis become an ongoing commitment. Where extra resources needed to collect data, NETS to support costs with maximum of $200. ACTION: Judy K / Alison / Heather will send out template.
  • Draft compilation of final assessment tool. Table not yet circulated; variedassessment tools and philosophies made collation of data difficult. However, ALL are using NCNZ competencies for final sign off in some way. Future work: development of possible templates and joint sign off or sign-off statement with education and clinical – needs to be robust but not onerous. Clinical interest regarding support around students not achieving. Ongoing work needs statement with clarity of purpose (replacement of State Finals?) and work with NCNZ.
  • Jill Parsons Resit policies.Ongoing.
  • 1st Aid certificate required for clinical placements.Circulated by Diana. Data will inform decisions made in individual Schools.
  • Draft for visiting politicians. Circulated byKathy earlier. Some employing organisations not allowing direct contact with MPs.
  • Clinical Placement draft re costings (with NENZ). Exec need to discuss this further and bring a project outline back to NETS membership ACTION: Exec
  • IV Policy review.Useful to have national information; wide variation surprising. NENZ EXEC to take IV information to their national meeting. Raised question do RNs need IV certification?
  • PBRF. Work ongoing for Council of Deans and Midwifery journal evaluation/ranking. To be circulated by Judy or Annette. ACTION: Judy Kilpatrick / Annette Huntingdon
  • Immunisation survey. Every DHB covered showing huge variation across the country; particularly with Hepatitis and Tb. Research evidence to inform decisions is conflicting. Health students in Auckland nursing, pharmacymedical collaborating to progress this. Survey results to be sent to NENZwith a letter looking forconsistency across the whole health team and a national approach. Deb was acknowledged by the group for this work.
  • NETS strategic plan: changes finalised and to be put on website. ACTION: KathyHolloway
  • Academic & Nurse Led Health Clinics: response from Ruth Dyson. These services do not require a 24/7 service. ACC response is now 8-10pm accessibility but 7 day requirement remains.? Project group to consider this further- no action confirmed
  • Tracking documents of NETS discussion points and decisions – work ongoing. Thematic analysis of recent (last 10 yrs?) to be commenced. Decided that this is worthwhile work in line with NETS strategic direction and will provide ongoing guidance around key issues including 2nd level nurse, clinical placements, nurse prescribing, task force, KPMG report responses. Decision that NETS resource this work. EXEC will develop a list of main issues (Judy K. to be involved) and an EOI released for the project.ACTION: EXEC / Judy K
  • NENZ meeting feedback. Discussion included the briefing paper from Greg Coyle to MOH & TEC (circulated); clinical placement models; confirmation by NENZ exec of the present comprehensive education pathway for RN scope of practice.? (Maurice suggested the need tochoose language that conveys current meanings –comprehensive nurse no longer a scope of practice). NENZ group are interested in an annual national Infection Control postgraduate certificate - but numbers would probably be small and potentially nonviable for a tertiary institute. Discussion in response to this includedthe philosophical considerations inherent in national provision and that DONs have the opportunity to work with a provider to develop something. The NETS position (November 2007 minutes) upheld for national standards but regional provision.
/ Heather Baker
Moved: Alison Dixon
2nd:Deb Penlington
CARRIED.
Maurice Drake
Diana Fergusson
Cathy Andrew
(Rose in Bert’s absence).
Deb Spence
Kathy Holloway
Moved:Kathy Holloway
2nd: Judy Kilpatrick
CARRIED.
Kathy Holloway
4. Treasurers report / Treasurer’s report tabled.
  • NETS currently is healthy financially with investments and a positive cash balance.
  • Conference seeding moneyfor the Christchurchgroup hosting 2009 Australasian Nurse Educators Conference (ANEC): $2000 recommended and another $1000 when the budget sheet is provided by conference organisers.
/ Moved:Alison Dixon
2nd: Rachael Vernon
CARRIED
Moved:Alison Dixon
2nd: Deb Spence
CARRIED
5. National Coordinator’s report and activities /
  • Diary of time spent– ongoing challenge to complete this. Membership reportedfeeling informed and connected with NETS information.
  • NETS EXEC structure working well re visibility and NETs positioning on issues.
  • Succession planning - someone from central region required to work alongside Kathy – interested parties to contact Kathy.
  • Agreed that admin support for Chairperson is required for meeting preparation etc. ACTION: Kathy to arrange

6. Regional Co-ordinators report and activities / Review of purpose of regional meetings to be placed on November AGM agenda ACTION: Kathy
CENTRAL (Chair: Rachael Vernon).
- Recruitment and remuneration of Masters prepared lecturers. Letter to be sent to CEOs of TEI’sregarding salary differential relevant to recruitment & retention of lecturers in the context of the current DHB MECA. Maurice wrote to NCNZ last year broadening the view of Masters prepared lecturers & suggesting ratio – ACTION: Maurice will circulate letter for wider use. (ASTE not interested in progressing this as nurses represent only one group among many). Leanne collating information re retention and recruitment issues ACTION: Leanne Pool/ ALL
- Mental health placements: some providers only wanting year 3 students. This to be discouraged where possible.
- Return to Nursing programmes: someDONs declining placements because of length of time out of practice. ACTION:NETS EXEC to take to next NENZ meeting
SOUTHERN(Chair: Cathy Andrew)
- Different models of Maori consultation discussed.
NORTHERN (meeting later Day 1)
Auckland subgroup
- Managing placements: trial managing information flow between clinical & education. Good progress being made in spite of challenges. Meeting together across sectors is useful.
- Concern expressed regarding new Te Whare Wānanga o Awanuiārangiprogramme placements in already congested timetable for placements. How will placements be managed / student home communities or in Auckland? Invitation to HOS to become NETS member once confirmed ACTION: EXEC.
7. Feedback/reports from NETS representatives
Nurse Practitioner Action group (Susan Jacobs, Alison Dixon, Judy Kilpatrick)
Australia and New Zealand Council of Deans (Jan Duke/Judy Kilpatrick)
MOH Palliative & Cancer Nursing expert advisory group (Kathy Holloway)
CTA expert advisory group (Alison Dixon)
Advisory committee on the clinical workforce to support registered nurses
DHBNZ Support and clinical placement experiences for Maori and Pacific student nurses and midwives project / Feedback from Nurse Practitioner (NP) facilitation project group. Susan’s summary reported by Rachael (final report not yet released by chairperson - this will be circulated when available).
  • MOH funded project now finished
  • Terms of Reference: To promote the role of the NP with a focus on using NP services
  • Year long project has achieved the development of a well used & expanding website (MOH)
  • feedback to stakeholders
  • DHB plans for NPs not as successful as hoped to date
  • Nearly completed DVD with support from media experts (describes how NP role fills service gaps; promotes removal of boundaries to address population needs & profiles 2 NPs
  • Promotes utilisation of NPs via an innovations fund.
Questions from NETS in response: (to Susan as NETS rep and cc to project manager)
  • Where is report going?
  • Where / who at DHB (lead CEOs) will keep it moving for this spend?
  • Where / who are the clinical champions who will keep up the momentum?
  • What is the link between champions and funding?
  • Where is the funding and positions for NP?
  • What are the 13 NP positions?
ACTION: Rachael to raise with Susan
Next meeting October.
Australian news: nursing degree about to commence in TAFE responding to DONs public concerns re Australian nurses shortage / national definition of clinical hours (?about 1000) / working towards one regulatory authority. Issue re registration difficulties for NZ RN in the UK – potential for joint approach to UK with NCNZ
Global Alliance of Nursing Education conference Canada– Judy is attending.
Palliative / cancer care – levels of nurse education for quality service being considered. Competencies for different practice areasstandards of practicesubmissions are back and being worked through. Consideration of ring fencing education money (like PHC). Non provider arms not all accessing money available. Training for clinical colleagues required in releasing funding for nurse education.
Developing NETP expansion programme: draft tabled for any comments. Timeline forward July with Sept/Oct sign off by NCNZ for DHBs for 2009 places (over and above DHB NETP programmes).
(Debbie on behalf of Rose McEldowney). Four principles with series of tasks identified: report and recommendations will be sent to Kathy who will circulate. Short time for feedback on recommendations expected. Alison moved that NETS sees it as a priority to respond to the consultation doc and to spend what required to manage this.
DHBNZ (Deb Spence) No progress to report - next meeting on Aug 1. Travel support discussed as DHBNZ wants formal NETS representation on national committee. One position is that if DHBNZ consider this demonstrating partnership – responsibility to support travel should accompany invitation. Agreement that NETS should be involved but the principle should be tabled at next meeting. ACTION: Deb Spence / Rachael (on behalf of Susan)
Judy Kilpatrick
Kathy Holloway
Moved:Alison Dixon
2nd: Rachael Vernon
CARRIED
8. CPIT Presentation / Supporting Clinical Learning: Dedicated Education Units
Michelle Casey (CDHB) & Rose Whittle (CPIT)
Power Point handout and recommended literature available from Rose (CPIT).
9. Preparation for NCNZ meeting /
  • NCNZ standards review. Issues:flexibility to accommodate new modes/ technology(including simulation) in nurse education / NETS should be part of process / Orders of competence are a small percentage of nurses who need disciplinary attention – NC to be commended for their work in this area but need to consider the actual % and that this is not reflecting the whole of undergraduate education.
  • Extended undergraduate programme. Context of overseas registration becoming difficult (esp European Union countries) as hours required exceed NZ requirements. Also midwives moving towards 4year programme. Discussion of 4 year programmes (and attendant problems including funding) / 3 years with provisional regulation and 4thNETP year programme / internship part of other health professions.
  • Under-resourcing of nursing education - NETS position one of under-resourcing (not under-funding) including staff/student ratio. This differentiation would be useful to clarify with NCNZ as statuary body so message is unified (e.g: audit recommendations).

10. Other agenda items / open questions / Australian & NZ Council of Deans. Proposal for trans-Tasman research map (what research is in progress / topics /grants / completed). Possibility for trans-Tasman projects. Jo will convey NETS interest and get more information. ACTION: Jo Walton.
Microbiology content in curricula: (Deb Spence). Interest in how micro is included in curricula. ALL schools have microbiology embedded in some way.
Oral History project. Interviews now complete – 13 inaugural Heads of School interviews being transcribed. Small number of HOS not able to be interviewed – discussion and members agreed for a slight shift in project focus to capture the beginnings of all schools if possible by interviewing early staff if HOS not available. Small additional resource required to complete this. Lorraine to liaise with Ali who has discretion to fund further airfares. / Jo Walton
Deb Spence
Lorraine Ritchie
Moved:Alison Dixon
2nd: Kathy Holloway
CARRIED
11. General business / NZNO manifestolaunch last night – Kathy attended – manifesto circulated
ANEC in Christchurch September 2009 promoted by Rose Whittle (see Treasurers report above).
Friday 11 July 2008 [Day 2]
12. Undergraduate/postgraduate meetings
  • Postgraduatemeeting
  • Undergraduate meeting
/ Issues discussed:
Shift of focus from under funded to under resourced. Provide information for Programme Leaders to provide strategies / diff models
  • Organisational liability
  • Contracts need to reflect that Clinical Education (clinical access) money to support clinical learning
  • Budget for max cost / max students
  • Change language avoid “clinical access” use - Clinical Education agreements
  • Reflects NETS strategy to highlight funding different between ITP sector & unis
  • Gather data to reflect national picture of clinical education models
  • ?Develop guidelines for budgeting best practice for clinical education
  • Staff / student ratio ?set by regulating body
Recommendation: Want resource to support student learning and evidence for this.
  • A number of programmes are multidisciplinary and accredited by NC.
  • Otago Polytechnic is responding to request from local providers to stay engaged in postgraduate education. Collaborative ventures being developed.
  • Back fill funding required to make postgrad education accessible to RNs e.g: Aged Care
  • Concern that clinical masters pathways is notgrowing (perhaps even decreasing) research capability among nurses.
  • Relationship with Te Pou – improving
  • UNITEC has ceased to offer non-clinical postgrad education / PG Cert in nursing radiography
ACC submission
ACC to be congratulated for recognising changes that have occurred in the health sector / legislation and NETS heartily endorse these points (in response to document) as follows
  1. Endorsed.
  2. Endorsed and long overdue
  3. Endorse ACC intent (other professionals to work under ACC contracts) but must fit the provisions under the HPCAA.
  4. This area would not be an issue if providers under HPCAA.
  5. A/a
  6. A/a
Submissions due 8 August. NETS will send submission and encourages all schools to send individual ones to strengthen response. NETS submission will be circulated to schools to use with minor changes to wording. ACTION: Alison / Judy K / Kathy
Meeting with NZNO student representatives. Reportedly a positive meeting.
Student issues raised: support / placements / time with lecturers.
NETS presentation on function of NETS.
Followed by discussion at NETS: culture of schools changing / issues in clinical environment include precentorship / bullying (clinical & class).
General business /
  • NETS dates set for 2009
April 23/24 VUW
July 2/3 VUW
Nov 5/6 VUW ACTION: Kathy to confirm with Chris Fox
  • Portfolio groups. Agreed these have not been effective. Perhaps regional groups should take up specific projects.
  • TEC reforms - complete
  • Common sign off of end of programme (ongoing in Northern group)
  • Nurse prescribing (ongoing)
  • Support worker for RN )ongoing)
  • Minutes thematic analysis (ongoing – work to be contracted)
  • ACC submission (ongoing)
  • Review of HPCAA - issues emerging for nurses (ongoing)

Meeting with NCNZ / Meeting with Nursing Council
  • Standards Review (clarified that this is not an education review). Timeline: late October pre-consultation with key stake holders (NETS, NENZ, DONs, MH) – then consultation paper will go out. Issues: national standards able to be regionally responsive / NETP programmes / place of simulation in education & new delivery modes. Carolyn is looking at issues of funding regarding Te Pou. Action: Council to identify standards for review, assign responsibility and then feedback to NETS EXEC.
  • Delegation & Direction expected to be available for HOS within the week and will go on website.
  • Update on Overseas (OS) registration. Pathway to registration in NZ - apply to NC for assessment and applicants will be directed what is required. Some OS nurses are going directly into undergraduate programmes / being RPL’d into UG. Discussion on the ethics of requiring more than is required to get around IELTS. US nurses with ‘associate degree’ (L5 on NZQA) are nurse assistant level in NZ. NCNZ is still accepting nurses from hospital programmes but this to be reviewed. Dramatic increase in applications from Philippines - NZQA list of nursing schools in Philippines looking at nursing content. Police check – done by immigration. Increasing fraudulent documentation from overseas noted.
  • Advanced Competencies –consultation ongoing.
  • Update on prescribing: now up to MOH. Unable to do anything about authorised status until Medicines Act (MA) change – this is a significant delay. However, under current MAdesignated prescribing status possible (OTCs). Draft consultation paper may go out with options to MOH in month or so..then out for consultation.
  • UK registration - NMC still accepting NZ grads, however directive from EU of required clinical hours (Ireland has adopted) and 1500 practice hours not being accepted.
  • Workforcedraft report due anytime – timeframe for feedback will be short. Key recommendations – move Nurse Assistant programme L5 but entry at L4 (NZQA). Integration of current EN and NA to new 2nd level nurses scope. Principles that all care be given by RNs (but in reality care often given by unregulated carers). RNs to be supported when delegating and directing this care (needs funding etc).
ACTION: Debbie to send to Kathy H for circulationDONE
  • Te Whare Wānanga o Awanuiārangiprogramme now approved with capped numbers / most placementsin Auckland.
  • NC previous consultation and review of processes– results not yet seen.
  • Review of HPCAAand implications for nursing. Consultation paper delayed until August. MOH focusing on implementation of current Act. NCNZ sees no structural change planned. Some MOH interest in a higher regulatory body than NC – see NMC.org.uk website CHRE review / report Apr/May published.
  • Surgical & operative procedures. NC has commissioned research on how this relates to RN scope of practice – does RN scope need to be broadened or surgical procedure endorsement added to Practicingcertificate.
  • Australian NMC moving to national registration from 2010. They are looking at European directive, Australia has never stipulated hours previously. RN programme moving into TAFE

NETS business round up /
  • ACC submission – submission to go out to membership group as above.
  • Add UCOL to UG Template (Alison has amended – to Heather)
  • Out of region placements for transition students. Some schools require student to get signed letter from provider to confirm placement does not take the place of a local student (Example of letter from Rose to be circulated). ACTION: Rose Whittle
  • 4 weeks response time for NC Standards consultationdocument. NETS response and schools encouraged to submit individual responses (numbers matter!). EXEC will progress this and send sub out to members for feedback (in 2 weeks). Consult with Ali re resources for feedback group. N.B: feedback required on recommendations only.ACTION: EXEC / ALL.
  • Succession planning – names to Kathy or EXEC.
  • Portfolio groups redundant: strategic plan change required in November (agenda).
Remits for AGM will be sent prior to AGM. ACTION: EXEC
Next meeting: 12/13 (Wednesday/Thursday) NovemberVUW(room to be advised)

Education in Tertiary Sector (NETS)